Labour Department

Form I

Application for Permission to construct/extend factory

Fields marked with * are mandatory.

Applicants Detail

1. Name of the Applicant *:

2. Applicant's Calling *:

3. Applicant's Address*:

4. Mobile No. * :

5. Email id:

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. Particulars of Plant to be installed *:

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

Form I

Application for Permission to construct/extend factory

Applicants Detail

Factory Details