Employee compensation claim form sets out injury, wages, accident notice, settlement efforts, and disputed liability questions. Employee's compensation claim is presented in a prescribed application form for submission to the competent authority under the labour law framework. The applicant states that personal injury was caused by an accident arising out of and in the course of employment, identifies the injuries sustained, and records the monthly wages and age of the employee. The form also requires particulars of notice of the accident, reasons for any delay or omission, and the compensation claimed by way of half-monthly payments or a lump sum.