Approved form AF2002-138

made under the
Workers Compensation Rules 1938

Workers Compensation Rules 1938— Form 13
(see r 21)
Notice of filing of submission to an award, or of payment into court in the case of an injured worker
[Heading as in Request for arbitration.]
TAKE NOTICE—
That the respondent, C.D.,			     has this day filed with me a notice (copy of which is sent herewith) that he or she admits his or her liability to pay compensation in this matter, and submits to an award for payment by him or her to you of the weekly sum of 
[Or and has paid into Court the sum of		in satisfaction of such liability].
[Or
TAKE NOTICE—
That the respondent, C.D.			    , has this day filed with me a notice (copy of which is sent herewith) that he or she denies his or her liability to pay compensation in this matter, but that he or she submits to an award for payment by him or her to you of the weekly sum of	         [or but that he or she has paid into Court the sum of			in satisfaction of your claim].]
If you elect to accept such weekly sum [or the sum so paid into Court] in satisfaction of your claim, you must, within a reasonable time before the day fixed for proceeding with the arbitration, send by post to the Registrar of this Court, and to C.D.			      , a written notice of such acceptance in the prescribed form, or leave such notice at the office of the Registrar, and at the residence or place of business of C.D.
If you send such notice, the Court will, on application made to it, make an award directing payment of such weekly sum to you [or directing payment of the said sum of			to you, or applying the said sum of			    for your benefit], and you will be liable to no further costs.
In default of such notice, the arbitration will be proceeded with; and if no greater payment is awarded to you, you will be liable to be ordered to pay the costs incurred by the respondents subsequent to the receipt by you of this notice.
Dated:						
Registrar of the Magistrates Court.
To the applicant, A.B.

Endnotes
1	This form was originally in the Workers Compensation Rules 1938, schedule 1.  Under amendments made by the Legislation (Consequential Amendments) Act 2001, the form was omitted from the rules and became a form approved under the rules, rule 89 (see amdt 1.2805, amdt 1.2807).
2	This republication includes amendments made under the Legislation Act 2001, part 11.3 (Editorial changes).

©  Australian Capital Territory 2002