Labour And Employment FORM - 2 (Prescribed under Rule 4, 5 and 11) Application for registration and grant or renewal of license for the Year ________ and Notice of occupation specified in section 6 and 7 1. Full name of the factory with number if already registered factory license : 2. (a) Full Postal address and situation of the factory : (b) Full address to which communications relating to the factory should be sent : 3. Nature of manufacturing process/Process : (a) carried on in the factory during the last twelve months (*In the case of factories already in existence ) and (b) to be carried on in the factory during the :: next twelve months (in the case of all factories) 4. Name and valves of Principal products manufactured : during the last twelve months 5. (i) Maximum number of workers proposed to be : employed on any one day during the year (ii) Maximum number of workers employed on any : one day during the year (iii) Number of workers to be ordinarily employed : in the factory 6. (i) Nature and total amount of power (horse power) : installed (ii) Maximum amount of power (horse power) : proposed to be used (including existing) 7. Full name and residential address of the person who : Shall be the manager of the factory for the purpose of the Act 8. Full name and residential address of the Occupier (iii) Where a managing agent has been appointed, : the name of managers agent and directors thereof, (iv) share holders in case of a private company where no managing agents have been appointed (v) The Chief Administrative head in case of a : Government or Local fund authority 9. Full name and address of the owner of the premises : or building ( including the precincts thereof) referred to in section 93. 10. In the case of a factory constructed or extended after the date of the commencement of the rules : (a) Reference number and date of approval of the : plans for site whether for old or new building and for construction or extension and for construction or extension of factory by the Chief Inspector (b) Reference number and date of approval of the : arrangements, if any made for the disposal of trade waste and effluents and the name of the authority granting such approval 11. Amount of fee Rs. _______ (Rupees__________________________) (i) The proprietor of the factory in case of the private firm/proprietary concern : (ii) Directors in the case of a public limited liability Company/firm : paid in _____________ Treasury on __________ vide chalan No._________ Dated ___________ (Enclosed) Signature of Occupier Date; Signature of Manager Date:
