The SFE - Doc 138 Asisstant Chief Fire Officer Mark Sanderson

GA
21st July 1998

THE FIRE BRIGADES
UNION
Bradley House
68 Coombe Road
Kingston Upon Thames
Surrey KT2 7AE
Telephone 081 541 1765

APPLICATION FOR LEGAL AID
IN ACCORDANCE WITH RULE 25 (3)
Use this form to apply for Legal Aid for ANY matter connected with your employment OTHER than an accident or illness.

This form should be read carefully and the fullest possible information given in the spaces provided. It should then be handed to your Branch Secretary or Chairperson to complete Part II. It is then his/her responsibility to forward it to Head office for action. If Legal Aid is granted the solicitor will be in touch with you direct to advise you of the next steps to be taken in the matter.
Do not delay in returning this form if you are unable to answer some of the questions.

PART I

1. Full Name (in capitals). ANTHONY WIGGLESWORTH.
2. Address. LOWESTOFT, SUFFOLK, UK.
3. Telephone. 01502 403432.
4. Branch. LOWESTOFT FIRE STATION.
5. Employing Authority. SUFFOLK FIRE SERVICE.
LOWESTOFT FIRE STATION.
6. Date of joining service. 3RD OCTOBER 1978.
7. Your rank and how long held. SUBO 4 YEARS
8. Details of matter for which legal aid is required. Full details must be given and relevant documents attached to this form.

I suffered a back strain on 1st May 1998. This was caused by lifting and dragging of drill dummies in preparation for de-contamination exercise the same day. My method of working was normal custom and practice. The matter was subject to full investigation by ADO Paul Hayden who interviewed me on the afternoon of 1st May 1998 at approximately 15.30 hours. I did not book sick and continued to work for a further two days and was engaged in further strenuous physical work while delivering breathing apparatus instruction (2nd & 3rd May 1998). On the 4th & 5th of May 1998 I was off duty and remained fully fit for firefighting duties. On the evening of 5th May 1998 whilst engaged in Athletics training at the Recreation Ground athletics track I collided with a steeplechase barrier by mis-timing a vault over the solid wood hurdle. As a result I struck the hurdle sideways on and incurred further strain to my back and aggravating the mild strain I had occasioned on 1st May 1998. As a precautionary measure I booked sick by phone to the duty watch at Lowestoft on or around 6th May 1998. I returned to work on 13th May 1998.

I wish to apply for legal assistance on the basis of the particulars given above. I have no solicitor acting for me in relation to this matter and hereby authorise you to instruct a Solicitor to act on my behalf if legal aid is granted. I confirm that I am and was a member of the F.B.U. on the date of the accident/incident/contracted illness as stated above. I understand that I am obliged to give the full facts to the Union and the unions nominated Solicitors, and that if I fail to do so or give false misleading facts, legal assistance will be withdrawn and I shall be responsible for the costs incurred by the Union and any party to litigation in which the Union has supported me. I understand that a report of my case upon its conclusion may be published by the Union.

Signed A Wigglesworth Date 21st July 1998

PART II

To be completed by the Branch Secretary or Chairperson who is responsible for passing the form to the Brigade Secretary or chairperson for endorsement and forwarding to Head Office.

Branch Secretary signature M. J. Hyde


PART III

Endorsed by Brigade Chairperson C. Hayward