Form-I

[See sub-rule (1) rule 15 & Section 7]

APPLICATION FOR REGISTRATION OF ESTABLISHMENTS EMPLOYING BUILDING WORKERS

If you have already filled the details partially , Please Enter the temporary Application number :
Name of the establishment where building or other construction work is to be carried on *   location of the establishment where building or other construction work is to be carried on :*  
Postal address of the establishment :*  
Full name of the establishment, if any :*   Permanent address of the establishment, if any :*  
District :*   Sub Division :*  
Taluk:*  
Mobile Number :*     Email ID:*  
 
Full name of the manager or person responsible for supervision and control of the establishment:*   Address of the manager or person responsible for supervision and control of the establishment:*  
Nature of building or other construction work carried/ is to be carried on in the establishment:*   Maximum number of building workers to be employed on any day:*  
Estimated date of commencement of building or other construction work:*  
dd-MM-yyyy  
Estimated date of completion of the building or other construction work:  
dd-MM-yyyy  
No Of Contract Workers:*   Online Registration Fee (In Rupees):*
Sector:
                                                                                 
                                                                                        

Document 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. List with full address and Identity Card of Partners/Directors/Owners/Occupiers/Proprietor of the Organization:*  
3. Declaration regarding Non-employemnt of Child Labour:*  
4. Sanctioned Plan approved by local Authority :*  
5.Advance Cess Paid Details  
6. Copy of the Registration / Challan or ESI/PF/ST/Registration Certificate either under Factories Act or Shop Act, VAT, TIN:
7.Partnership deed:*  
8.Registration of Establishment by ROC:
9.MOA:*  
10.Joint Venture Agreement:*  
11.Work Order:*  
I hereby declare that the particulars given above are true to the best of my knowledge and belief. :*
                                                       The Applicant shall scan his/her latest Signature file with max. size 50kb in .jpg Format
Place:

Date:                

   Signature of the Applicant:*

 
               
Please send your Queries to this mail ID : labouronlineservices.helpdesk@gmail.com
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