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Form Iiiiiiiii: A. Details of The Contractor

This document is an application form for a license or renewal of a license under the Contract Labour (Regulation and Abolition) Act of 1970 and the Inter-State Migrant Workmen Rules of 1980. The form collects information about the contractor such as name, address, identification numbers, and contact details. It also requests details about the work being contracted, such as nature of work, duration, location, and maximum number of workers. For a renewal application, it asks for the license number and expiration date. Finally, it has sections to provide payment details for the license fee and security deposit.

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Keyur Dattani
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© © All Rights Reserved
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Download as DOC, PDF, TXT or read online on Scribd
100 views

Form Iiiiiiiii: A. Details of The Contractor

This document is an application form for a license or renewal of a license under the Contract Labour (Regulation and Abolition) Act of 1970 and the Inter-State Migrant Workmen Rules of 1980. The form collects information about the contractor such as name, address, identification numbers, and contact details. It also requests details about the work being contracted, such as nature of work, duration, location, and maximum number of workers. For a renewal application, it asks for the license number and expiration date. Finally, it has sections to provide payment details for the license fee and security deposit.

Uploaded by

Keyur Dattani
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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FORM IIIIIIIII

[Under rule 21(1) and rule 29(2) of the Contract Labour (Regulation and Abolition) Central Rules, 1971;
And Rule 7(1), Rule 7(2) and rule 14(2) of the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Central Rules, 1980]

Application for Licence / Renewal of Licence


under the Contract Labour (Regulation and Abolition) Act, 1970 (37 of 1970) /
The Inter State Migrant Workmen (Regulation of Employment and Condition of Service) Central Rules, 1980

A. Details of the Contractor


1 Name and Address of the contractor :

2 LIN / PAN No. of the Contractor : LIN :


PAN :
3 Email Id of the Contractor
4 Mobile Number of the Contractor

B. Details to be filled only in case of Application for Licence

Particulars of Establishment Where Workman is to be Employed


(a) Name of the Principal Employer :
(b) Number and date of Certificate of Registration of the
:
Establishment under the Act
Particulars of Contract Labour
(a) Nature of work in which workman is Employed or is to
:
be employed in the Establishment
(b) Duration of the proposed contract work
(Particulars of proposed date of Commencement and :
Completion)
(c) Name and address of the Agent or Manager of
:
Contractor at the work-site
(d) Maximum Number of Workmen proposed to be
:
employed on the Establishment on any date:
(e) Whether a certificate by the Principal Employer, in
:
Form III is enclosed:
C. Details to be filled only in case of Application for Renewal of Licence
(a) Number and Date of the Licence :

(b) Date of expiry of the licence :


D. Details of Licence Fee and Security Deposit
(a) Amount of Licence fee, Name of the Bank, Demand
Draft Number and Date / Transaction no. and Date in
:
case the amount has been deposited in the notified
Bank Account
(b) Amount of Security Deposit, Name of the Bank,
Demand Draft Number and Date / Transaction no. and
: --- Not Applicable ---
Date in case the amount has been deposited in the
notified Bank Account

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