छत्तीसगढ़ शासन श्रम विभाग

Form I
(See Rule 4 and 8)
THE CHHATTISGARH.MOTOR TRASPORT WORKERS RULES 1962.
Application for Registration of the Undertaking and grant of Certificate of Registration
Under Motor Transport Workers Act 1961

1.Name of Motor Transport Undertaking

2.Full Postal address of Establishment

Name of Building *

Street *

Landmark *

Locality *

State *

जिले का नाम*

City Type शहरी/ग्रामीण

ग्रामीण

शहरी

विकासखण्ड/नगर निकाय विकासखण्ड/नगर निकाय

पंचायत

ग्राम/वार्डग्राम/वार्ड

PinCode *

Mobile No. * *

Email-Id *

Fax No

Landline No

3. Full address to which communications relating to the industrial premises should be sent
(Same As Above)

Name of Building *

Street *

Landmark *

Locality *

State *

जिले का नाम *

City Type शहरी/ग्रामीण

ग्रामीण

शहरी

विकासखण्ड/नगर निकाय रजिस्टर्ड प्रधान कार्यालय का विकासखण्ड/नगर निकाय

पंचायत

ग्राम/वार्ड रजिस्टर्ड प्रधान कार्यालय का ग्राम/वार्ड

PinCode *

Mobile No. * *

Email-Id *

Fax No

Landline No

4.Nature of motor transport services,e.g. city services,long distance passenger service,long distance freight service.

Motor Transport Service Type *

5.Details with distances in kilometers of routes operated in case of long distance passenger/freight service

Route Distance *

6.No of motor transport vehicles used

No Of Vehicle Used *

7.Maximum Number Of Motor Transport Workers Proposed to be employed on any one day during the year

Males *

Females *

Transgender *

Total

Fee

E-Chalan No. *

E-Chalan Link (Head-0230-101)

8.Full name and residential addresses of the propreitor and partners of the motor transport undertaking in case of a firm not registerd under the companies Act,1956

Whether Registered under The Companies Act 1956.

YES

DIRECTOR / PARTNER / PROPRIETOR DETAILS

Name *

Address *

I, Mr./Mrs./Ms. hereby declare that the above particulars furnished by me are to the best of any knowledge and belief accurate
I Agree
Kindly recheck the filled information before submitting the form / application, as you will not be able to change it later.

Form I (See Rule 4 and 8) THE CHHATTISGARH.MOTOR TRASPORT WORKERS RULES 1962. Application for Registration of the Undertaking and grant of Certificate of Registration Under Motor Transport Workers Act 1961