FORMS UNDER APSE ACT

 

Government of Andhra Pradesh

LABOUR DEPARTMENT

 

Application for Registration                       FORM - I

Of Establishment under

Section (1) & Rule (3)

 

Vide Rule 3 A.P.Shops & Establishment Rule 1990

 

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1. Classification of Establishment        1.       Proprietory Firm

2.                 Partnership Firm

3.                 Private Limited Company

4.                 Public Ltd., Company.

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2. Category of Establishment              1. Shop               

2.     mercial Establishment

3.     Hotel, Restaurants Catering House Lodging and Café

 

4.     Public Ltd., Company.

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3. Name of Establishment                   _________________________________

                                                          _________________________________

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4. Address :                              Door No.______________________________

                                                Locality _______________________________

                                                Village/Town __________________________

                                                District ________________________________

                                                Pin Code

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5. Location of Office, Godown, Ware-                   Door No.              Locality

   house or Work Place attached to      1.______________     _______________

   the Shop/Establishment but              2.______________     _______________

   situated outside the premises of it.    3.______________     _______________

 

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6.Employer/Managing Partner/            Name : ___________________________

   Managing Director as the                 Father’s Name _____________________

    case may be                                   Designation _______________________

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7. Residential address of the      Door No. ______________________________

    employer                              Locality _______________________________

                                                Village / Town _________________________

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8. Manager/Agent if any with     Name _________________________________

    residential address                 Father’s Name __________________________

                                                Designation ____________________________

                                                Door No. ______________________________

                                                Locality _______________________________

                                                Village / Town. _________________________

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9. Nature of Business :

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10. Date of Commencement               Date            Month         Year

of business :

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11.Name of family member of employees family engaged in Shop/Establishment

 

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                   Relationship          Adults                   Young Persons

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Male :

 

Female :

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Total

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12. Total No.of Employees                                    Adults         Young persons

                                                Male

                                                Female

                                                Total

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13. Name of Employees :

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In a Managerial Capacity | As Sweeper caretaker| As persons employed | Others

                                      | & Travelling Staff      | loading & unloading  |

                                      |                                   | of goods at godowns |

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          1.                                       2.                                 3.                        4.

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14. Details of remittances of the fees :

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Name of the Treasury      |         Challan No.       |    Date   | Amount of fee paid

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              1.                                         2.                  3.                4.

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                                      |                                  |                                  |

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I declare that the above information is true to the best of my knowledge & belief

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Signature of the Employer

 

 

Note : This statement shall be submitted to the Inspector of the concerned area accompained by challan in support of payment of fees as Prescribed Schedule 1.

Government of Andhra Pradesh

Labour Department

FORM – III

(See Rule 3 (4) )

APPLICATION FOR RENEWAL

1. Name of the Shop/Establishment :

and address          

 

2. Previous Registration Certificate :

No. & Date

 

3. Year for which renewal is required

along with

(i)      Challan No. with date

(ii)      Amount paid through the challan

 

4. Full Name of the Employer including

Father’s name

 

5. Full Name of the Manager including

Father’s Name

 

6. Change in the name of the Partners

if any

 

7. Change in the postal address and door

No. if any of Shop / Establishment

 

8. Total number of Employees :

 

          I hereby declare that the above information is true to the best of my knowledge and belief.

 

 

Signature of the employer / Manager

 

 

 

FORM E – NOTICE OF CHARGE

(Vide Rule 7 of A.P.Shops & Establishment Rule – 1968)

 

          Name of the Establishment already registered _________________________

 

 

Name of the Employer _________________________________________________

Registration Certificate Number _________________________________________

Address ____________________________________________________________

 

Dated the  __________________________ day of ___________________ 200 

 

To

          The Inspector

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(Under the Andhra Pradesh Shops and Establishment Act 1966) Notice is hereby given that the following change has taken place in respect of information forwarded to you in Form ‘I’ which please note.

 

          The Registration Certificate and Challan No. ______________________

Dated __________________ for Rs. __________________________________

Are herewith enclosed.

 

 

Signature of Employer

NOTE : The notice of change in this form shall be sent together with such fees as are prescribed in schedule II.