The Inter-State Migrant Workmen (Regulation of Employment & Conditions of Service) Karnataka Rules, 1981
 F O R M – ‘I’ [See Rule 3 (I)]

Application for Registration of Establishments employing Migrant Workmen

             (Please go through the Instructions carefully, available on the Home Page of this Website before entering the information for Online Application)       
                    If you already filled the details partially, Please Enter the Temporary Application number       
Name of the establishment *   Location of the establishment *  
Postal address of the establishment :*  
Full name of the Principal Employer :*   Address of the Principal Employer :*

(furnish father’s/husband’s name in the case of individuals)
 

Division :*   District/Sub Division :*  
Taluk:*  
Mobile Number :*     Email - ID:*  
 
Full name of the Directors/particular partners (in case of Companies and firms): *   Address of the Directors/particular partners (in case of Companies and firms): *  
Full name of the Manager or person responsible for the supervision and control of the Establishment: *   Address of the Manager or person responsible for the supervision and control of the Establishment: *  
Nature of work carried on in the establishment:*   Total No of Workers*  
Particulars of contractors and migrant workmen *
SNoName of the ContractorsAddress of the ContractorsNature of work for which migrant workmen are to be recruited or are employedMaximum number of migrant workmen to be employed on any day through each contractorEstimated date and commencement of work under each contractorEstimated date of termination of employment of migrant workmen under each contractor 
1             dd-MM-yyyy     dd-MM-yyyyDelete
        

Documents Required to be submitted at the time of online Registration


(The Applicant shall scan his/her latest documents with max. size 250kb for each document in .pdf format and upload the same while submitting the Online application for registration. The applicants shall not upload any other documents (except the below specified documents) at the stage of submitting the online application).
1. Authentic Identity Card of the Applicant (Like EPIC,Driving licence,Pan Card,Aadhar Card,Passport,Bank OR Post Office Passbook,Ration Card,Railway Identity Card,Identity Card for the Disabled):*  
2.Certified Copy of Agreement / Contract between Principal Employer and the Contractors:*  
3. Copy of the Registration / Challan or ESI/PF/ST/Registration Certificate either under Factories Act or Shop Act, GST:*  
4. List with full address and Identity Card of Partners/Directors/Owners/Occupiers/Proprietor of the Organization:*  
5. Applicants / Authorised Signatories Full Name, Address, Designation with Seal:*  
6. Declaration regarding Non-employemnt of Child Labour:*  
7. Copy of Memorandum of Association (MOA) / ROC in case of Private / Public Companies:*  
Particulars of Treasury Receipt Enclosed(Name of the treasury) :*
I hereby declare that the particulars given above are true to the best of my knowledge and belief. :*
(Please upload the Signature file in JPEG format and less than 50KB)
No of Workers:* Online Registration Fee (In Rupees):*
Place: Date: Signature of the Applicant(Principal Employer):*

 
Note: Labour Department is not responsible for your Uploaded Files. Please Check before Uploading your Files.
       
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