The Occupational Safety, Health and Working Conditions (Andhra Pradesh) Rules, 2026
Form XII (D)
Official text
Open in the official PDF (p. 463)
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PART – IV
[See rule 141(4)]
Composition Certificate
Ref: Notice No………….. Date:
This is to certify that the offence under sub-section ….. of section 114 in
respect of which Notice No……..Dated: _____ was issued to Sh/Smt. ………….
(Applicant), the employer of ……………. (name and registration number of the
establishment) has been compounded on upon receipt of the full amount of
Rs ……….. (Rupees _________________) towards compounding of the
offence, to the satisfaction of the requirements of the said notice.
(Signature)
Name and Designation of the Officer
Date:
Place:
To:
………………..(Employer/Establishment)
…………………(Name and registration number)
………………….(Address)