Form 2

(see rule 5(1)(d))

Certificate of Registration of Establishment

Registration No. Date

A Certificate of registration containing the following particulars is hereby granted under sub-

section (2) of section 3 of the Occupational Safety, Health and Working Conditions Code, 2020

(Central Act No 37 of 2020) to…………………………………….. (Name of the establishment)

1. Nature of work carried on in the establishment (Please tick mark)

(a) Factory (b) Mining

(c) Dock work (d) Contract Work

(e) Building and Other Construction Works (f) Any other work (not covered above)

2. Details of the establishment:

a. Total Number of employees engaged directly in the establishment:

b. Total Number of the employees engaged through contractor:

‍611

c. Total Number of Contractors and their details:

d. Number of inter-state migrant workers engaged:

3. (a) For factories

Details of the Full postal address and Name and address of Maximum number

manufacturing situation of the factory the occupier and of workers to be

along with plan approval employed on

process manager

details any day

1 2 3 4

3. (b) For mines

Name of Lease extent of the Name and address Average Monthly Maximum

Mineral(s) mine (in Acres) of the owner output, targeted number of

(Tonne) persons to be

employed on any

day

1 2 3 4 5

3. (c) For Dock work

Name of Dock Types of Dock Name of the Cargo Name of the Name of the

Work / Major Works handled and chemicals handled hazardous

Port stored along with and stored along chemicals

quantity with quantity handled and

stored along

with quantity

1 2 3 4 5

3. (d) For building and other construction work

Type of Details of

Probable period of Expected period for

Construction approval of the

commencement of work completion of work

work local authority

1 2 3 4

4. Amount of registration fee paid:

5. Remarks of registering officers:

Signature E -Sign/DSC of Registering Officer along with designation

Place:

Date:

Conditions of Registration

(1) Every certificate of registration issued under rule 4 shall be subject to the following conditions,

namely:

(a) the certificate of registration shall be non-transferable;

(b) the number of workers employed in an establishment directly and contract employees shall

not, on any day, exceed the maximum number specified in the certificate of registration; and

(c) Save as provided in these rules, the fees paid for the grant of registration certificate shall be

nonrefundable.

(2) The employer shall intimate the change, if any, in the number of workers or the conditions of

work to the registering officer within 30 days

(3) The employer shall, within thirty days of the commencement and completion of any work,

intimate to the Inspector-cum-Facilitator , having jurisdiction in the area where the proposed

establishment or as the case may be work is to be executed, intimating the actual date of the

commencement or, as the case may be, completion of establishment such work in Form-4

annexed to these rules electronically.

(4) A copy of the certificate of registration shall be displayed at the conspicuous places at the

premises where the work is being carried on.