Application Form

To, 
The Labour Commissioner 
Govt. of NCT of Delhi
5 Sham Nath Marg 
Delhi
 
SUB: Application for Exemption from provisions of Shops & Establishment Act 1954

Sir,
The undersigned is Proprietor/ Partner/ Manager for establishment as per the following particulars.
1.    Name & Address of Establishment:    
 

2.    Name of the Proprietor / Partner / Manager     
3.    Registration No. under S&E Act:     
4.    Nature of Business:     
 
Retailer / Shop / Manufacturer / Corporate Office / Society / Place of Entertainment / Others i.e ______________

           
5.    
No. of employees:    Male:
     Female:
     Children:
 
6.    Working Hours:     
7.    Weekly off day:     
     
     Shift Timings
     No of persons in each shift
 
 
8.    Interval for rest _______ to ________, Interval for meals _______ to _______
 
It is requested that exemption may kindly be given under section 14 and / or section 15 and /or section 16 of the S&E Act 1954 in following respect till 31st March 2003.

      
9.    Extend /Change working hours from-         AM to         AM and         PM         to         PM
                                                   
10.    Allow opening of Establishment on: Weekly off / National Holiday.
11.    List of employees with designation who will work after the normal working hours and details of benefits
Which shall be given to them is attached. - Yes    No     
12.    A copy of intimation circular given to these employees to this effect with their signatures obtained on the
Circular is attached. - Yes    No     
Dated:                                                                         (Signature of Applicant)
 
Name & Designation:     
Seal of Establishment:     
 
UNDERTAKING
 
1.    Employer shall make suitable arrangement regarding safety, security and transportation of all the employees, who have been asked to work overtime.
2.    Overtime wages should be paid to eligible employees at double rate of wages and in accordance with the provision of Delhi Shops & Establishments Act, 1954.
3.    Employees working on National Holidays shall be given compensatory leave in lieu thereof and double rate of wages as overtime.
4.    Weekly off day will be allowed to employees in rotation.
5.    Shift working shall be by rotation so as to ensure that no employee is forced to work in night shift only.
6.    A copy of this order shall be displayed on the Notice Board by the Employer.
Dated:                                                                                            (Signature of Applicant)
Name & Designation:    
 

                                                                                                                Seal of Establishment:

Last Updated Date :- 05-12-2018

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