The Occupational Safety, Health and Working Conditions (Central) Rules, 2026
Form IV
Official text
Open in the official PDF (p. 250)
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[(See rule 3(11)]
Certificate of cancellation of Registration Certificate of Establishment
No. Date:
The Registration No…………………………………dated…………………… of …….……………………….. (Name of the establishment), of Factory/
Mine/Dock Work/ Contract Work/ Building or Other Construction Work/ Any other work (work carried on in the establishment) is hereby cancelled with
effect from …………………. under sub-section (5) of section 3 of the Occupational Safety, Health and Working Conditions Code, 2020 (37 of 2020).
Place: Signature/ E -Sign/DSC of Registering Officer
Date: along with designation