छत्तीसगढ़ शासन श्रम विभाग

आवेदन का निराकरण 45 दिवस के भीतर नहीं होने की स्थिति में स्वमेव(डीम्ड) पंजीयन जारी करने संबंधी प्रावधान है|

APPLICATION FOR REGISTRATION BY PRINCIPAL EMPLOYER UNDER INTER STATE MIGRANT WORKMEN ACT 1979

FORM-II
[See Rule 4(1)]

Category of Establishment*

* (See Section 2(1)(g)(ii) & 2(1)(g)(iv))

Information of Principal Employer

Full Name*

Father's Name*

Dateof Birth *

Designation *

Postal Address*

Age*

State *

Rural/Urban*

Pin Code*

* *

Dist*

Block Name*

Adhar Number*

PAN

* *

Mobile Number*

* *

Email ID*

Full Name*

Father's Name*

State

Designation*

Postal Address*

Dist*

Rural/Urban*

Pin Code*

* *

PAN*

* *

Block Name*

Adhar Number *

E-Mail ID*

Mobile Number*

* *

Nature of Work*

Number of Worker Directly Employed

Name*

Address*

Nature of Work*

No. of Workmen*

* *

Date of Commencement of Work*

Estimated Date of End Work*

Work Order No.*

Work Order Date*

Tresury Receipt Description

Fees*

* *

E-Chalan Link
(Head-0230 Labour & Establishment Subhead-106 Receipts Under Inter State Migrant Workmen ACT 1979)

E-Chalan No.*

Help for e-challan

Enclosed Document

Firm/Memorandum of Association/Partnership Deed*

* * *

Create New User

User Name*

Mobile No.*

* *

E-Mail ID*

Password*

Telephon No.

I hereby declare that the particulars given and document uploaded here in above are true to the best of my knowledge and belief

S.No.	No. of Labour	Fees
1	Below 20	60.00
2	Above 20 and Below 50	100.00
3	Above 50 Below 100	200.00
4	Above 100 Below 200	400.00
5	Above 200 Below 400	800.00
6	Above 400	1500.00