Form XXV

[See Rule 58]

(Complaint under Section 91 of the Industrial Relation Code, 2020)

Before the Conciliation officer/ Arbitrator/ Tribunal or, National Tribunal …………….,

In the matter of :................................... Reference No…………………………………….

A...................... Complainant(s);

Versus

B...................... Opposite Party(ies).

Address:

The petitioner(s) begs/beg to complain that the Opposite Party(ies) has/have been guilty

of a contravention of the provisions of section 90 of the Industrial Relation code, as

shown below:

(Here set out briefly the particulars showing the manner in which the alleged

contravention has taken place and the grounds on which the order or act of the

management is challenged.)The complainant(s) accordingly prays/pray that the

Conciliation officer/ Arbitrator/ Industrial Tribunal may be pleased to decide the

complaint set out above and pass such order or orders thereon as it may deem fit and

proper. The number of copies of .the complaint and its annexure required under rule 91 of

the Industrial Relation Code are submitted herewith.

Dated this............day of............20..... Signature of the Complainant(s)

Verification

I do solemnly declare that what is stated in paragraph.......... above is true to my

knowledge and that what is stated in paragraphs.................. above is stated upon

information received and believed by me to be true. This verification is signed by me

at......................... on ................................day of....................20.....................

Signature

or Thumb impression of the person verifying.

By Order of the Governor of Bihar,