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Queenslanders Credit Union is an agent for CGU Insurance Ltd ABN 27 004 478 371 and CGU-VACC Insurance Ltd ABN 73 004 167 953 QCU0134 [763] Queensland Government Gazette EXTRAORDINARY PP 451207100087 PUBLISHED BY AUTHORITY ISSN 0155-9370 Vol. CCCXXXIII] TUESDAY, 1 JULY, 2003 [No. 54 QUEENSLAND GOVERNMENT GAZETTE NOTICE Notification of Approval of Forms under the Workers’ Compensation and Rehabilitation Act 2003 1. Approval of Forms The forms mentioned in the following table were approved by the Chief Executive Officer, Q-COMP on the date listed: 273373—1 764 QUEENSLAND GOVERNMENT GAZETTE, No. 54 [1 July, 2003 TABLE Item Approval Heading Number Version Date Number 1 1 July Application for Compensation Form 132.AMH 1 2003 (Australia Meat Holdings Pty Limited) Copies of the form are available from Australia Meat Holdings Pty Limited, 175 Riverview Road, Dinmore, Queensland, 4303, 07 3810 2305 2 1 July Application for Compensation (ANZ Banking Group Limited) 132.ANZ 1 2003 Copies of the form are available from ANZ Workers’ Compensation Unit QLD, ANZ Bank, Level 2, ANZ Centre, 324 Queen Street, Brisbane, Queensland, 4000, 07 3228 3586 or 07 3228 3524 3 1 July Application for Workers Compensation 132.ARN 1 2003 (Arnott’s Biscuits Campbell’s Soups (Queensland)) Copies of the form are available from Arnott’s Biscuits Limited, 46 Robinson Road East, Virginia, Queensland, 4014, 07 3243 5602 4 1 July Application for Compensation Form for Workers 132.BAL 1 2003 (Brambles Australia Limited) Copies of the form are available from Brambles Australia Limited, Brambles Insurance Services, 39 Fulcrum Street, Richlands, Queensland, 4077, 07 3375 4000 5 1 July Application for Compensation Form (BHP Billiton) 132.BHP 1 2003 Copies of the form are available from BHP Billiton, BHP Queensland Workers’ Compensation, Level 13, Riverside Centre, 123 Eagle Street, Brisbane, Queensland, 4000, 07 3226 0797 6 1 July Commonwealth Bank of Australia Group Application for Workers’ 132.CBA 1 2003 Compensation Copies of the form are available from Commonwealth Bank of Australia Group, Workers’ Compensation, Queensland, Commonwealth Bank Building, 240 Queen Street, Brisbane, Queensland, 4000, 07 3237 3525 7 1 July Compensation Application (Brisbane City Council) 132.CC 1 2003 Copies of the form are available from Brisbane City Council, City WorkCover, Lower Ground, 69 Ann Street, Brisbane, Queensland, 4000, 07 3403 9530 or 07 3403 6529 8 1 July Application for Compensation Form for Workers 132.CMG 1 2003 (Consolidated Meat Group) Copies of the form are available from Consolidated Meat Group Self- Insurance Unit, Teys Bros Beenleigh, Logan River Road, Beenleigh, Queensland, 4207, 07 3382 5199 9 1 July Employee’s Application for Compensation (Coles Myer Ltd) 132.CML 1 2003 Copies of the form are available from Coles Myer Ltd, Injury Services Unit, Level 1, 643 Kessels Road, Upper Mt Gravatt, Queensland, 4122, 07 3347 8467 10 1 July Application for Compensation (CSR Limited) 132.CSR 1 2003 Copies of the form are available from CSR Limited, Level 4, 188 Wills Street, Townsville, Queensland, 4810, 07 4720 8831 11 1 July Application for Compensation Form for Workers 132.GCCC 1 2003 (Gold Coast City Council) Copies of the form are available from Gold Coast City Council, Nerang Southport Road, Nerang, Queensland, 4211, 07 5582 8815 12 1 July Compensation Application Form for Workers 132.GCL 1 2003 (Golden Circle Limited ) Copies of the form are available from Golden Circle Limited, 260 Earnshaw Road, Northgate, Queensland, 4013, 07 3266 0176 13 1 July Application for Compensation Form for Injured Workers 132.JL 1 2003 (Jupiters Limited) Copies of the form are available from Jupiters Limited, Claims Unit, Level 9, Niecon Tower, 17 Victoria Avenue, Broadbeach, Queensland, 4218, 07 5584 8900 14 1 July Application for Compensation 132.LGW 1 2003 (Local Government Association of Queensland) Copies of the form are available from Queensland Local Government Workcare Scheme, Local Government House, 25 Evelyn Street, Newstead, Queensland, 4006, 07 3000 5555 1 July, 2003] QUEENSLAND GOVERNMENT GAZETTE, No. 54 765 15 1 July Application for Compensation Form for Workers 132.MIM 1 2003 (M.I.M. Holdings Limited) Copies of the form are available from M.I.M. Holdings Limited, MIMCare, Level 2, 410 Ann Street, Brisbane, Queensland, 4000, 07 3833 8363 16 1 July