Form XIX

Made under The Occupational Safety, Health and Working Conditions Code, 2020Notification No. 101, 30 Jun 2026

Official text

Open in the official PDF (p. 399)

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(See Rule No.-62)

(Application for Permission to work outside the Industrial Premises)

1. Registration no of Establishment-

2. Licence number -

3. Full name & address of Industrial Premises -

4. Name & address of Employer/Contractor -

5. Maximum number of worker employed any day in Establishment in last 12 Month. -

6. Maximum number of workers for which employer's wants permission for work outside the

industrial premises.

Signature of Applicant

Source: The Occupational Safety, Health and Working Conditions (Bihar) Rules, 2026, Notification No. 101 — Bihar Gazette Extraordinary No. 699, 1 July 2026, p. 399 of the PDF. Open our copy at p. 399 · official download · all sources