Document ID: chunk:federal_register_of_legislation:F2020L01536:schedule:1
Version: federal_register_of_legislation:F2020L01536
Segment Type: schedule
Provision Reference: sch 1
Character Range: 5863–6589

Schedule 1—Forms
Note: See subsection 10(2).

Form 1—Accident report

This form must be completed by an employer when an employee suffers death or permanent incapacity arising out of, or in the course of, the employment.

Please fill in this form using block capitals. Do not leave any blank spaces. If a question is not applicable, write "N/A" in the answer space.

This form must be provided to the Minister within 7 days after the death or permanent incapacity became known to the employer.

Form 1—Accident report
Item                    Information required                                                                                                                                                            Answer