Enforcement Rules of Protection for workers Incurring Occupational Accidents Act Article 6
When applying for death subsidy of occupational accident in accordance with Paragraph 1 of Article 6 of the Act, the following forms and documents shall be prepared:1. Application form of worker incurring Occupational accident for death subsidy and receipt of subsidy.2. A written diagnosis of death or prosecutor's autopsy certificate; a court's verdict if a person's death is publicly announced.3. Relevant supporting documents for occupational accident.4. A transcript of household certificate with the date of death listed; if the applicant is an adopted child, the date of adoption shall be recorded. If the applicant and the deceased worker are not in the same household, the transcript of household certificate shall be prepared at the same time for each person.5. Name of business establishment, name and address of the responsible person and other relevant information.6. A written statement that receiving no occupational accident death compensation paid by the employer in accordance with the provisions of Labor Standards Act.
中文原文 職業災害勞工保護法施行細則第6條
依本法第六條第一項規定申請職業災害死亡補助，應備下列書件：
一、職業災害勞工死亡補助申請書及補助收據。
二、死亡診斷書或檢察官相驗屍體證明書；受死亡宣告者，法院判決書。
三、職業災害相關證明文件。
四、載有死亡日期之戶口名簿影本；申請人為養子女者，並需載有收養日期。
申請人與死亡勞工非屬同一戶籍者，應同時提出各該戶口名簿影本。
五、事業單位之名稱、負責人姓名及地址等相關資料。
六、未領取雇主依勞動基準法規定給付職業災害死亡補償之聲明書。
一、職業災害勞工死亡補助申請書及補助收據。
二、死亡診斷書或檢察官相驗屍體證明書；受死亡宣告者，法院判決書。
三、職業災害相關證明文件。
四、載有死亡日期之戶口名簿影本；申請人為養子女者，並需載有收養日期。
申請人與死亡勞工非屬同一戶籍者，應同時提出各該戶口名簿影本。
五、事業單位之名稱、負責人姓名及地址等相關資料。
六、未領取雇主依勞動基準法規定給付職業災害死亡補償之聲明書。