The Code on Social Security (Lakshadweep) Rules, 2025
Form III
Official text
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[See Rule 17 (1) (iv)]
Employee's Insurance Court at Register of proceedings in the year 20…..
1 Date of presentation of application
2 No of proceedings
3 Name Applicant
4 Description
5 Place of residence
6 Particulars opposite party
7 Amount of value, if any
8 Place of residence Claim
9 Particulars
10 Amount or value, if any
11 When the cause of action accrued
12 Day of parties to appear appearances
13 Applicant
14 Opposite-party
15 Date final
16 For whom
17 Order
18 Date of Decision of appeal, if any appeal
19 Judgment in appeal,
20 Date of application executive
21 against whom
22 For what, and amount of money
23 Amount of costs
24 Date of order transferring to another
civil court
25 Other remarks, if any