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[[preprinted]] Form C-23. 1-30-29-125,000 (6-4632)

STATE OF NEW YORK
DEPARTMENT OF LABOR
OFFICE OF THE INDUSTRIAL COMMISSIONER
BUREAU OF WORKMEN'S COMPENSATION
125 EAST 27th STREET, NEW YORK CITY

^[[✓]] Case No. [[/preprinted]] 2874883 Inj. 12-5-28
[[preprinted]] Ins. Carrier's No. [[/preprinted]] B-1726073 [[preprinted]] NOTICE OF DECISION [[/preprinted]]

James Richard Sullivan [[preprinted]] Claimant [[/preprinted]] Trav. N. Y
1159--50th St.Brooklyn,N.Y *30 E. 42nd St.City

^[[Jim]]
Jacques Seligmann & Co. Inc. [[preprinted]] Employer [[/preprinted]]
3 East 51st St.N.Y.City

[[preprinted]] You are hereby notified that at a hearing held before the State Industrial Board on [[/preprinted]] 3-21-29 [[preprinted]] a decision was made as follows: [[/preprinted]]
Closed files--non-appearance.
[[preprinted]] Award to the claimant for disability........weeks compensation at $........per week, total $........covering the period from..........to........and the case was........

The employer and the insurance carrier are directed to pay this amount to the claimant at once, less payments already made to him covering this period.

Dated [[/preprinted]] 3-23-29FS 

^[[Marcus [[?]] ]]
[[preprinted]] Industrial Commissioner

TO THE CLAIMANT:-Any compensation due will be sent to you by check by the insurance carrier named above.
1. This award to be paid in full whether claimant returns to work or not. It is therefore advisable for him to resume work as soon as possible.
2. "CLOSED" means that the award as made is in full settlement of the claim.
3. "CONTINUED" means that there may be further disability and you will be given another hearing to determine the extent of this disability, if any.
4. The claimant should keep a careful record of the payments received in order that he may have evidence of payment or non-payment in case of dispute.
5. A claimant should not pay money to anyone representing him on his case unless the amount of the payment is ordered by a Commissioner or a Referee.
N. B. Un reclamante non dovrá pagare moneta a nessuna persona che rappresenta il suo caso, eccettuatene quando l'ammontare del pagamento sara ammesso dal Commissario.
אַַ םלענעד זאָל מייז נעלך נישט נעבעו צו אַ פאַרטרעטער פון זייןִ פּראָצעס, אויסער אַַז ריא סוטע וויפיעל צו בעצאָחלעו איז בעווילינט נעוואָרעז פון םאָטישאָנער אָרער אַ רעפפערי