Contents of the OSH Rules (Andhra Pradesh)

The Occupational Safety, Health and Working Conditions (Andhra Pradesh) Rules, 2026

Form XII (C)

Made under The Occupational Safety, Health and Working Conditions Code, 2020G.O.Rt. No. 146, 6 Aug 2026

Official text

Open in the official PDF (p. 460)

Tables and forms lose their layout when extracted; the PDF is the authoritative version.

[See rule 141(2)]

APPLICATION FOR COMPOSITION OF OFFENCE

1. Name of applicant :

2. Father’s / Spouse name :

3. Address of the applicant :

4. Name of establishment:

5.Particulars of the offence: …………………………………………………….

6. Section of the Code under which the offence is committed: …………………

7.Maximum fine provided for the offence under the Code :…………………..

8.Whether prosecution against the applicant is pending or not: ……………….

9. Whether the offence is a first offence or whether the applicant has

committed any other offence prior to the offence. If yes, then, full details of

such prior offence: …………………...

10. Any other information which the applicant desires to provide:

………………..…………..

Applicant

(Name and signature)

Dated:

Source: The Occupational Safety, Health and Working Conditions (Andhra Pradesh) Rules, 2026, G.O.Rt. No. 146 — Andhra Pradesh Gazette Extraordinary (as ordered by G.O.Rt. No. 146), p. 460 of the PDF. Open our copy at p. 460 · official download · all sources

Text from the Government Order that orders the notification's publication in the Andhra Pradesh Gazette; the Gazette issue itself was not found on the AP e-Gazette.