FORM F
REPRESENTATION OF PARTIES
(Rule 36)

Before ________________ (Mention the authority concerned)
Ref. No ______________ of ___________________ Workmen
Versus
__________________ Employer
In the matter of ___________________ I/we hereby authorise Shri/Sarvashree _________ to represent me/us in the above matter.
Dated this ____________ day of ________________ 19 _____________
Signature of person (s) nominating the representative (s)
Address ________________
Accepted.
Signature of representative (s) __________________________________
Address __________________________________________________