Form 05

Made under The Occupational Safety, Health and Working Conditions Code, 2020F. No. 08/04/2024-LE&T, 27 Apr 2026

Official text

Open in the official PDF (p. 230)

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[See rule 6 (5)]

Details of inter-state migrants employed/to be employed in an establishment

1. Name of establishment:

2. Address of establishment:

3. Name and address of employer:

4. Details of inter-state migrant workers

Sl. Name Father/Husband Permanent Address Aadhaar Mobile

No Name

Town/ District

Village

Page 231 of 273

Signature of the Employer

Source: The Occupational Safety, Health and Working Conditions (Lakshadweep) Rules, 2025, F. No. 08/04/2024-LE&T — Lakshadweep Gazette Extraordinary Vol. LXII, No. 07, p. 230 of the PDF. Open our copy at p. 230 · official download · all sources