Form I

(See rule 3)

(Memorandum of settlement arrived at during conciliation/ or settlement arrived at between the

employer and his workers otherwise than in the course of conciliation proceedings)

Names of Parties:

................................................................................ Representing employer(s);

..................................................................................... Representing workers;

Short recital of the case Terms of settlement Signature of the parties

Witnesses:

(1)

(2)

*Signature of Conciliation Officer

In case the settlement arrived at between the employer and his workers otherwise than in the course of

conciliation proceeding the copy of the memorandum shall be marked to the concerned Deputy Labour

Commissioner.