Form XVIII

(see rule 49, 51 and 53)

Application for permission of Lay-off/ Continuation of Lay-off/ Retrenchment/

Closure to be given by an employer / Industrial establishment /Undertaking to

the State Government under the provisions of Chapter X of the Industrial

Relations Code, 2020 and rules made there under

(Tobesubmittedonline.Incaseofexigenciesonpaperintheprescribedformatbelow)

Name of Industrial Establishment or Undertaking orEmployer.....................................

Labour IdentificationNumber.........................................................................................

Dated.................

( Note: The application to the State Government shall be served as indicated below: Lay-

off : at least 15 days before the intended Lay-off

Continuation of Lay-off – at least 15 days before the expiry of earlier Lay-off

Retrenchment – at least 60 days before the intended date of Retrenchment Closure – at

least 90 days before the intended date of Closure)

To,

The Secretary to the Government of Rajasthan, Labour Department,

Jaipur

1. *(Lay-off) (a). under section 78(2) of the Industrial Relations Code, 2020, I*/we*hereby

apply for

―permissiontolay-off……….workers**outoftotalof……..workers**employedinmy*/our*

establishment (details to be given in Annex-I) witheffectfrom

…………..(DD/MM/YYYY).

or

*(Continuationoflay-

off)(b)Undersection78(3)oftheIndustrialRelationsCode,2020,I*/we*herebyapply for

permission to continue the Lay-off .........workers** out oftotalof...................laid off

workers** inmy*/our* establishment (details to be given in Annex-I) witheffectfrom

………….(DD/MM/YYYY).

or

*(Retrenchment) (c) Under section 79(2) of the Industrial Relations Code, 2020, I*/we*

hereby apply for permission for intended retrenchment of................. workers out of total

of …….. workers** employed in my*/our* establishment (details to be given in Annex-I)

witheffectfrom…………….(DD/MM/YYYY).

or

*(Closure) (d) Under section 80(1) of the Industrial Relations Code, 2020, I / we* hereby

inform you that I*/we* intended to close down the undertaking........................................

(name of the industrial establishment or undertaking or employer) (details to be given in

Annexure-1) with effect from.............

(DD/MM/YYYY). The number of workers whose services would be terminated on

account of the closure of theundertakingis (number ofworkers)

2......................................................................................................................................................................*

(Lay-off/Continuation of Lay-off) The worker(s) concerned

weregivenon……………..(DD/MM/YYYY) notice in writing as required under section 78(2)*/

section 78(3)* of this Code.

or

*(Retrenchment/ Closure) The worker(s) concerned were given on……...

(DD/MM/YYYY) one month‘s notice in writing as required under section 79*/ section

80* of this Code.

or

*(Retrenchment/ Closure) The worker(s) have beengivenon (DD/MM/YYYY) one

month‘s pay inlieu of notice as required under section 79*/ section 80* of this Code.

3. The details of affected worker(s) is at Annexure-II.

4. (Retrenchment) I*/we* hereby declare that the workers concerned will be retrenched in

compliance to the Section 71 and section 72 of thisCode.

5. *I/We* hereby declare that the worker(s) concerned have been*/will be* paid all the dues and

compensation due to them under section 67, read with section 78(10)*/ section 79* / section 80*

of this Code before or on the expiry of the noticeperiod.

or

*I/We hereby state that currently Insolvency proceedings are on in respect of the said

Industrial Establishment/Undertaking/Employer, and that I*/we* will pay all the dues

along with the compensation due to them under concernedlaws.

6. I/ we* hereby declare that no court case is pending before any Court in the matter, and if yes,

the details thereof have beenAnnexed.

7. I/ we hereby declare that the above information given by me/ us* in this notice and enclosures

is/ are* true, I/ we am/ are solely responsible for its accuracy and no facts/ materials has been

suppressed in thematter.

The permission sought for may please be granted.

(* Strike off which is not applicable.)

(** Indicate number in figures and wordboth)

(***Copy of Authorization letter issued by the employer shall be enclosed)

Yours faithfully,

(Name of Employer / ***Authorised Representative with Seal)