(3)Filing and form of petition for intervention. A petition for intervention shall be filed at the office of the workers' compensation commissioner Such a petition is deemed filed when it is received by that office. The workers' compensation commissioner will provide the petitioner with a file-stamped copy of the petition for intervention if the petitioner provides an extra copy for this purpose. A petition for intervention must be typewritten or legibly handwritten in ink and must substantially conform to the following form: BEFORE THE WORKERS' COMPENSATION COMMISSIONER
Petition by (Name of Original Petitioner) for a Declaratory Order on (Cite provisions of law cited in Original Petition). Petition for intervention by (Name of Intervenor).
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PETITION FOR INTERVENTION
The petition for intervention must provide the following information:
1. Facts supporting the intervenor's standing and qualifications for intervention.2. The answers urged by the intervenor to the question or questions presented and a summary of the reasons urged in support of those answers.3. Reasons for requesting intervention and disclosure of the intervenor's interest in the outcome.4. A statement indicating whether the intervenor is currently a party to any proceeding involving the questions at issue and whether, to the intervenor's knowledge, those questions have been decided by, are pending determination by, or are under investigation by, any governmental entity.5. The names and addresses of any additional persons, or a description of any additional class of persons, known by the intervenor to be affected by, or interested in, the questions presented.6. Whether the intervenor consents to be bound by the determination of the matters presented in the declaratory order proceeding. The petition must be dated and signed by the intervenor or the intervenor's representative. It must also include the name, mailing address, and telephone number of the intervenor and intervenor's representative, and a statement indicating the person to whom communications should be directed.