B 22
CAP. 282]
[Subsidiary]
1
Before
on
Employees' Compensation (Rules of Court) Rules
day, the
day of
[1983 Ed.
. 19.........
Upon revision of the order for periodical payments made on the
day of
arrived at between the said parties on the
by
for the applicant and Mr.
19...... (or the agreement day of 19......) and upon hearing the evidence given
and Mr.
...... for the respondent.
It is hereby ordered that the said order/agreement be varied in the following
manner:
and that the costs of the said
of and incidental to this application and order be taxed or assessed and paid by the said
to the said
Dated this....
day of
19......
Registrar of the Court
FORM 10
EMPLOYEES' Compensation (Rules of Court) Rules Notice by Principal Contractor to Sub-Contractor
The
Case No.
In the matter of an Application between-
To (1)
Court of
and
[rule 22.]
.., applicant,
2
respondent.
Notice is hereby given to you that an application/a claim for compensation is made against (2)
by (3)
the said (4)
who alleges that
is liable to pay him compensation in respect of an accident which occurred at (5)
on the
of
19
Dated this
day of
(6)
(1) Name and address of the sub-contractor.
(2) Name and address of principal contractor.
(3) Name and address of employee.
(4) Name of principal contractor.
(5) Place of accident.
(6) Signature and address of person giving the notice.
19......
day