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S.I. No. 286/1953 - Workmen's Compensation (Amendment) Act, 1953 (Prescri Bed Declarations) Regulations, 1953.

S.I. No. 286/1953 - Workmen's Compensation (Amendment) Act, 1953 (Prescri Bed Declarations) Regulations, 1953. Skip to content Disclaimer Feedback Helpdesk Gaeilge Léim go dtí an t-ábhar Séanadh Aiseolas Deasc chabhrach English Gaeilge English Produced by the Office of the Attorney General Táirgthe ag Oifig an Ard-Aighne Home Legislation Acts of the Oireachtas Statutory Instruments Pre-1922 Legislation Constitution External Resources Bills (Houses of the Oireachtas) Iris Oifigiúil / Official Gazette Revised Acts (LRC) Classified List of Legislation (LRC) Translations (acts.

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  3. s)or rangeBliain nó blianta nó raon TypeCineál All Legislation Acts Statutory Instruments Advanced SearchCuardach Casta HomeBaile Statutory InstrumentsIonstraimí Reachtúla 1953 S.I. No. 286/1953 - Workmen's Compensation (Amendment) Act, 1953 (Prescri Bed Declarations) Regulations, 1953. S.I. No. 286/1953 - Workmen's Compensation (Amendment) Act, 1953 (Prescri Bed Declarations) Regulations, 1953. AmendmentsLeasuithe S.I. No. 286 of 1953. WORKMEN'S COMPENSATION (AMENDMENT) ACT, 1953 (PRESCRI BED DECLARATIONS) REGULATIONS, 1953. I, SÉAMAS Ó RIAIN, Minister for Social Welfare, in exercise of the power conferred on me by subsection

(3)of section 10 of the Workmen's Compensation (Amendment) Act, 1953 (No. 25 of 1953), hereby make the following Regulations :
  1. These Regulations may be cited as the Workmen's Compensation (Amendment) Act, 1953 (Prescribed Declarations) Regulations,
  3. In these Regulations "the Act" means the Workmen's Compensation (Amendment) Act, 1953 . 3.—
(1)Where a declaration is required in accordance with the provisions of subsection
(1)(
  1. a)of section 10 of the Act it shall be furnished in the Form 1(
  2. a)in the Schedule to these Regulations.
(2)Where a declaration is required in accordance with the provisions of subsection
(1)(
  1. b)of section 10 of the Act it shall be furnished in the Form 1(
  2. b)in the Schedule to these Regulations. SCHEDULE Form 1(
  3. a)WORKMEN'S COMPENSATION (AMENDMENT) ACT, 1953 . Form prescribed by the Minister for Social Welfare. DECLARATION BY A WORKMAN FOR THE PURPOSE OF OBTAINING SUPPLEMENTAL ALLOWANCES. Name and Address of Employer............................................................ ............................................................ ..... ............................................................ ............................................................ ..... 1. Surname of Workman............................................................ ............................................................ ................... 2. Full Christian Names of Workman............................................................ .......................................................... 3. Full Address of Workman............................................................ ............................................................ ............ 4. Have you a wife, now alive and married to you at the time of the accident, in respect of whom you are claiming a supplemental allowance? If so, give the following particulars:— Christian Names Surname at the time of your marriage to her Date of marriage Town or place where married 5. Particulars of any child or children now alive and under the age of 15 years should be given overleaf. 6. Are you receiving or claiming weekly compensation under the Workmen's Compensation Acts for another injury (accident or disease) from any other employer (or employer's insurer) ? If so, state the name and address of the other employer, and the amounts of the weekly compensation and supplemental allowances which you receive from such employer (or insurer) :— ............................................................ ............................................................ ............................................................ ....... I DECLARE that all the information given above and overleaf is true and correct. Signature of Workman*....................................... Date....................... WARNING: Any person who, for the purpose of obtaining a supplemental allowance for himself or any other person or of increasing the amount of any such allowance, knowingly makes a false statement or false representation, shall be liable to a fine not exceeding £50 or to imprisonment for any term not exceeding three months or both. *Where the workman is unable owing to illness or other reasonable cause, himself to sign the declaration, the wife or other representative of the workman should inform the employer (or his insurer) of the reason why he is unable to sign it and should complete the form so far as practicable. (REVERSE SIDE) Give particulars hereunder of your child* or children now alive and under 15 years of age. Christian Names Surname Date of Birth Place of Birth Day Month Year .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ .................... .................... .............. ........ .............. ........ ................... .................... .............. ........ .............. ........ .................... *For the purposes of the Workmen's Compensation (Amendment) Act, 1953 , " child " means, in relation to a male workman entitled to a weekly payment :— (
  4. a)any legitimate or illegitimate child born to him not later than ten months after the accident giving rise to compensation, (
  5. b)any step-child, being a legitimate child whose mother was married to him before the accident, and (
  6. c)any child adopted before the accident by him, or by him and his wife jointly, in pursuance of an adoption order made under the Adoption Act, 1952 . For Use by Insurers Where this claim for Supplemental Allowances is dealt with by an Insurance Company or a Mutual Indemnity Association on behalf of the employer, the name and address of the insurer should be stated:— Name of Insurer............................................................ ............................... Address............................................................ ............................................. FORM 1(
  7. b)WORKMEN'S COMPENSATION (AMENDMENT) ACT, 1953 . Form prescribed by the Minister for Social Welfare. PERIODICAL DECLARATION BY A WORKMAN IN RECEIPT OF SUPPLEMENTAL ALLOWANCES. 1. Surname of workman............................................................ ............................................................ ................ 2. Full Christian names of workman ............................................................ ....................................................... 3. Full address of workman ............................................................ ............................................................ .......... 4. Name and address of employer on whose behalf the Declaration is required............................................. 5. Is your wife, in respect of whom a supplemental allowance is being paid still alive ? (If not, give the date and place of death) ............................................................ ............................................................ ................... 6. Is the child or each of the children, in respect of whom a supplemental allowance is being paid, still alive ? (Give the name and date and place of death of any child who has died) ................................................... 7. Is the child or each of the children under the age of 15 years ? (Give the name and date and place of birth of any child who has reached the age of 15 years) ............................................................ .......................... 8. Are you receiving or claiming weekly compensation under the Workmen's Compensation Acts for another injury (accident or disease) from any other employer (or employer's insurer) ? If so, state the name and address of the other employer, and the amounts of the weekly compensation and supplemental allowances which you receive from such employer (or insurer) :— ............................................................ ............................................................ ............................................................ .. ............................................................ ............................................................ ............................................................ . I DECLARE that all the information given above is true and correct. Signature of Workman*.................... Date ....................... *Where the workman is unable, owing to illness or other reasonable cause, himself to sign the declaration, the wife or other representative of the workman should inform the employer (or his insurer) of the reason why he is unable to sign it and should complete the form so far as practicable. GIVEN under my Official Seal, this 31st day of August, 1953. SÉAMAS Ó RIAIN, Minister for Social Welfare. Privacy Statement Accessibility European Legislation Identifier (PDF) Open Data License Ráiteas Príobháideachais Inrochtaineacht Aitheantóir Eorpach Reachtaíochta (ELI) Ceadúnas Sonraí Oscailte Liosta Fianán © Government of Ireland. Oireachtas Copyright Material is reproduced with the permission of the Houses of the Oireachtas © Rialtas na hÉireann. Atáirgtear ábhar faoi Chóipcheart le cead ó Thithe an Oireachtais

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