1964_EMPLOYEES__COMPENSATION_REGULATIONS — Page 3

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1987 Ed.]

Employees' Compensation Regulations

[CAP.282

逕啓者:(1)

表格

僱員賠償條例(香港法例第二八二章) 工作意外傷亡通知書

〔規例第三條〕

(由僱員填報或代僱員填報)

# (2)................

4. A.............. E TE (3)

受傷

因(4).

以致(5)

死亡

特向台端通知要求賠償。此致

(6)......

一九

年月

(1) 僱員詳細姓名及地址

(2) 遇事日期

(3) 遇事地點

(4) 傷亡原因

(5) 將不適用者删去

(6) 僱主或總承判商姓名及地址

(7) 填報者之簽名、姓名及地址

To: ()

(7).

FORM IA

EMPLOYEES' COMPENSATION ORDINANCE

(Chapter 282)

NOTICE BY OR ON BEHALF OF EMPLOYEE of Incapacity

OR DEATH DUE TO OCCUPATIONAL DISEASE

[reg.3.1]

[Subsidiary]

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1987 Ed.] Employees' Compensation Regulations [CAP.282 逕啓者:(1) 表格僱員賠償條例(香港法例第二八二章) 工作意外傷亡通知書〔規例第三條〕 (由僱員填報或代僱員填報) # (2)................ 4. A.............. E TE (3) 受傷因(4). 以致(5) 死亡特向台端通知要求賠償。此致 (6)...... 一九年月 (1) 僱員詳細姓名及地址 (2) 遇事日期 (3) 遇事地點 (4) 傷亡原因 (5) 將不適用者删去 (6) 僱主或總承判商姓名及地址 (7) 填報者之簽名、姓名及地址 To: () (7). FORM IA EMPLOYEES' COMPENSATION ORDINANCE (Chapter 282) NOTICE BY OR ON BEHALF OF EMPLOYEE of Incapacity OR DEATH DUE TO OCCUPATIONAL DISEASE [reg.3.1] , A3 [Subsidiary]

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1987 Ed.] Employees' Compensation Regulations [CAP.282 逕啓者:(1) 表格僱員賠償條例(香港法例第二八二章 ) 工作意外傷亡通知書〔規例第三條】 (由僱員填報或代僱員填報) # (2)................ 4. A.............. E TE (3) 受傷因(4). 以致(5) 死亡特向台端通知要求賠償。此致 (6)...... 一九年月 (1) 僱員詳細姓名及地址 (2) 遇事日期 (3) 遇事地點 (4) 傷亡原因 (5) 將不適用者删去 (6) 僱主或總承判商姓名及地址 (7) 填報者之簽名、姓名及地址 To: () (7). FORM IA EMPLOYEES' COMPENSATION ORDINANCE (Chapter 282) NOTICE BY OR ON BEHALF OF EMPLOYEE of IncapaciTY OR DEATH DUE TO OCCUPATIONAL DISEASE [rcg.3.1 , A3 [Subsidiary]

2026-05-04 16:12:41 · Baseline

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