Form XL

Made under The Code on Social Security, 2020Notification No. 1431/XXXVI-3-2026-1399661, 27 Aug 2026

Official text

Open in the official PDF (p. 175)

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PART-IV

[ See sub rule (3) of rule 91 ]

Composition Certificate

Ref Notic No........ Date:

This is to certify that the offence under sub-section of section 133 in respect of which Notice No.

Dated:………… was issued to Sh……............. (Applicant), the employer of ………………………………………..

(name and registration, number of establishment) has been compounded on account of remission of full amount

of Rs …………..... (Rupees…………………………..) towards the composition of offences to the satisfaction of

the said notice.

(Signature)

Name and Designation of the

Compounding Officer

Date: …………..

Place: ………….

To:

…………………...(Employer/Establishment)

…………………...(Name and registration number)

…………………….(Address)

Source: The Uttar Pradesh Code on Social Security Rules, 2026, Notification No. 1431/XXXVI-3-2026-1399661 — Uttar Pradesh Gazette Extraordinary, 27 August 2026, p. 175 of the PDF. Open our copy at p. 175 · official download · all sources

The rules were made in Hindi. The English text is the translation published by order of the Governor under clause (3) of Article 348 of the Constitution, which makes it the authoritative text in English. Rule headings are printed as marginal notes.