FORM A





[See Rule 16 (1)]



Year…………

Name and address of employer………………………… Place of work………………….

........................................ Nature of work being done by the establishment……………..

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

Sl.No.



1.Name of child

2.Father’s Name

3.Date of Birth

4.Permanent Address

5.Date of joining the establishment

6.Nature of work on which employed

7.Daily hours of work

8.Intervals of rest

9.Wagers paid

10.Remarks