law: Workmen's Compensation Act, 1923 
  22. Form of application 
  (1) Where an accident occurs in respect of which liability to
  
  pay compensation under this Act arises a claim for such compensation may
  
  subject to the provisions of this Act be made before the Commissioner,
  (1A) Subject to the provisions of sub-section (1) no application
  
  for the settlement of any matter of Commissioner other than an application by a
  
  dependant or dependants for compensation shall be made unless and until some
  
  question has arisen between the parties in connection therewith which they have
  
  been unable to settle by agreement.
  (2) An application to a Commissioner may be made in such form
  
  and shall be accompanied by such fee if any as may be prescribed and shall
  
  contain in addition to any particulars which may be prescribed the following
  
  particulars namely :-
  (a) A concise statement of the circumstances
  
  in which the application is made and the relief or order which the applicant
  
  claims;
  (b) in the case of a claim for compensation
  
  against an employer the date of service of notice of the accident on the
  
  employer and if such notice has not been served or has not been served in due
  
  time the reason for such omission;
  (c) the names and addresses of the parties;
  
  and
  (d) except in the case of an application by
  
  dependants for compensation a concise statement of the matters on which
  
  agreement has and of those on which agreement has not been come to.
  (3) If the applicant is illiterate or for any other reason is
  
  unable to furnish the required information in writing the application shall if
  
  the applicant so desires be prepared under the direction of the Commissioner.