Compensation
Premium
Fill Out Application, Below, Cut Out and MaiI to the Aetna Life, or Any Representative. and‘You Are Protected from January 1,1914
or Any Subsequent Date on Whit: Application ls Received. .
I ' ‘ ACCOI‘dan: to .pllllOll Rendered by Attorney General Light
The Connecticut en ’8 Com ensatron A61
-Relating to Employees lnjnred' In the Course of Their Employment—w -
APPLI S TO YOU
Even If You Employ Only One Servant or Farm Worker, Part or Whole Time
ADPIIWIOH for Workmens Compensation {If ‘ , Application for 'WOrkmen’s Compensation for
PR VATE RESIDENCE NOT FARM I f FARM...INCLUDINQ RESIDENCE
Annual Premium
INSURANCE PROVIDING COMPENSATION FOR . V A“““"" premi‘m
A Regular INDOOR SERVANTS (not men than two) , INSURANCE PROVIDING COMPENSATION FOR
B ALL flagginlédlifigg £21.;h as the dressmaker coming to work by the day. ' A-. Regular; employees (not more than two.)
C One pan-tie? igdoorhservant gllving you mogle glean a chiral of his or her -:<~ $7 50 ( B. All occasional help employed during the year costing got more than $325 9
time $11 at I: ma comm re at to It: t
A or the laundrws whonwwsorlgs a day orgtwo 3’ wall) 0 your umace in wages or in wages and board (board. if furnished. to be calculai‘ $ 90
nd also
ed at onenlfird cash Wages.)
D. Protecting you against your legal liability for ACCIDENTS TO THE PUB-
LIC" In and about your premises‘ Number
_ N mb . _ . . ~ ‘ WW ' AIiIITtional Coverage
l' ‘ Erngloyzil ‘ Add‘tiona' SCI'VIIIIIS ' . Additional regular help. not house servants ......... at $3.00 each $
""" Additional indoor servants (in excewof two) "I """"" at $L5° each 3 .... . . .Addirional regular house servants .... . . . . . . . . . . . . . (at $1.50 each $
...... Additional part-time indoor servants (in excess of one) giving Wages paid (inchiding board. if furnished) for (mm H
yOugnOI more than a third of their time ................. at 0.50 each 3 Sim help IN EXCESS OF $335. Estimated
...... Outdoor-servants(suchascoachmemstablemen Hardenamand ‘54“; at$ at 35MB per $.00 $
fillelfifis) ................ 4 .......................... ,. . .. at $3 00 each $ ~ ._ {I I‘ ,, * . I . . ' ’ . I I
...... mfime outdoor servants (suehas the man who comesto A .... W'L"'V“i"thauficm‘s “at $1030 “ad’s
" attend to your lawn ........... . . . . . . . . . . .‘ .......... . . at $I.oo each 3 Protection against ACCI DENI‘S TO THE PUBIjIC
...... Chami‘eups at$xo.ooeach$’ (any mother than your employees) on farm. includ»
' T l .A I ‘“ ‘ ing‘ residence. barns and all outbuildings .................. at $3.00
ota ruiua l-‘rem'un ..
i ‘ $ ADD five cents per acre for all acreage in excess of five.
N am: ofrrEmployer .....................................................................
, . .acres It five cents ............................... S
Business .................... ' ..........................................................
~ ' -4;
Address; ........................................................................... '*
State melee: one or two family house or apartment ................ i .................... - TOTAL ANNUAL PREMIUM s
“ e ........... . ...............
Are you owner or t nant? ................................... Name of Emplchr ...........................................................
Do you desire quotation for Combination Residence Policy described below?
*The compensation Insurance granted [or this premium will be sold at an annual rate
of $4 50 ‘to‘ those holdifl or nurchasing Aetna Combination Residence Policies covering
Burglary. Glace Breakage. Water Damage. Lose of Use and Public Liability Insurance. Pr‘ - l or
Write for further particulars Inclpa 0p ..............................................................................
