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JS Mahal Form XII - CLR

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0% found this document useful (0 votes)
28 views2 pages

JS Mahal Form XII - CLR

Uploaded by

sakubar sathick
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FORM XII

[Under rule 17(1A) of the Tamil Nadu Contract Labour (Regulation and Abolition) Rules, 1975]

APPLICATION FOR REGISTRATION OF ESTABLISHMENTS EMPLOYING CONTRACT LABOUR

Details of Establishment

Construction of Marriage Hall Building (G+1)


at RS No: 77/1C, 71/6, 81/3, 81/4,
1 Name and address of the establishment/site Viraganoor Village, Madurai – 625 009.

Mr.J. Vivek, s/o C. Jegadeesan


2 Postal address of the establishment No: 639, K.K nagar, Madurai – 625 020.

Permanent Account Number (PAN)/ Goods and


3 Services Tax Identification Number (GSTIN) /Labour AKDPV8878L
Identification Number (LIN)

Mr.J. Vivek, s/o C. Jegadeesan


Full name and address of the Principal No: 639, K.K nagar, Madurai – 625 020.
4
Employer/Employer

Full name and address of the Manager or person


5 responsible for supervision and control of the Nambi Rajan.R
establishment / construction work Manager

Nature of work or building or the other construction


6 work carried on in the establishment / site Construction of Commercial Building /
Number of floors G+1 Terrace floors.

Maximum number Contract Labour to be employed in Thirty workers


7
the establishment on any day

Estimated date of commencement of building or


8 16/07/2024
other construction work

Estimated date of completion of building or other


9 31/12/2025
construction work
Details of contractors

Prasanna Engineering Contractor


k. prasanna S/O K. kuppusamy
1 NAME AND ADDRESS No:2/119,Northstreet,
Thanichiyam,Vadipatti,
Madurai - 625221

2 PAN/GSTIN/ LIN NUMBER 33BAXPP725B1ZF

3 MOBILE NO
+91 98944 90408

4 E MAIL ID [email protected]

5 NATURE OF WORK Construction of Commercial Building/


G+1 Terrace floors.
MAXIMUM NUMBER OF WORKMEN TO BE
6 Thirty workers
EMPLOYED ON ANY DAY

7 ESTIMATED DATE OF COMMENCEMENT OF WORK


16/07/2024

8 ESTIMATED DATE OF COMPLETION OF WORK


31/12/2025

10. Amount of registration fee:

Signature of the Principal Employer /Employee

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