Application for compensation to be lodged with court

(1) A workman or an employer (in this section called the applicant) who desires the determination of any question arising out of an accident in which compensation is or might be claimed shall lodge with the clerk of the court a written application in the prescribed form accompanied by particulars containing, the clerk of the accompanied by particulars. (a) a concise statement of the circumstances under which the application is made and the relief or order which the applicant claims, or the question he desires to have determined; (b) the full name and address of the applicant and of his attorney or agent and the name and address of the respondent. (2) If the application be made by an employer, it shall be accompanied by a statement whether he admits his liability to pay compensation, or denies such liability and whether the admission or denial is total or partial, and if he admits or denies liability partially, a statement of the extent to which he 50 admits or denies liability. In the case of denial of liability the grounds shall be stated. (3) If the clerk of the court be satisfied that the applicant is, owing to illiteracy, blindness or any other physical cause, unable to furnish the information required, he shall himself fill in the application and particulars on the prescribed form. application and particulars to be