BETTER TODAY THAN TOO LATE
[ET NA LIFE INSURANCE COMPANY
The Etna Accident and Liab 11in Company
IMPORTANT: The Connecticut Compensation Act Effective January 1, 1914
Total Acreage (. . . cultivated. . . .not cultivated) .................. i .................... i ......
m
.2, A- m 1 a z; A « H w HM n—I
"lair-"n. Fun ANDRE“ Ind and at twelve yearn of no he left. l’utulll. Province to Inkling thin letter .39 M, a. member of tho NOWK joined It New York lodge utter llll‘l rn ; FIND WOMAN IN DANBURV. however WM wit to the Million Mn
‘ .homn to chill for hlmnolt. From the position "Hr. Illumination wont. to lay Methodlot Church and 1,, active In the turn from South Carolina. luet prov-l WM» unttu ltllthmlllnll and n letter ‘MIH re
] fluTflfllflsu“ II“ “II "I" until I"? I‘IIUPM from MUM lnu knoll tor the Harlem River mu» work no one at the omelet board He our; to ill!) marriage He In new ll mom Bertha Smith, Ward et Mammalian": valved am my "I the) MM, Worm,”
' hnnlnoun name years ago. Mr. ’l‘lutclrln- road and took charge at the work of m alwnye been active In church work her of Old Well undue. No Hm. I)! “ch, le Returned. SMItnln Bradley that the young wt,»
(IJI’IIIIII‘IIIIJ from “W WM) non Illa Ii mnn‘n work every any. 'lrle laying trmfc up no tar on what In new and, at one limo. wan bumpintendarfl flotith Norwullr. ' Bertha Smltlt m w W who man was Ii word or the Male pml Ilmr
...... wns I! mllroml contractor in the male, Wixmlnwn. on the New York, New at a colored 3m“), school In Upwi Il-lo In a property holder In flouth ‘ ' ' “u; rm; "“ ‘ ' elm w“ in “My mmmay nntll mu. w
my Gamma (N .13). New York city. although he superlntondod oll neldn In “oven and Hartford Railroad later Nor-walk. IxNorwnllIl and also In Dayton. Floridanhfi” WWI“ “"3 II “MW” “I “I‘II‘W {,wmltqup War” of lien.
momma (IN. )2). Bymmmo (N. v.3, Pennsylvania. and onrflod'on vnrtonn he laid new rolls from New York to My. llntuhlnnone “mm. was born“) although much at his Southern estate other; more, or loam work, Inn; III-ml to Friday afternoon the young worm»w
Wfllmford. Gannon «smug... Ringo- other linen of endeavor Iill through Mali Konnleu Button. and allortly thereof Vermont, and «me In the torn part. of all been disposed at In the pen! to“ noted In Dnnbnry and was Saturday one mien In lmnhury try Patrolman
field. Waiver-t and other mm», W ”"31““ ““5- WI‘ ‘Wmfi ”WMMIW 0‘ “'9 «cotton hln lite ll captain of the first. 'Sounn years. 11 h” Wm Mr. HWAIIMI’“ II DIM-6d In charlie or an agent of tho. George Young and he won her M
m, “mm, In 1349‘ Mr. Hummngm became a”. of truck between Harlem 'ltlvnr and dimer and also of “w,“ boats ply. enltomtonlmlld his MIMI"! In Florltlu. State Board of Charity of llansnellu chemo. Hire wne queetloned by (full
The W was decorated In ”01mm, «etiolated with a burly or engineer» Tremont. ‘ in"; we “m“ river. IMI‘. Huhchln’ but tnr the peat mvernl yearn he hurl cells, who came for her Bertha (Mil medley Ill. Illa offline and mm min
remained North. He usually remained. in a. comer young women and to II to Ilmntlvlnw term to liwnlt. rm; In‘r'lvl’
array, mum! pine. holly, and the oil» working on the New York It llulom ' It «on» nrounu this time that Mr. son's mother m Alice lllllxa. mm, ot ;
