Form XIV

(See rules 32, 33, 35,37 and 47)

(APPLICATION FOR PERMISSION OF LAY-OFF/ CONTINUATION OF LAY-OFF/

RETRENCHMENT/CLOSURE TO BE GIVEN BY AN EMPLOYER / INDUSTRIAL

ESTABLISHMENT /UNDERTAKING TO THE STATE GOVERNMENT UNDER THE

PROVISIONS OF CHAPTER X OF THE INDUSTRIAL RELATIONSCODE, 2020 AND RULES

MADE THEREUNDER)

(To be submitted online. In case of exigencies on paper in the specified format below)

Name of Industrial Establishment or Undertaking or Employer...........................

Labour Identification Number.............................................................................

Dated.................

(Note: The application to the State Government shall be served as indicated below:

Lay-off : at least 15 days before the intended Lay-off

Continuation of Lay-off – at least 15 days before the expiry of earlier Lay-off

Retrenchment – at least 60 days before the intended date of retrenchment

Closure – at least 90 days before the intended date of closure)

To,

The Principal Secretary, Labour, Factories, Boilers and Insurance Medical Services

Department, Government of Andhra Pradesh, AP Secretariat, VELAGAPUDI,

Guntur Dt.

1. *(Lay-off) (a). Under section 78(2) of the Industrial Relations Code, 2020 (35 of 2020),

I*/we* hereby apply for “permission to lay-off ……….workers** out of total of ……..

workers** employed in my*/our* establishment

(details to be given in Annexure-I) with effect from ……….. (DD/MM/YYYY).

or

*(Continuation of lay-off) (b) Under section 78(3) of the Industrial Relations Code, 2020 (35

of 2020), I*/we*hereby apply for permission to continue the Lay-off .........workers** out of

total of …….. laid off workers** in my*/our* establishment (details to be given in

Annexure-I) with effect from ……….. (DD/MM/YYYY).

or

*(Retrenchment) (c) Under section 79(2) of the Industrial Relations Code, 2020 (35 of

2020), I*/we* hereby apply for permission for intended retrenchment of.................

workers out of total of …….. workers** employed in my*/our* establishment (details to be

given in Annexure-I) with effect from ……….. (DD/MM/YYYY).

or

*(Closure) (d) Under section 80(1) of the Industrial Relations Code, 2020 (35 of 2020), I /

we* hereby inform you that I*/we* intended to close down the

undertaking........................................ (name of the industrial establishment or

undertaking or employer) (details to be given in Annexure-I) with effect

from.............(DD/MM/YYYY). The number of workers whose services would be terminated

on account of the closure of the under taking is................. (number of workers)

* (Lay-off/Continuation of Lay-off) The worker(s) concerned were given on ..................

(DD/MM/YYYY) notice in writing as required under section 78(2)*/ section 78(3)* of the

Industrial Relations Code, 2020 (35 of 2020).

or

*(Retrenchment/ Closure) The worker(s) concerned were given on……... (DD/MM/YYYY)

three month‘s notice in writing as required under section 79*/ section 80* of the

Industrial Relations Code, 2020 (35 of 2020).

or

*(Retrenchment/ Closure) The worker(s) have been given on……... (DD/MM/YYYY) three

month‘s pay in lieu of notice as required under section 79*/ section 80* of the Industrial

Relations Code, 2020 (35 of 2020).

2. The details of affected worker(s) is at Annexure II.

3. (Retrenchment) I*/we* hereby declare that the workers concerned will be retrenched in

compliance to the Section71 and section 72 of the Industrial Relations Code, 2020 (35 of

2020).

4. *I/We* hereby declare that the worker(s) concerned have been*/will be* paid all the

dues and compensation due to them under section 67, read with section 78(10)*/ section

79* / section 80* of the Industrial Relations Code,2020 (35 of 2020) before or on the

expiry of the notice period.

or

*I/We hereby state that currently Insolvency proceedings are on in respect of the said

Industrial Establishment/Undertaking/Employer, and that I*/we* will pay all the dues

along with the compensation due to them under concerned laws.

5. I/ we* hereby declare that no court case is pending before any Court in the matter, and

if yes, the details there of have been annexed herewith.

6. I/ we hereby declare that the above information given by me/ us* in this notice and

enclosures is/ are* true, I/ we am/ are solely responsible for its accuracy and no facts/

materials has been suppressed in the matter.

The permission sought for may please be granted.

Yours faithfully,

(Name of Employer/ ***Authorised Representative with Seal)

(* Strike off which is not applicable.)

(** Indicate number in figures and word both)

(***Copy of authorisation letter issued by the employer shall be enclosed)

Copies to

1) The Assistant Commissioner of Labour of the area

2) The Deputy Commissioner of Labour concerned

3) The Joint Commissioner of Labour concerned

4) The Commissioner of Labour, Andhra Pradesh, Vijayawada