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[接上页] 在(3).......................................................................支付已于19..........年..........月..........日 进行聆讯的申请的评定讼费或估计讼费,以及为数$.................................................. 且现已到期支付并须由上述(1)......................................................................................... 支付予上述(2)....................................................................................的款项,而该款项为按每月付款.........................................计算,由19..........年..........月..........日受伤当日起至本命令日期止的应得款项;此外,由本命令日期起至另有命令为止,每逢..................................须再在同一地点支付为数....................................的款项。 日期:19..........年..........月..........日 ............................................................法院司法常务官或司法常务主任 _______________________________________________________________________ (1)雇主姓名或名称及地址。 (2)雇员姓名及地址。 (3)付款地点。 (2000年第28号第47条) 表格8 [第28条] 雇员补偿(法院规则)规则 考虑更改按期付款的申请 ....................................................................................................................................法院 申请案件编号.................................................................................................................... 与此宗申请案有关的两方为─ ..............................................................................................................................(申请人) 与 ..............................................................................................................................(答辩人) ..............................................................................................谨此针对...................... .......................................................而申请考虑更改法院于19..........年..........月..........日作出的命令(或上述两方于19..........年..........月..........日达成的协议),并申请终止支付(或暂时中止支付、减少支付或增加支付,视属何情况而定)须付给上述..........................................................的每月付款,而该笔付款是根据上述命令(或协议)就其在受雇工作期间因工身体受伤而须付的。 现随本申请附有 (或附上) 有关的详情─ 详情 (1)受伤雇员姓名及地址........................................................................................ ............................................................................................................................ (2)须付补偿的雇主姓名或名称及营业地址........................................................ ............................................................................................................................ (3)意外发生的日期及意外的性质,以及有关的损伤........................................ ............................................................................................................................(4)订定每月付款的命令作出日期或协议订立日期、须付款额及开始付款日期......................................................................................................................... ............................................................................................................................ (5)申请人所寻求的济助(终止支付款项、暂时中止支付款项、减少支付款项或增加支付款项)................................................................................................ ............................................................................................................................ ............................................................................................................................(6)申索(终止支付款项、暂时中止支付款项、减少支付款项或增加支付款项)理由─ ............................................................................................................................ ............................................................................................................................ ............................................................................................................................ 申请人及其代表律师或大律师的姓名或名称及地址为─ 申请人∶............................................................................................................ ............................................................................................................ ............................................................................................................代表............................................................................................................ |