Form XXXI (B)

[See Rule 69(3)(b)]

Whereas an agreement to pay compensation is said to have been reached between . . . . . . . . . . . . . . .

and . . . . . . . . . . . . . .and whereas . . . . . . . . . . . . . . . . . has /have applied for registration of the agreement

under section 89 of the Code on Social Security, 2020 and whereas it appears to me that the said agreement

ought not to be registered for following reasons, namely . . . . . . . . . . . . . an opportunity will be afforded to the

said . . . . . . . . . . . . . . . . . . . . . of showing cause on . . . . . . . . . . . . . .20 . . . . . . by the said agreement should

not be registered.

Any representation which you have to make with regard to the said agreement should be made on that

date. If adequate cause is then shown the agreement may be registered.

Dated . . . . . . . . . . . . 20 . . . . . . .

Competent Authority