Please provide the format of Form A for the return of the list of holidays

Dear All, please provide the format of Form A for the return of the list of holidays

You have to inform under what Act your establishment is covered, the format would depend on the Act applicable. However format of a general circular is as follows:
Holiday notice
Date: _______ (Dt. )
Holiday Notice
This is to notify all employees that our Factory/Plant/office/shop will remain closed from ___day____ (dd/mm/yyyy) to ____day_____ (dd/mm/yyyy) (or) On______day_____ (dd/mm/yy) on account of _____________ (reason for holiday).
After this holiday declared, our Factory/Plant/Office/shop will reopen for regular work at _______hours on ___ day_______(dd/mm/yy).
By order
HR Manager.
c.c.to: The Labour Inspector, Factories Act/ or other Competent Authorities.

under shops and establishment act