}
1983 Ed.]
Employees' Compensation (Rules of Court) Rules
[CAP. 282
B 21
[Subsidiary]
Particulars are hereto appended (or annexed)—
PARTICULARS
(1) Name and address of injured employee
(2) Name and place of business of employer by whom compensation is
payable
(3) Date and nature of accident, and injury
(4) Date of order or agreement fixing monthly payment, amount of such
payment, and date from which it commenced
(5) Relief sought by applicant, (whether termination, suspension, diminution,
or increase)
(6) Grounds on which (termination, suspension, diminution or increase) is
claimed-
are-
The names and addresses of the applicant and his Counsel or Solicitor
Of the applicant:
are
Of his Counsel
or Solicitor:
The name and address of the respondent to be served with this application
Dated this
day of
... 19......
Applicant (or his Counsel or Solicitor)
The
Case No.
FORM 9
EMPLOYEES' COMPENSATION (RULES OF COURT) Rules Order on Revision of Order/Agreement for Periodical Payments
In the matter of an Application between-
Court of
[rule 28.]
applicant,
and
...., respondent.