Approved form AF2002-193

made under the
Workers Compensation Rules 1938

Workers Compensation Rules 1938— Form 68
(see r 79)
Authority to agent
[Heading as in application for arbitration.]
I authorise [full name]			whose signature appears in the margin [address and description]			  to appear and act on my behalf in any proceeding connected with the question or matter which I propose to bring before the Magistrates Court, Canberra, for determination.
Dated:
[name of party]
[address]
[description]

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