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Nebraska

bound by Part II of the Act prescribing the liability of the employer to make compensation for injuries received by an employé in the course of his employment, approved April 21, 1913, and amendments thereof.

Dated the...

..day of....

19...

Employé.

Address.

The above notice must be given by the employé to the employer and the employé must file a duplicate original of the notice, with proof of service attached thereto, with the Insurance Commissioner.

The proof of service should be substantially in the following form:

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over the age of...

day of......

being duly sworn, deposes and says that he is

..years, and that on the...

19.., at..

in the State of Nebraska, he served the foregoing notice on.

with said.

thereof.

* by delivering to and leaving

..a duplicate original

(If the employer is a corporation proceed as above to * and then as follows: by delivering to and leaving with.....

a duplicate original of said notice. Deponent further says that he knew said person so served to be an officer, to wit, the..

of said..... ...., a corporation.)

(If the employer is a partnership, service on one partner will doubtless be sufficient; in which case the affidavit of service should proceed as follows from the * in above form: by delivering to and leaving

Nebraska

with.....

..a duplicate original of said notice. Deponent further says that he knew the person so served to be one of the partners of the said firm of..

Sworn to before me this.

.)

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Employer's Withdrawal of Notice of Election not to Be Bound by Compensation Feature of the Statute

(§ 13)

The undersigned employer hereby gives notice to its (his) employés that it (he) hereby withdraws the notice heretofore given not to be bound by the provisions of Part II of an act prescribing the liability of an employer to make compensation for injuries received by an employé in the course of his employment, known as the Workmen's Compensation Act, approved April 21, 1913, and hereby accepts the provisions of Part II of said Act. Dated the.

.day of......

19...

Employers.

The above notice must be posted about the place or places where the workmen of the employer are employed. It may be written or printed. A duplicate of the notice, with proof of such posting attached must be filed with the Insurance Commissioner. The affidavit of posting should be substantially in the following form:

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....., being duly sworn, deposes and says, that he is the employer named in the above notice. (Or in case of partnership; that he is one of the employers named in the above notice and a member of the firm of......

; or in case of a corporation:

Nebraska

that he is an officer, to wit, the...

.of the corporation em

ployer named in the above-entitled notice); that the above notice was on the......... ...day of..... 19., duly posted about all the places where the workmen of the above-entitled employer were employed. (Or specify the particular places where the notice was posted.)

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Notice by Employé Withdrawing Election not to Be Bound by

Compensation Provision

(§ 13)

To....

Employer.

Please take notice, that the undersigned hereby waives the notice of election heretofore given not to be bound by Part II of the Act prescribing the liability of an employer to make compensation for injuries received by an employé in the course of the employment and hereby withdraws such election and consents to be bound by the provisions of Part II of said Act.

Dated the........ day of....

19...

Employé.

Address.

The affidavit of service of the above notice should be as follows:

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of....

19., at.

foregoing notice on.. with said..

FORM

being duly sworn, says that he is over the age years and that on the....

.day of......

.in the State of Nebraska, he served the * by delivering to and leaving

a duplicate original thereof.

Nevada

(If the employer is a corporation, proceed as above to the *, and then as follows: by delivering to and leaving with.. a duplicate original of said notice. Deponent further says that he knew the said person so served to be an officer, to wit, the...

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(If the employer is a partnership service on one partner will doubtless be sufficient; in which case the affidavit of service should proceed as follows from the * in the above form: by delivering to and leaving with..... .a duplicate original of said notice. Deponent further says that he knew the persons so served to be one of the partners of the firm of....

Sworn to before me this... day of......

......)

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After the above notice is served on the employer a duplicate thereof, with the above affidavit of service, attached thereto, should be filed with the Insurance Commissioner. § 13. The waiver accomplished by the above notice does not become effective until noon of the fifth day after the filing of the notice, with proof of service, with the Insurance Commissioner. § 13.

NEVADA

The Nevada Act is an elective State insurance plan. An employer cannot adopt the compensation principle except by paying the premiums to the State insurance fund.

The election to adopt the compensation principle, however, is a presumptive one. That is, all employers are presumed to have adopted the compensation principle if they take no action at all. The act applies to all employers of labor in the State of Nevada and their employés, except domestic servants and farm laborers.

Before the election to adopt the compensation principle becomes effective, so as to limit the employé to a demand for compensation rather than damages, the employer must

Nevada

keep himself out of default in making payments of premiums to the Nevada Industrial Commission, §§ 6 and 37.

The principal sections of the act applicable to the manner in which employers and employés are brought within the terms thereof including forms of notices which are printed in the statutes are as follows:

"§ 1. *** (c) If an employer having the right under the provisions of this Act to elect to reject the terms, conditions and provisions thereof and in such case exercises the right in the manner and form by this Act provided, such employer shall not escape liability for personal injury sustained by an employé of such employer when the injury sustained arises out of and in the usual course of the employment because:

"(1) The employé assumed the risks inherent to or incidental to or arising out of his or her employment; or the risks arising from the failure of the employer to provide and maintain a reasonably safe place to work, or the risks arising from the failure of the employer to furnish reasonably safe tools or appliances, or because the employer exercised reasonable care in selecting reasonably competent employés in the business.

"(2) That the injury was caused by the negligence of a coemployé.

"(3) That the employé was negligent unless and except it shall appear that such negligence was wilful and with intent to cause the injury; or the result of intoxication on the part of the injured party.

"(4) In actions by an employé against an employer for personal injury sustained arising out of and in the course of the employment where the employer has elected to reject the provisions of this Act, it shall be presumed that the injury to the employé was the first result and growing out of the negligence of the employer; and that such negligence was the proximate cause of the injury; and in such case the burden of proof shall rest upon the employer to rebut the presumption of negligence.

Ҥ 1 (c) 4. *** Every such employer shall be conclusively presumed to have elected to provide, secure and pay

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