Form 45

{see sub-rule (1) of Rule 116, sub-rule (2) of rule 117, sub-rule (2) of rule 118 and sub rule (2) of rule 148}

Notice of occupation for Registration and grant or Renewal/ amendment of Licence

LICENCE NUMBER………………

Full name of the factory and its licence number, if already registered:

1. Postal address and situation of the factory including the police station, tehsil and district with PIN

code:

2. Address to which communication Relating to the factory should be sent:

3. Contact Number of Factory:

4. Email Address of Factory:

5. Nature of manufacturing process/ processes-

(a) carried on in the factory during the next twelve months (in case of factories already in

existence).

(b) to be carried o in the factory during the next twelve months (in case of all factories).

(c) Details of National Industrial Classification-2008 (NIC) code.

(i)sub-class( 6 digit)-

(ii)description as per NIC-

6. Names and values of the principal products manufactured during the last twelve months.

7. Man power:

(a) Maximum number of workers proposed to be employed on any one day during the year.

(b) Maximum number of workers employed in any day during the last twelve months

(c) Number of workers to be employed in the Factory.

8. Power to be used:

(a) Nature and total amount of power (kW.) installed or proposed to be installed

(b) Maximum amount of power (kW) proposed to be used:

NOTE.—If power is not proposed to be used originally but is introduced later, the fact

should be immediately communicated to the Chief Inspector-cum-Facilitator.

9. In the case of a factory constructed or extended after the date of the commencement of the rule:

(a) Reference number and date of approval of the plans for site, whether for old or new

building and for construction or extension of factory, by the State Government/ Chief

Inspector-cum-facilitator.

(b) Reference number and date of approval of the arrangements, if any, made for the

disposal of trade waste and effluents and the name of the authority granting such approval.

10. Full name, father's name and residential address of-

(a) The person who shall be Manager of the factory for the purposes of the code:

(b) The occupier of the factory:

11. If the factory is covered by the provisions of Section 80 of the Code, full name, father's name, and

address of the owner of the premises or buildings in which the factory is situated.

12. Half Yearly(if applicable)& Annual return submitted (Yes / No).

13. Date on which the Manager assumed charge

14. Date on which the occupier occupied the premises or will occupy the premises.

15. Detail of fee:

(Amount of fee in Rupees paid through Bank / E-Challan /Electronically, reference number and

date).

16. Last annual return submission date-

17. Validity of No objection certificate for premises from U.P. Fire control services-

Amendments in Licence

Year when Valid Maximum Total amount of Manufacturing Name of Updation in Details of

amended for number of power installed process occupier/ address of Amendment

workers on ( KW) employer premises in Licence

any one day

1 2 3 4 5 6 7 8

I/We certify that information given by me/us is true and correct to the best of my/our knowledge.

Full signature of occupier………………..

Full signature of manager………………..

Full signature of owner, if any…………..

Date

Notes.

(1) This form should be completed in ink in block letters or typed.

(2) If any of the persons named against the item is minor the fact should be clearly stated.

(3) In the case of a factory where a Managing Agent or Agents have been appointed as occupiers under the

Indian Companies Act, 1913 (VII of 1913), information required in the item should be supplied in respect

of that person or persons.