【法规名称】
【法规编号】 79973 什么是编号？
【正 文】
第6页 CAP 282B EMPLOYEES' COMPENSATION (RULES OF COURT) RULES
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[接上页] (4) Nature of injury to the deceased and date of death ................................................... (5) Monthly earnings of the deceased from employment with the respondent- (a) for the month immediately preceding the accident ............ (b) on average during the 12 months (or any lesser period of employment with the employer) prior to the accident ........................................................................ (6) Particulars as to members of the family by whom or on whose behalf the application is made- Name Address Description Occupation Relationship to the deceased Age (7) Amount claimed as compensation ............................................................................ (8) Date of giving notice of accident to respondent(s) ..................................................... (9) If notice not given, reason for omission to give such notice ........................................ ..............................................................................................................................The name and address of the applicant or his solicitor are- Of the applicant ............................................................................................................ Of his solicitor .............................................................................................................. The name and address of the respondent(s) to be served with this application are .............. ............................................................................................................................................. Dated this day of 19 . .............................................................. Applicant/Solicitor for the Applicant * Delete as required (L.N. 227 of 1983; L.N. 383 of 1995; 52 of 2000 s. 38) ____________ FORM 3 [rule 16] EMPLOYEES' COMPENSATION (RULES OF COURT) RULES General Application The ........................................................... Court of ............................................................. Case No. .............................................................................................................................. In the matter of an Application between- .............................................................................................................................., applicant, and.........................................................................................................................., respondent. Application is hereby made by (1) ............................................................................................. ................................ against (2) ............................................................................................. ............................................................................................................................................. The circumstances in which the application is made are shortly as follows: (3) ..................... ............................................................................................................................................. ............................................................................................................................................. The relief or order which the applicant claims is shortly as follows: (4) ................................ ............................................................................................................................................. ............................................................................................................................................. The full names and addresses of the applicant and his solicitor are- Of the applicant ............................................................................................................ ............................................................................................................ ............................................................................................................ Of his solicitor .............................................................................................................. ............................................................................................................ ............................................................................................................ The name and address of the respondent to be served with this application are .................. ............................................................................................................................................. Dated this ................ day of ........................ 19 ......... ................................................ Applicant (or his Solicitor) Note-Where the application is made by an employer, and any question of his liability to pay compensation is involved, it must be accompanied by a statement whether he admits his liability to pay compensation or denies such liability, and whether the admission or denial is total or partial, and if he admits or denial is total or partial, and if he admits or denies liability partially, a statement of the extent to which he admits or denies liability. In the case of a denial of liability, the ground shall be stated. |
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