FORM I
[SEE RULE 3(L)]
APPLICATION FOR REGISTRATION OF ESTABLISHMENTS EMPLOYING MIGRANT WORKMEN

1. Name and location of the establishment.
2. Postal Address of the establishment.
3. Full name and address of the principal employer (furnish father’s/husband’s name in the case of individuals).
4. Names and addresses of the directors/particular partners (in case of companies and firms).
5. Full name and address of the Manager or person responsible for the supervision and control of the establishment.
6. Nature of work carried on in the establishment.
7. Particulars of contractors and migrant workmen.
(a) Names and addresses of contractors.
(b) Nature of work for which migrant workmen are to be recruited or are employed.
(c) Maximum number of migrant workmen to be employed on any day through each contractor.
(d) Establishment date and commencement of work under each contractor.
(e) Estimated date of termination of employment of migrant workmen under each contractor.
8. Particulars of crossed demand draft --------------(Name of the Bank, Amount, Number and Date)
I hereby declare that the particulars given above are true to the best of my knowledge and belief.
Principal Employer
Seal and Stamp Office of the Registering Officer
Date of receipt of application: