The Occupational Safety, Health and Working Conditions (Andhra Pradesh) Rules, 2026
Form XVII
Official text
Open in the official PDF (p. 472)
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[See Rule 53]
Application for transfer of Licence in case of death of Licensee
To,
The Licencing Authority
……………………………
……………………………
Sir/Madam,
Notice is hereby given that in accordance with the requirements of
Rule 60, that the Licensee Sri ________________________________ to
whom Licence No…………………………………………….was granted on _________,
has died on _____________. The Said Licence was valid from _______ to
_______.
Therefore, it is informed that I am the legal heir/legal representative
to the said deceased and I request to transfer the said licence in my name
and I undertake to state that I shall abide by the terms and conditions of the
licence and liabilities for the purpose which it was granted. The Death
Certificate and other relevant documents are furnished herewith for
necessary action.
Encls:
1.Death Certificate and Signature of the Applicant
2. Other relevant documents, Please Specify.