The Rajasthan Occupational Safety, Health and Working Conditions Rules, 2026
Form 28
Official text
Open in the official PDF (p. 203)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
(see rule 77)
EXPERIENCE CERTIFICATE OF CONTRACT EMPLOYEE
To whom so ever concerned
1. Name of contractor/employer*:
2. LIN/PAN No. of the contractor/employer *:
3. Email Id of the contractor /employer *:
4. Mobile No. of the contractor/employer *:
5. Nature and location of work:
6. Name of Principal Employer*:
7. LIN/PAN No. of the Principal Employer :*
8. Email Id of the Principal Employer : *
9. Mobile No. of the Principal Employer :*
10. Name of the worker*:
11. UAN / Aadhaar No.:
12. Mobile No. :
13. Serial Number in the Employee Register :
14. Registration number, date and name of the Board if the building and other construction worker is
registered as a beneficiary:
15. Period of Employment:
16. Designation:
Seal and Signature of Contractor