Questions and answers on national insurance : a practical and clear handbook for all / by Gilbert Stone.
- Gilbert Stone
- Date:
- 1912
Licence: In copyright
Credit: Questions and answers on national insurance : a practical and clear handbook for all / by Gilbert Stone. Source: Wellcome Collection.
86/260 page 60
![I Application to an APPROVED SOCIETY for the issue of a new contribution card to replace a card previously issued. I ('insert name) (Contributor’s No. ) of [insert address) hereby declare that— (a.) The contribution card issued to me for the current quarter has been lost (or destroyed) (or damaged) (or defaced). (6.) I have ceased to be a voluntary contributor, and am or am about to become an employed contributor. (c.) I have changed my employer. (cZ.) I have surrendered my card to [insert name of Society or Post Office) (e.) I have changed my place of residence from to the above address. and I hereby apply for the issue to me of a new card. Signature of Applicant Date 191—- Note.—When making this application, the applicant must surrender the old card if it is still in his possession. Strike out the lines not applicable. II EMPLOYED CONTRIBUTOR. [This form may be used by a Voluntary Contributor who is not a member of an Approved Society, but the Postmaster must in this case send the application to the proper Insurance Committee without issuing a card.] Application for the issue of a new Contribution Card to replace a card previously issued. I [insert name) of [insert address) hereby declare that— Strike out the words or lines not applicable to the case. r (1) I am an Employed Contributor; (2) I have ceased to be a voluntary contributor, and am or am about to become an employed contributor; (3) I have surrendered to my Society the contribution card pre- viously issued to me, and am unable to obtain a new card from my Society before the next contribution in respect of , me becomes payable; f (4) the contribution card issued to me for the current quarter has been lost, destroyed, damaged, defaced; (5) I have changed my employer; (6) I have surrendered my contribution card for the current quarter to (insert name of Society or Post Office) [а) upon ceasing to be a member of that Society ; (б) upon changing my place of residence from to the above address; and I hereby apply for the issue to me of a new card. Signature of Applicant Date 191](https://iiif.wellcomecollection.org/image/b28112787_0086.jp2/full/800%2C/0/default.jpg)
