Here is a copy of Form 4 A per Uttar Pradesh Factories Rules, 1950.
[Form No. 4-A]
Notice of Change of Manager
Rule 14- D
Name of the factory with current Licence number ………
Postal address of the factory …………
Name of the outgoing manager ……………..
Name of the new manager with his postal residential address and telephone number, if any …………………..
Date from which new manager took over charge ………
Date ………….. Signature of new Manager ……………
Place ………….. Signature of the Occupier …………….