Department of Labour and Employment FORM - 3A (Prescribed under Rule 12) Notice of change of Manager 1. Full name of the factory with current license number : 2. Full Postal address : 3. Name of the outgoing Manager : 4. Full name of the new manager with his residential address and telephone number, if installed : 5. Date of appointment of the new : manager Place: Signature of the new Manager Date: Signature of the Occupier