APPLICATION FOR REGISTRATION OR RENEWAL OF REGISTRATION OF AN ESTABLISHMENT.
1. Name of the employer.
2. Full postal address of the employer.
3. The name, if any, of the establishment.
4. Full postal address of the establishment.
5. The category of the establishment.
6. The date of which the establishment commenced work.
7. No. employee/employees employed on the date of
8. In case of renewal of registration whether the
Registration certificate of the previous year enclosed.
9. An amount of Rs.______(Rupees.__________)ob\only has been paid_______ Treasury ____
On_____ under the head of
account _______(vide challis No._____ date.__________
Date._________ Signature of the employer.
State if it is a shop, an establishment, residential hotel, Non-residential hotel, resturant, boarding or eating house, theatre or other place of public amusement or entertainment.