Application for Compensation (Mayne Group Limited) 132.MNL 1 2003 Copies of the form are available from Mayne WorkCover, 125 Flockton Street, Everton Park, Queensland, 07 3353 6177 17 1 July Application for Compensation (OneSteel Limited) 132.OS 1 2003 Copies of the form are available from OneSteel Limited, 692 Boundary Road, Archerfield, Queensland, 4108, 07 3275 8455 18 1 July Workers Compensation Claim (Qantas Airways Limited) 132.QF 1 2003 Copies of the form are available from Qantas Airways Limited, Workers Compensation Unit, Brisbane Engineering Services Building, 9 Qantas Drive, Brisbane Airport, Brisbane, 4007, 07 3860 8715 or 07 3860 8853 19 1 July Application for Workers Compensation (Queensland Rail) 132.QR 1 2003 Copies of the form are available from Queensland Rail Workers’ Compensation Unit, Floor 1, Railcentre 2, 309 Edward Street, Brisbane, Queensland, 4000, 07 3235 2648 20 1 July Application for Compensation Form for Workers 132.RWC 1 2003 (Redland Shire Council) Copies of the form are available from Redland Shire Council, Workers Compensation Unit, Council Depot – South Street Cleveland, Queensland 4163, 07 3829 8339 21 1 July Application for Compensation Form for Workers 132.TCC 1 2003 (Townsville City Council) Copies of the form are available from Townsville City Council, Risk Management Section, Suite 2, 22 Walker Street, Townsville, Queensland, 4810, 07 4772 2784 22 1 July Application for Workers’ Compensation (University of Queensland) 132.UQ 1 2003 Copies of the form are available from University of Queensland, Work Injury Management, Level 5, Gordon Greenwood Building, University of Queensland, St Lucia, Queensland, 4072, 07 3365 6022 23 1 July Application for Compensation (Westpac Banking Corporation) 132.WBC 1 2003 Copies of the form are available from Westpac Banking Corporation, Occupational Health and Safety Unit, Level 21, 260 Queen Street, Brisbane, Queensland, 4000, 07 3227 2174 24 1 July Application for Compensation Form for Workers 132.WW 1 2003 (Woolworths Limited – Queensland) Copies of the form are available from Woolworths Limited, Woolworths Supermarkets QLD, Insurance Department, Fox Road, Acacia Ridge, Queensland, 4110, 07 3213 4307 25 1 July Application for Compensation (WorkCover Queensland) 132.WC 1 2003 Copies of the form are available from WorkCover Queensland, 280 Adelaide Street, Brisbane, Queensland, 4000 or any WorkCover Queensland regional office, 1300 362 128 26 1 July Application for Compensation – Fatal Injury 132F.AMH 1 2003 (Australia Meat Holdings Pty Limited) Copies of the form are available from Australia Meat Holdings Pty Limited, 175 Riverview Road, Dinmore, Queensland, 4303, 07 3810 2305 27 1 July Application for Compensation Fatal Injury 132F.ANZ 1 2003 (ANZ Banking Group Limited) Copies of the form are available from ANZ Workers’ Compensation Unit QLD, ANZ Bank, Level 2, ANZ Centre, 324 Queen Street, Brisbane, Queensland, 4000, 07 3228 3586 or 07 32283524 28 1 July Application for Workers Compensation – Fatal Injury 132F.ARN 1 2003 (Arnott’s Biscuits Campbell’s Soups (Queensland)) Copies of the form are available from Arnott’s Biscuits Limited, 46 Robinson Road East, Virginia, Queensland, 4014, 07 3243 5602 29 1 July Application for Compensation Fatal Injury 132F.BAL 1 2003 (Brambles Australia Limited) Copies of the form are available from Brambles Australia Limited, Brambles Insurance Services, 39 Fulcrum Street, Richlands, Queensland, 4077, 07 3375 4000 766 QUEENSLAND GOVERNMENT GAZETTE, No. 54 [1 July, 2003 30 1 July Application for Compensation Form – Fatal Injury (BHP Billiton) 132F.BHP 1 2003 Copies of the form are available from BHP Billiton, BHP Queensland Workers’ Compensation, Level 13, Riverside Centre, 123 Eagle Street, Brisbane, Queensland, 4000, 07 3226 0797 31 1 July Commonwealth Bank of Australia Group Application for 132F.CBA 1 2003 Compensation – Fatal Injury Copies of the form are available from Commonwealth Bank of Australia Group, Workers’ Compensation, Queensland, Commonwealth Bank Building, 240 Queen Street, Brisbane, Queensland, 4000, 07 3237 3525 32 1 July Compensation Application – Fatal Injury (Brisbane City Council) 132F.CC 1 2003 Copies of the form are available from Brisbane City Council, City WorkCover, Lower Ground, 69 Ann Street, Brisbane, Queensland, 4000, 07 3403 4986 33 1 July Application for Compensation Fatal Injury 132F.CMG 1 2003 (Consolidated