Labour Department

Form 2

Application for Renewal of factory License

Fields marked with * are mandatory.

REGISTRATION DETAILS

1. Registration No.:

2. Registration Date.:

3. License Valid till:

Factory Details

1. Name of the Factory *:

2. Address of the Factory *:

a. District *

b. Tehsil *

c. City/Village *

d. Survey No. *

e. Postal Code *

f. Nearest Police Station *

g. Nearest Steamer Ghat *

3. Address for Communication*:

4. Mobile No. * :

5. Email id:

Manufacturing Detail

1. Nature of manufacturing Process/ Processes *:

a. Carried on in factory during last twelve months (In case of factories already in existence) *

B. To be carried on in the factory during next twelve months (In case of all factories) *

2 A. Name of Principal Product manufactured during last 12 months *:

B. Value of Principal Product manufactured during last 12 months *:

3. No. of workers*:

a. Proposed to be employed on any day during the year (In case of factories already in existence) *

b. Maximum No. employed on any day during the last 12 months (In case of factories already in existence) *

c. No.to be ordinarily employed in the factory(In case of factories already in existence) *

4 a. Total amount of HP Installed *:

b. Maximum amount of HP proposed to be used *:

5 a. Name of the Manager*:

5 b. Residential Address of Manager *:

6 a. Name of the Occupier*:

b. Residential Address of Occupier *:

7 a. Name of the Owner of premises *:

b. Address of the owner of premises *:

8. Whether trade waste or effluents generated*:

Yes

DECLARATION

This is to certify that the information furnished is true and correct to the best of my knowledge and belief. I also affirm that in case, I have provided wrong information, I am liable for action by Competent Authority.

NOTE:- All Documents have to be in pdf format and size less than 500KB each and clearly legible for approval by Department. All documents are to be uploaded .

S.No.

Documents

Choose File to Upload

DECLARATION

This is to certify that I have uploaded all the documents required for registration. I also cofirm that it is a genuine Application and I am liable for action by Department , if any information furnished by me is found incorrect.

A & N Administration

SUBMITTED SUCCESSFULLY

Factory License Renewal :-

Form 2

Application for Renewal of factory License

Factory Details

Manufacturing Detail