The Occupational Safety, Health and Working Conditions (Bihar) Rules, 2026
Form XXIII
Official text
Open in the official PDF (pp. 401–402)
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[See Rule-64(4) & 64(5)]
Application for grant of licence for factory as specified in rule
1. Registration details:
a) LIN (if any)
b) Registration number
2. General Information:
a) Full name of the factory
b) Factory licence number (if licence issued earlier)
3. Address and contact information:
a) Full postal address the factory including-
district, subdivision, block, village/town,
police station, post, pincode mobile number/
telephone number, email id
b) Full address of factory along district, subdivision, block, village/town, police
station, post, pincode mobile number/telephone number email id (if different
from above)
4. Details of manufacturing processes:
a) Whether factory involves hazardous process
b) Whether factory involves dangerous operations
c) Date of commencement of manufacturing process
d) Manufacturing process to be carried on in the factory
during the next twelve months
e) Details of product(s) to be manufactured
5. Workers employed:
Others
Details of workers Male Female (transgender/ Total
adolescents)
1 2 3 4 5
Maximum number of workers proposed to be employed
during the year
Maximum number of workers employed during the last
twelve months on any day
Number of workers ordinarily employed in thefactory
6. Power installed:
a) Maximum amount of Power (H.P) (installed)
(attach sanction load and first electricity bill)
b) Maximum amount of Power (H.P) to be used
c) Total rated capacity ( kilowatt) of generator installed
d) Total rated capacity ( kilowatt) of generator to be used
e) Total rated capacity ( kilowatt) of transformer insalled
f) Total rated capacity ( kilowatt) of transformer insalled
g) Total capacity of transmission station ( kilowatt)
7. Particulars of Factory Manager:
Name and address of the person who shall be the Factory Manager
(if appointed) of the factory for the purposes of the code
Name
Residential address
Mobile No. & Email id
8. Particulars of Occupier:
a) Name and address of the occupier (in case of a private firm.)
Name
Residential address
Mobile No.
Email id
b) Name and address of the occupiers Attach list of partners with complete details,
(in case of partnership firm)
Name
Residential address
Mobile No.
Email id
c) In case of Private/Public Limited Company, the name and address of the Director
should be enclosed along with the list of Directors.
Name
Residential address
Mobile No.
Email id
d) Full name and residential address of the owner of dock
Name
Residential address
Mobile No.
Email id
e) Full name and residential address of the Managing Agent in case where a managing
agent is appointed by the Central Government/ State Government/ Local authority
as Occupier
Name
Residential address
Mobile No.
Email id
9. Land & Building:
a) Full name and address of the owner of the premises or building (including the
precincts thereof)
Name
Residential address
Mobile No.
Email id
b) Reference number and date of approval of the plans for site, whether for old or new
building and for construction or extension of factory by the State Government /
Chief Inspector
Date
10. Disposal of wastes and effluents:
* Name of the waste and approving authority
11. Fees Details:
12. Total amount of fees paid
NOTE :-
a) In case of any change in the above information, Department shall be informed in writing.
b) Seal bearing “authorized signatory“ shall not be used on any document.
Place:-
Date:-
Signature of Factory Manager:
Signature of occupier:
I the above named Occupier do hereby further solemnly affirm that the contents given above are true
to the best of my knowledge.
Place:
Date:
Signature of Occupier