The Uttar Pradesh Code on Social Security Rules, 2026
Form XXVIII
Official text
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{See sub-rule (2) of Rule 68}
Show-cause Notice to parties for refusal to record memorandum of settlement
To,
1 (Name and address of the employer)
2 (Name and address of the employee)
Whereas, an agreement to pay compensation is said to have been reached between……………………….. and
……………………….. and whereas................................ has/ have applied for registration of the said agreement under
sub-section (1) of section 89 of the Code and whereas it appears to me, that the said agreement ought not to be
registered for the following reasons, namely-
1. ………………………………………………………………….
2. ………………………………………………………………….
3. ………………………………………………………………….
an opportunity will be afforded to you of showing cause on why the said agreement should be
registered on ……………… day of …………….. 20............ If no adequate cause is shown on this day, the
registration of the agreement will be refused.
Date:
Competent Authority.
Seal
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