FORM NO. 2

(Prescribed under rules 4, 6, 7 and 8)

Application for Registration and grant of/renewal of licence for the year and notice of occupation (to be submitted in duplicate )

1. Period of License

Choose Application type *

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Fresh Registration

Renewal of Licence

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Year(s) for which license is applied for

Renewal From *

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Registration From *

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To *

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Factory Details

2. General Information

(a) Full name of the factory *

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(b) Factory Registration number (if already registered)

3. Address and contact information

District (Where Factory is Located) *

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(a) Full postal address along with Pincode *

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Mobile No. *

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HIDE LABEL

If communication Address is same as above

(b) Full postal address along with pin code for communications (if differ from above) *

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4. Nature of manufacturing processes

(a) Date of start of production (for registration)

(b) Manufacturing process carried on in the factory in the last twelve months

(c) Manufacturing process to be carried on in the factory during the next twelve months

Details of product (s) manufactured during the last twelve months

5. Workers employed

(a) Maximum number of workers proposed to be employed during the year

Male *

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Female *

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Total *

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(b) Maximum number of workers employed during the last twelve months on any day

Male *

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Female *

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Total *

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(c) Number of workers ordinarily employed in the factory

Male *

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Female *

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Total *

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6. Power installed

(a) Total rated horse power (installed or to be installed) *

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(b) Maximum amount of Power (H.P.) proposed to be used *

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Choose Type of Factory *

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Power generating stations

Electrical substations

Other Factory

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Amount (₹)

Late Fee (25% of the original or 500 whichever is maximum)

Total Treasury Challan Value (₹)

7. Particulars of Factory Manager

Name and address of the person who shall be the Factory Manager (if appointed) of the factory for the purposes of the Act

Name

Residential Address

Mobile Number

Signature of Factory Manager

8. Particulars of Occupier

(a) Name and address of the occupier (in case of a private firm.) Attach list of partners with complete details, (in case of partnership firm)

Full Name *

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Residential Address

Mobile Number

Signature of Occupier

(b) Name and address of the Director (In case of a private / public limited company.) (attach list of director with details)

Full Name

Residential Address

Mobile Number

(c) Full name and residential address of the Managing Agent in case where a managing agent is appointed by the Government/ State Government/ Local authority as Occupier

Full Name

Residential Address

Mobile Number

9. Land and Building

(a) Full name and address of the owner of the premises or building (including the precincts thereof) (referred to in section 93 of the Act)

Full Name

Residential Address

Mobile Number

(b) Reference number and date of approval of the plans for site, whether for old or new building and for construction or extension of factory by the State Government/ Chief Inspector

10. Disposal of wastes and effluents

Reference number and date of approval of the arrangements, if any made for disposal of trade waste and effluents and the name of the authority granting such approval.

Verification

I the above named Occupier do hereby further solemnly affirm that the contents given above are true to the best of my knowledge.

I Agree *

Notes :

If power is not used at the time of filling up this form but is introduce latter, the fact should be communicated to the Chief Inspector of Factories immediately
If any of the persons named against item 8 is minor the fact should be clearly stated
In the case of a factory, where under the provision to sub-section (1) and (2) of Section 100, as person has been nominated as the occupier, information required in item 8 should be supplier only in respect of that person.
In the case of a factory here a managing Agent of Agents have been appointed as occupier under the Indian Companies Act, 1933 (VII of 1922) information required in item should be supplied only respect of that person of persons.