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FORM - I

[See Rule 23 (1)]

Application for Registration of Establishments Employing Building Workers

 

1.

Name and location of the Establishment where building or other construction work is to be carried on

 

2.

Postal address of the Establishment

 

3.

Full name and permanent address of the Establishment, if any.

 

4.

Full name and address of the Manager or person responsible for the supervision and control of Establishment.

 

5.

Nature of building or other construction work carried / is to be carried on in the Establishment.

 

6.

Maximum number of building workers to be employed on any day

 

7.

Estimated date of commencement of building or the other construction work

 

8.

Estimated date of completion of the building or other construction work

 

9.

Particulars of demand draft, enclosed (name of the Bank, Amount, Demand Draft No and Date)

 

 

Declaraton by the employer

(i)                  I hereby declare that the particulars given above are true to the best of my knowledge and belief.

(ii)                I undertake to abide by the provisions of the Building and other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996 and the Rules made thereunder.

 

Principal Employer

Seal and Stamp

... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...

Office of the Registering Officer appointed under the Building and other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996 and Central Rules made thereunder.

 

Date of receipt of application : _________________