Australian Capital Territory
Workers Compensation (Certificate of Capacity for Work) Approval 2016
approval statement for
Approved form AF2016–105
made under the  
Workers Compensation Act 1951, s 222 (Approved forms)

1	Name of instrument
This instrument is the Workers Compensation (Certificate of Capacity for Work) Approval 2016.
2	Commencement 
This instrument commences on the day after its notification day.
3	Approval
The attached form is approved.
4	Revocation
The Workers Compensation Act 1951—Form 1 — Medical Certificate for ACT Workers Compensation Claims AF2004-3 is revoked 12 months after this forms notification day.
Rachel Stephen-Smith
Minister for Workplace Safety and Industrial Relations
  21   December 2016