Form 50

(See rules 82, 96 and 149)

Common License For Factory / Beedi & Cigar Work / Engaging Contract Labour

Administration of Lakshadweep

Office of designated authority under section 119 of The Occupational

Safety, Health And Working conditions code 2020

License number : Date issue :

A license is granted to Shri………………….. (Name of Occupier) of establishment

M/S ………………………… registered under the section – 3 of the code having

registration number …………….. as below.

A. Torun as a factory in which manufacturing process……………….. shall be carried by

employing not more than………………… workers and power not more than

………………. KW for the purpose of the Occupational Safety, Health and Working

Conditions Code 2020 and rules made there under and whose plans are approved by

Chief inspector – cum-Facilitator vide number …………….. date.

This license will remain in force from ………………… till ………………….

Fee ………………………… Date of Deposit ……………………

B. Engagement of contract labour subject to the conditions annexed to this license as

given below.

Fee …………………………. Date of deposit ……………………….

Maximum number of employees and

1 workers to be employed as contractor

labour

Nature of activity for which contractor

2

labour shall be engaged

C. To use as a industrial premises to carry work of beedi or cigar by employing not more

than ………. Workers for the purpose of The Occupational Safety, Health and

Working Conditions Code 2020 and rules made there under and whose plans are

approved by chief Inspector-cum-Facilitator vide number …………………. Date

…………………..

This license will remain in force from …………….. till ………………………..

Fee ………………… date of deposit ………………………

Name and Dsc of designated authority /

Secretary labour (UT of Lakshadweep)