Form VI

Made under The Code on Wages, 2019F. No. 08/01/2024-LE&T, 15 Jun 2026

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Open in the official PDF (p. 24)

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[See rule4 5]

APPLICATION UNDER SUB-SECTION (4) OF SECTION 56 FOR COMPOSITION

OF OFFENCE

1. Name of applicant :

2. Father’s/ Spouse name :

3. Address of the applicant :

4. Particulars of the offence : ………………………………………………...

…………………………………………………………………………………………

5. Section of the Code under which the offence is committed:………………………

6. Maximum fine provided for the offence under the Code:…………………………….

7. Whether prosecution against the applicant is pending or

not……………………………

8. Whether theo ffence is first offence or the applicant had committed any other offence

prior to the offence. If yes, then, full details of the prior

offence.…………………………………………………………………………………………

…………………………………………………………………………………………………

……………………………………

9. Any other information which the applicant desires to

provide…………………………………………………………………………………………

…………………………………………………………………………………………………

……………………..

Dated:

Applicant (Name and signature)

Source: The Code on Wages (Lakshadweep) Rules, 2025, F. No. 08/01/2024-LE&T — Lakshadweep Gazette Extraordinary Vol. LXII, No. 20, p. 24 of the PDF. Open our copy at p. 24 · official download · all sources