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The Pamphlet Collection of Sir Robert Stout: Volume 29
Form of Claiming Sick Benefit
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Sir,—This is to inform you that I became, on the______day of______ 18____, incapable of working at my trade, on account of______, and I therefore request sick benefit from that date.
Name,______
Form of Claiming Sick Benefit.
Mr. Jones proposed—
Mr. Flinn seconded—
"That the following form be adopted: "—Rejected.
To the Secretary of the_______Branch.
The________day of________18
Insert here cause of the inability to work.
(Signed),
The claimant must here sign his name and address.
Address,______
- For 8 16 (2 votes).
- Against 1 2 3 4 5 6 7 9 10 11 12 13 14 15 (14 votes).