Alabama Code Title 25. Industrial Relations and Labor § 25-5-79

The notice referred to in Section 25-5-78 may be served personally upon the employer or upon any agent of the employer upon whom a summons may be served in civil actions or by sending it by registered or certified mail to the employer at his last known residence or business place within the state and shall be substantially in the following form:

“Notice -- You are hereby notified that an injury was received by ․․․․․․․․․․ who was in your employ at ․․․․․․․․․․ while engaged as ․․․․․․․․․․, under the superintendency of ․․․․․․․․․․, on or about the ․․․․․․ day of ․․․․․․․․․․, 2․․․, at about ․․․ o'clock, ․․․ m., and who is now located at ․․․․․․․․․․ (give town, street and number), that so far as now known, the nature of the injury was ․․․․․․․․․․ and that compensation may be claimed therefor.  Signed ․․․․․․․․․․ (giving address) ․․․․․․․․․․ dated ․․․․․․․․․․, 2․․․”

No variation from this form shall be material if the notice is sufficient to advise the employer that a certain employee, by name, received a specified injury in the course of his employment on or about a specified time, at or near a certain place specified.


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