Schedule I

Declaration by way of Affidavit

I, __________________ s/o Sh._________________ Age ________ yrs.

r/o__________________________________ do hereby solemnly affirm and declare as

under:-

1. That I am the elected General Secretary of "……………..(Name of

Union)"………………………………..(Address of Union.)

2. That to the best of my knowledge and belief no Union / Association by the name of

“_________________________ (Name of Union)” is registered under the Industrial

Relations Code, 2020 in Rajasthan or anywhere in India.

3. That in case of any legitimate claimant of union's name, we will surrender the

certificate and change name of the union as per directions of the Registrar Trade

Unions, Rajasthan.

4. That no member or office bearer has ever been convicted by Court of India for any

offence involving moral turpitude and sentenced to imprisonment.

5. That all particulars supplied as per Form-III as well as other documents are true.

6. That the scope of the Union shall be for the employees of ------------- (Name of

Establishment).

7. That neither the applicants nor the office bearer and I are the member of any other

union functioning in ________________ (Name of Establishment)

8. That there are approximate __________ workers working in ______________ (Name

of Establishment) and out of which_________________ workers are members of our

union.

9. That this is my true statement.

Deponent

Verification

Verified at ________________ on__________________ that the contents of the paras 1

to 9 of my above declaration by affidavit are true and correct to the best of my knowledge

and belief. No part of it is false and nothing material has been concealed therefrom.

Deponent