Formate of FORM 'A'




FORM 'A'


[See sub-rule (1) of rule 3]

Notice of Opening

1.     Name and address of the Establishment.
2.     Name and designation of the Employer.
3.     Number of persons employed.
4.     Maximum number of persons employed on any day during the preceding twelve months with date.
5.     Number of employees covered by the Act.
6.     Nature of industry.
7.     Whether seasonal.
8.     Date of opening.
9.     Details of Head Office/Branches.
(a)   Name and address of the head office. Number of employees.
(b)   Names and addresses of other branches in India.
1.
2.
3.

I verify that the information furnished above is true to the best of my knowledge and belief.
Place                                                                                        Signature of the employer
Date                                                                                         with name and designation

To

The Controlling Authority
…………………………….
…………………………….


1.
Ins. by G.S.R. 2868, dated 22nd November, 1975.