work(0
2
resulting in the death/partial/total incapacity of a permanent/lempor ary nature(5) of the workman.
AND NOTICE is hereby further given that in consequence thereof compensation is claimed from you.
Dated this
M
day of
19
A
(5)
3
Explanatory Note.
(This Note is not part of the regulations, but is intended to indicate their general purport).
These regulations make minor amendments to the Workmen's Compensation Regulations 1953 conséquent upon the Workmen's Compensation (Amendment) Ordinance 1964.
(Secretariat GR7569/450)
(D) Name and Address of the employer or potpal.
(2) Pult mat and addret of the workinsa.
(1) Dase apoa which dipere in and to bave been discovered.
(0) State datote of the work which la maid to have coured the decupatiORLİ
ditense
(5) Dekere whichever is jampplicable.
16) Signature, name and addrem at person giving the nonce."";
(b) after Form 2, of the following-
"FORM ZA.
WORKMEN'S COMPENSATION ORDINANCE 1953.
NOTICE BY EMPLOYER OF INCAPACITY OR DEATH. DUB TO OCCUPATIONAL DISEASE.
To: THE COMMISSIONER OF LABOUR,
Hoya Kong
NOTICE is hereby given thar(1)
a workman in my employ from the
to the
upon the following work ...
[ncg. 4]
day of ᎨᏎᎰ day of
day of
WALI
C) on the Co found to be suffering from the following disease
said to be due to his employment by me
The said disease is said to have resulted in the death/partial/total incapacity of a permanent/tempor- ary naturel? of the workman and compensation is claimed from me I respect thereof.
NOTICE is hereby given by me that I intend to dispute the workman's claim to compensation on the following grounds
Dated this
day of
כל
19
N
00 Full same and addeem of worÜLTELER,
(3) Period of employment.
D) Dak upon which disekke la vaid no bave been discovered.
(4) Siste mature of work which la sald to have chaved the ditekure.
(9) Delete whichever in Luapplicable.
(6) Complete where appropriate.
♡ Simontare, mame and addrem of employer. **-
lim
Clerk of Counci
COUNCIL CHAMBER,
16th March, 1965.
I