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Form No.4

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(PRESCRIBED UNDER RULE 5)

LICENCE TO WORK A FACTORY

Licence No............................... Reg. No............................... Date of Reg........................... Licence is hereby granted to..................................................... for premises known as .................................................. situated at.............................................. for use as a factory within the limits stated hereinafter, subject to provisions of the Factory's Act, 1948, and the rules made there under :-

 

The.................. 2O

Issuing Authority

 

Valid for

Calendar
Year

Maximum number of workers on any day

Maximum installed power capacity in

Fee

Date of payment

Excess fee of late payment

Date of payment

signature of the Issuing Authority

Granted
under 
rule 5

             

Renewed
under 
rule 7

             


TRANSFERS

To whom transferred Year of transfer Date of payment transfer fee signature of Issuing Authority
       
       
       
       


AMENDMENTS

Year When amended Workers Installed power capacity in H.P date of payment of amendment fee Additional fee Date of fee Signature of the issuing Authority
             
             
             
           
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