FORM C





See Rule 51



Form of authority in favour of legal practitioner or any official of a Registered Trade Union



I/We hereby authorise Shri/Shrimati/Kumari*….... a legal practitioner/an official of …………which is a registered Trade Union to a Pear and act on my/our behalf, under I sub-rule (3) of Rule 3/sub-rule (3) of Rule 4 in respect of the 1complaint/claim against (mention name of employer) on account of………… (Mention violation of the Act).

Signature(s)/thumb-impression(s) Of the worker(s)

Station……………….

Date…………………

Witness……………..

(1)

(2)

(3)

I accept the authorisation

1Legal practitioner

Official of a registered Trade Union

Station………..

Date………….

1. Strike out whichever is inapplicable.