er mwummtfi o! the men he» Railroad. Elie “milled engineering as l-lntclrtneon was married to Mlle Al mybroolc 0mm, and thus It to noon it! home tor the annual family minim ward at the Mananehnsottc ntate board, of someone to ”lie her Imek In nown‘
kg W1? arranged. lingo, how no Ivor-lied. Iliad some yearn later pur- mlrn macaroni, oi: lilo/nth Nor-walk. that, he came from good old Now m;- at Chmtmui time. lonvtng on one or Several melts use 51m left Boston Mrs. mention, on, mm: er the WM I
W it on flowers were 0180mm sued the «lady In alumna. I'll. Ye All» Mine Hutchinson riled In 1398. leaving lend melt. Andrew .1. minimum ‘tho (hm Linn steamers nllm‘tly aft/«Ir and was mild to him; been necompun hoard or Charity. Ill-moo Hitlm‘tlllx‘
about the room adding to meetmim tee thh‘nofitionéhe reeled (or Ii time two children. mun elder monol- who we: a phye‘l- Ml birthday. and returning home in led by on oldnr women They went to norm for the woman and Iuml Imr been _ _ ‘
macaw at we seem on the railroad from New York to cm When the Civil Wu broke mu m clan. ml who Illen In New mam o! Inlay of the follbwtnn 1w. . Bridgeport and twain them for some to MIMI.
norm eighty yearn am Mr. Hon ton mull u an emoll- manager. llutelrlneone work In Influx the yellow fever before Mr. Huwhlnnonl To his Meade In Iowa Mr» Antonin time. mm Eartha left her child and: ,.
031m was no evidence of thin all: :l-l'e next cup-flounder! the building real—ill avenue Md; New York city. was ten yam-a old. life also but on can In» ever been “A Ja" and Home in the course at her travels came to; WM”— W WW» - 4‘ " “we;
venom! we ‘39 In We. hearty. well M the Mim‘mm mulling. IA J. to mm enthralled by the Hetero ’l'hm hm misled!» In Kutehlneonumel of the older one» lull cell Ill! “Hutch." iNorwnlIt ISM met hem II man thII‘
“II «lemma given promise or rmle aliens tel-Ind emu finder the lmwea- In: no mnemonic pregnant» In New enema III Mirth Henna Ill mt he has my Month In Nerwelltl worlm not tar tram Dunbnry and In:
leg the century marl: rue received a Irina that II. and mum mutton him York lib went to the Mnaylvcnk ell hit home ‘ ltltll. leaving in child“ we closeted III/Ital» lured number a! companion him to Dummy and later mBHESTEBS Fin-Ls: "
,_ number II! mom presents and Illa lie iron: to (initiators. a. (I. lie the can halite, becomes a piece III unwound; am: (”dwelt m Burdlok, new of toilet ethane who called HM him to went in live In I; email village nearby c m: m mm, nee ,,
m m or all tor my more lum- pirntmn at that connect. out: to be out: for the U1 Ill Petroleum My. Brennan“: .‘. Ii minim Molmi I»! their room“ interstate ‘, l The Witty wiles Immfl‘i or Illa ' {IIIETI'II‘I'IEI ,
ex metronome. amine. «in Iona: m or rice lilo wire and cement» Llhtlm Intern . . . _ I “I I ' Imus mmt‘ll‘fi thmbma. hut Mi ' "““" “‘9 “in” In. ME.
" 1- ileum In i “we m workers the II time and tiles: men Weill. m the grille Hakim: New My; " ‘ Will helm twill EQMIMIIHW haul mi ordain. to late; her In . I: i’i
In W line In; Iraq mm W“ roell_,‘ma _ , . ' , ‘ , « ». , ‘ W‘IW w new mean It Wont AM for «lime! “to gmlmmj‘cfifl‘fl Illa nutmmunl Nels Nodal ' ,, Imm‘é‘ Elli II All
Norwalk Chronicler