Dear All,
Kindly find the form 4 for registration and renewals of liecence of employment.
1. (a) Full name of Factory :……………………………………………………….
(b) Factory licence under number if already registered before :……………………………………………………….
2. (a) Full postal address and situation of factory :……………………………………………………….
(b) Full postal address to which communications relating to :……………………………………………………….
factory should be sent
3. Nature of manufacturing process or processes :. ……………………………………………………...
(a) Carried on in the factory in the last twelve (months in the case : ………………………………………………………
of factories already in existences); and
(b) to be carried on in the factory during the next twelve months :……………………………………………………….
(in the case of all factories);
(c) whether it involves hazardous process as interpreted under :……………………………………………………….
Section 2 (cb) give details)
(d) whether it involve any dangerous operation, wholly or :……………………………………………………….
Partly, as declared under subrule (1) of the rule 107 under
Section 87 ( give details)
(e) whether any chemical substance as specified under second :……………………………………………………….
schedule of the Act is used, handled, stored or processed
there at
4. Names quantities and values of principal Name Qty. Value
manufactures during the last twelve months
(in the case of factories already in existence) 1.
2.
3.
5. (a) Maximum number of workers proposed to be employed on :……………………………………………………….
any one day during the year
(b) Maximum number of workers employed on any one day :……………………………………………………….
During the last twelve months (in the case of factories
already in existence).
(c) Number of worker to be ordinarily employed in the factory. :……………………………………………………….
6. Nature and total amount of power kilowatts/HP) :……………………………………………………….
(i) installed; or and
(ii) proposed to be installed in the year.
7. Full name and residential address of the person who shall be the :……………………………………………………….
manager of the factory for the purposes of the Act. ………………………………………………………..
8. Full name and residential address of the occupier, i.e. :……………………………………………………….
(a) the partner/ proprietor of the factory in case of a private :………………………………………………………
firm or proprietory concern
(b) the directors, in case of company or firm 1………………………………………………………
2……………………………………………………… 3………………………………………………………
4………………………………………………………
9. Full name and address of the owner of the premises or building :……………………………………………………….
(including the premises or building ( including the precincts there of ) ……………………………………………………….
referred to in Section 93. ………………………………………………………..
10. Reference number (s) and date of approval/ allotment of site :……………………………………………………….
Whether for old or new building and for construction or extension ……………………………………………………….
Of factory by the State Govt. ……………………………………………………….
11. Reference number and date of approval of the arrangements if :……………………………………………………….
Any, made for the disposal of trade waste and effluent and the :……………………………………………………….
Name authority granting such approval.
12. (a) Reference number ( s) and date (s) of approval of plans :……………………………………………………….
Under rule 3 of M.P. Factories Rules, 1962 by chief inspector
Of Factories, M.P.
(b) Description of the factory premises approved as above :……………………………………………………….
and which consist of
13. (a) Amount of fee paid :……………………………………………………….
(b) in Treasury -
(i) Name of treasury :……………………………………………………….
(ii) Date of payment; and :……………………………………………………….
(iii) Challan number: ( Original Challan be enclosed) :……………………………………………………….
Signature of Occupier :……………………………………………………….
Date : ……………………
Signature of manager : :……………………………………………………….
Date : ………………………
__________________________________________________ __________________________________________________
NOTES:- 1. This form should be completed in ink in block letters or typed and separate sheet may be attached for
detailed information.
2. If power is not used at the time of filling up this form, but is introduced later, the fact should be
communicated to the Chief Inspector of Factories immediately.
3. if any of the persons named against item 8 is minor, the fact should be clearly stated”.
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Kindly find the form 4 for registration and renewals of liecence of employment.
FORM 4
( Prescribed under Rule 6,7,9 & 10)
Application for registration and grant or renewal of licence for the year …………and notice of occupation in Section 6 & 7
( Prescribed under Rule 6,7,9 & 10)
Application for registration and grant or renewal of licence for the year …………and notice of occupation in Section 6 & 7
( To be submitted in triplicate)
( For renewal / Amendment / Transfer, Original licence shall be enclosed )
1. (a) Full name of Factory :……………………………………………………….
(b) Factory licence under number if already registered before :……………………………………………………….
2. (a) Full postal address and situation of factory :……………………………………………………….
(b) Full postal address to which communications relating to :……………………………………………………….
factory should be sent
3. Nature of manufacturing process or processes :. ……………………………………………………...
(a) Carried on in the factory in the last twelve (months in the case : ………………………………………………………
of factories already in existences); and
(b) to be carried on in the factory during the next twelve months :……………………………………………………….
(in the case of all factories);
(c) whether it involves hazardous process as interpreted under :……………………………………………………….
Section 2 (cb) give details)
(d) whether it involve any dangerous operation, wholly or :……………………………………………………….
Partly, as declared under subrule (1) of the rule 107 under
Section 87 ( give details)
(e) whether any chemical substance as specified under second :……………………………………………………….
schedule of the Act is used, handled, stored or processed
there at
4. Names quantities and values of principal Name Qty. Value
manufactures during the last twelve months
(in the case of factories already in existence) 1.
2.
3.
5. (a) Maximum number of workers proposed to be employed on :……………………………………………………….
any one day during the year
(b) Maximum number of workers employed on any one day :……………………………………………………….
During the last twelve months (in the case of factories
already in existence).
(c) Number of worker to be ordinarily employed in the factory. :……………………………………………………….
6. Nature and total amount of power kilowatts/HP) :……………………………………………………….
(i) installed; or and
(ii) proposed to be installed in the year.
7. Full name and residential address of the person who shall be the :……………………………………………………….
manager of the factory for the purposes of the Act. ………………………………………………………..
8. Full name and residential address of the occupier, i.e. :……………………………………………………….
(a) the partner/ proprietor of the factory in case of a private :………………………………………………………
firm or proprietory concern
(b) the directors, in case of company or firm 1………………………………………………………
2……………………………………………………… 3………………………………………………………
4………………………………………………………
9. Full name and address of the owner of the premises or building :……………………………………………………….
(including the premises or building ( including the precincts there of ) ……………………………………………………….
referred to in Section 93. ………………………………………………………..
10. Reference number (s) and date of approval/ allotment of site :……………………………………………………….
Whether for old or new building and for construction or extension ……………………………………………………….
Of factory by the State Govt. ……………………………………………………….
11. Reference number and date of approval of the arrangements if :……………………………………………………….
Any, made for the disposal of trade waste and effluent and the :……………………………………………………….
Name authority granting such approval.
12. (a) Reference number ( s) and date (s) of approval of plans :……………………………………………………….
Under rule 3 of M.P. Factories Rules, 1962 by chief inspector
Of Factories, M.P.
(b) Description of the factory premises approved as above :……………………………………………………….
and which consist of
13. (a) Amount of fee paid :……………………………………………………….
(b) in Treasury -
(i) Name of treasury :……………………………………………………….
(ii) Date of payment; and :……………………………………………………….
(iii) Challan number: ( Original Challan be enclosed) :……………………………………………………….
Signature of Occupier :……………………………………………………….
Date : ……………………
Signature of manager : :……………………………………………………….
Date : ………………………
__________________________________________________ __________________________________________________
NOTES:- 1. This form should be completed in ink in block letters or typed and separate sheet may be attached for
detailed information.
2. If power is not used at the time of filling up this form, but is introduced later, the fact should be
communicated to the Chief Inspector of Factories immediately.
3. if any of the persons named against item 8 is minor, the fact should be clearly stated”.
I hope it will be helpfull for you.Give feedback so that I may start posting such forms and documents usefull in HR practices.
Seniours plzzz Add your valuble suggestions