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Applicatoin For Licence

This document contains an application form for a contractor seeking a license to employ contract labor. The form requests information such as the contractor's name and address, details of the establishment where labor will be employed including address and business type, nature of the contract work, maximum number of laborers to be employed, whether the contractor was previously convicted or had licenses revoked, and confirmation that a certificate from the principal employer and fees/security deposits have been submitted.

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Ameet Ranjan
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54 views

Applicatoin For Licence

This document contains an application form for a contractor seeking a license to employ contract labor. The form requests information such as the contractor's name and address, details of the establishment where labor will be employed including address and business type, nature of the contract work, maximum number of laborers to be employed, whether the contractor was previously convicted or had licenses revoked, and confirmation that a certificate from the principal employer and fees/security deposits have been submitted.

Uploaded by

Ameet Ranjan
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Contract Labour (Regulation & Abolition) Central Rules FORM IV

See Rule 21(1)

Application for Licence


1. 2. 3. Name and address of the contractor (including his fathers name in case of individuals) Date of birth and age (in case of individuals) Particulars of establishment where Contract Labour is to be employed : (a) ame and address of the establishment; N

(b) T ype of business, trade, industry, manufacture or occupation which is carried on in the establishment; and employed in the establishment on any date of the preceding 5 years if so, give details; (c) umber and date of Certificate of Registration of the establishment under the Act; (d) ame and address of the Principal Employer. . 4. Particulars of contract labour: (a) ature of work in which contract labour is employed or is to be employed in the Establishment; N N

(b) D uration of the proposed contract work (give particulars of proposed date of commencing and ending);

(c) ame and address of the Agent or Manger or Contractor at the work-site;

(d) M aximum number of contract labour proposed to be employed in the establishment on any date; 5. 6. 7. Whether the contractor was convicted of any offence within the preceding five years? If so, give details. Whether there was any order against the contractor revoking or suspending licence or forfeiting security deposits in respect of an earlier contract. If so, the date of such order. Whether the contractor has worked in any other establishment within the past five years. If so, give details of the Principal Employer, Establishments, and nature of work.

8. 9.

Whether a certificate by the Principal Employer, in Form V is enclosed Amount of licence fee----name of the Union Bank, demand draft No. and date.

10. Particulars of security deposit, if any, required to be adjusted, including Treasury Receipt number and date. The amount of security or balance, if any, after adjustment of amount to be refunded under Rule 31, if any, deposited with Treasury Receipt number and date.

Declaration.-- I hereby declare that the details given above are correct to the best of my knowledge and belief. Place: Date: Signature of applicant (Contractor)

Note.--The application should be accompanied by a Treasury Receipt for the appropriate amount and a certificate in Form V from the Principal Employer

(To be filled in the Office of the Licensing Officer). Date of receipt of the application with challan for fees /Security Deposit. Signature of Licensing Officer.

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