Application for Grant of Licence/Renewal of Licence/Amendment of Licence (including common/single licence)

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....on Number    Date Acknowledgement Number: .......................... Date of Application:............................ I. Particulars of Establishment for which licence required: 1. Name of Establishment: 2. Address of establishment (a) Head Office address along with email Id : (b) Corporate office address along with email Id: 3. Telephone Number : 4. A....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....be employed Name Address, email id of the Site Incharge 1 2   3 4 5 6   5. Maximum number of workmen proposed to be employed on the establishment on any date: 6. Amount of Licence Fee: INR       (Transaction Id :) 7. Amount of Security Deposit: INR        (Transaction Id :) IV. DETAILS OF ESTABLISHMENTS F....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....2 3 4 5 6   Signature of Contractor (e-Sign/DSC) Note: This is an online application summary applied on Shram Suvidha Portal or designated Portal. APPLICATION FOR RENEWAL OF LICENCE 1. Licence No.                    Date : 2. LIN & PAN 3. Name and address of the establ....