Form VI

Made under The Code on Wages, 2019No. LAB(W)WC/47/2019, 19 Jan 2022

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[See rule 53(1)]

Application Under Sub-Section (4) of Section 56 for Composition of Offence

1. Name of applicant:

2. Father’s / Spouse name:

3. Address of the applicant:

4. Particulars of the offence: ...................................................................................................................

………………………………………………………………………………................………………………

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

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

7. Whether prosecution against the applicant is pending or not ………………………………..........…...

8. Whether the offence is first offence or the applicant had committed any other offence prior to the

offence.

If yes, then, full details of the prior offence.

………………………………………………………………………………................………………………

9. Any other information which the applicant desires to provide

………………………………………………………………………………................………………………

Dated: Applicant

(Name and signature)

Source: The Code on Wages (Arunachal Pradesh) Rules, 2022, No. LAB(W)WC/47/2019 — Arunachal Pradesh Gazette Extraordinary No. 35, Vol. XXIX, 24 February 2022, p. 14 of the PDF. Open our copy at p. 14 · official download · all sources