Form IV

(See rule 10(2))

Affidavit for Registration

I, ………………………………………S/o, D/o, W/o Shri / Smt.

………………………………………….... Address ………………………………………….

Occupation ………...…………………. Age ……………………. Years …………… truly

declare in writing that on this date……….…...... in this region / jurisdiction ………… for the

Union under the chairmanship of ….…………………. in which (Name of the Union) has

been registered under the Industrial Relations Code 2020. The name and the registration

details is as follows:

Title in the

S.N. Name Age Occupation Address

Union

The above-mentioned registrants and their deputation still stand valid and are still

valid members of the Union. On this date the executive committee was elected in the general

body election dated …… The above-mentioned persons have filed the application regarding

registration. According to my information, the applicant has been included in the list of

members, attached membership list is true. I swear and believe that the above statement is

true to my information and knowledge.

Signature of the Applicant