Section 52 in The Workmen's Compensation Rules, 1924
52. Registration of memorandum accepted for record .-In recording a memorandum of agreement, the Commissioner shall cause the same to be entered in a register in Form R and shall cause an endorsement to be entered under his signature on a copy of the memorandum to be retained by him in the following terms, namely:-
"This memorandum of agreement bearing Serial No.....of 20...., in the register has been recorded this......day of ....(Signature).....Commissioner."FORM A[See rule 6(1)]DEPOSIT OF COMPENSATION FOR FATAL ACCIDENT[Section 8(1) of the Workmen's Compensation Act, 1923]Compensation amounting to Rs .................is hereby presented for deposit in respect of injuries resulting in the death of the workman, whose particulars are given below, which occurred on .....................Name .............................................................Father's Name ..............................................(Husband's Name in case of married woman and widow).Caste ..............................................................Local address ...............................................Permanent address ......................................His/ Her monthly wages are estimated at Rs ............... He/She was over/under the age of 15 years at the time of his/her death.
