The Social Security (Central) Rules, 2026
Form XV
Official text
Open in the official PDF (pp. 223–224)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
[See rule 41(1)(a) and (b)]
Information for commencement or modification in respect of building or other construction
work by the employer
1. Name and address (permanent) of the establishment.
2. Name of the employer and address details
3. Name and address/ location of place where the building
or other construction is proposed to be carried on.
4. Name, designation and address of the authorised Person
along with contact details
5. Correspondence address for the proposed building or
other construction work
6. Nature of proposed construction work
7. Date of commencement of work(in case construction
has started)
8. Approximate duration of work
9. Details of any change /modifications in the proposed
construction work
Declaration
I/we hereby intimate that the building or other construction work (name of work) having
registration number ………………. dated ………………. is likely to commence or is likely to modify
with effect from (date)/ [on (date)].
Signature and Seal of
employer
Name:
Date:
Place:
Mobile Number:
E-mail (if any):