Dashboard
home
Inbox
mail
Download for Forms
cloud_download
Profile
person
Logout
power
account_circle
Home
home
Inbox
mail
Logout
power
menu
THE INTER-STATE MIGRANT WORKMEN (REGULATION OF EMPLOYMENT AND CONDITIONS OF SERVICE) ACT, 1979 - LICENCE
Registration Number
*
Registration Date
*
Search
Details of the Establishment
Name of Establishment
*
PAN Card Number of the Establishment / Proprietor
*
Date in PAN card
*
Upload copy of PAN card
*
(Maximum file size should not exceed 1 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Nature of Business
*
Select
Software
Food services
Retail
Wholesale
Manufacturing
Marketing
Transport
Communication
Logistics
Banking
Finance
Insurance
Ware Housing
Advertising
Educational Institution
Hospital
Man power supply
Others
If Others,Specify
*
Details of Organizational setup
*
Select
Sole proprietary
Partnership
Public Limited Company
Private Limited Company
Government
Co-operative Society
Others
If Others,Specify
*
Is there any Manager/Authorized Person responsible for the supervision and control of the establishment
*
select
No
Yes
Is there any Managing Agent or Directors Appointed for Establishment
*
Select
No
Yes
Is there any Share Holders for Establishment
*
Select
Yes
No
Address of Establishment
State
*
Select
Tamil Nadu
District
*
Select
Taluk
*
Select
Town/ Village
*
Select
Street 1
*
Select
Street 2
(Please Enter Street 2,if your street is not available in street 1)
Building/ Door/Flat No.
*
Pincode
*
Location of the establishment (photo of the name board with address. In the name board importance is given to Tamil)
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Details of the Employer / Proprietor (Contractor)
Name
*
Designation
*
Father / Husband
*
Date of Birth
*
Age
*
Gender
*
Select
Male
Female
Transgender
State
*
Select
Tamil Nadu
District
*
Select
Taluk
*
Select
Town/ Village
*
Select
Street 1
*
Select
Street 2
(Please Enter Street 2,if your street is not available in street 1)
Building/ Door/Flat No.
*
Pincode
*
Duly self-attested identity Proof (Pan Card/Aadhaar Card/Voter I.D./Driving Licence etc.)
*
(Maximum file size should not exceed 1 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Residential address of the employer of the establishment
*
(Maximum file size should not exceed 1 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Add More
Details of the Partners
Name
*
Age
*
Father / Husband
*
Address
*
Partnership Deed Copy
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload File
file_upload
Add More
Managing Agent or Directors Appointed for Establishment
Name
*
Age
*
Father / Husband
*
Address
*
Designation
*
Written order of nominated/ authorized person among the Directors
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload File
file_upload
Certified List of Directors
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload File
file_upload
Shareholder file
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Add More
Manager/Authorised Person Details (other than owner)
Name
*
Designation
*
Father / Husband
*
Gender
*
Select
Male
Female
Transgender
Date of Birth
*
Add More
Particulars of migrant workmen
Nature of work assigned to Migrant workmen
*
Maximum Number of migrant workmen proposed to be employed in the establishment on any date
*
Nature of Business
*
Select
Advertising
Banking
Communication
Educational Institution
Finance
Food services
Hospital
Insurance
Logistics
Man power supply
Manufacturing
Marketing
Retail
Software
Transport
Ware Housing
Wholesale
Others
If Others,Specify
*
Estimated date of commencement
*
Estimated date of ending
*
List of Contractors and their agreement copy
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Worksite Address
State
*
Select
Tamil Nadu
District
*
Select
Taluk
*
Select
Town/ Village
*
Select
Street 1
*
Select
Street 2
(Please Enter Street 2,if your street is not available in street 1)
Building/ Door/Flat No.
*
Pincode
*
Maximum Number of Employees Proposed to be Employed
Men
Women
Transgender
Total
On Roll
Out Sourced
Contract
Inter-State Migrants
Adolescent
Grand Total Number of Workers
Total Fees as per total contract employees
Conviction
Are You Previously Convicted ?
*
Select
No
Yes
Specify
*
Previous revoke/suspension of License OR FORFEITING SECURITY DEPOSITS IN RESPECT OF AN EARLIER CONTRACT
Whether there was any order against the contractor ?
*
Select
No
Yes
Order Number
*
Order Date
*
Whether the contractor has worked in any other establishment within the past 5 years ?
*
Select
No
Yes
Facilities provided to migrant workmen
Wages payable to migrant workman in an establishment
*
Select
Same rate of wages paid by Principal employer
Higher than the rate of wages paid by Principal employer
Medical facilities
*
Select
Yes
No
Protective clothing
*
Select
Yes
No
Drinking water
*
Select
Yes
No
Latrines, urinals
*
Select
Yes
No
Washing facilities
*
Select
Yes
No
Rest Rooms
*
Select
Yes
No
Canteens
*
Select
Yes
No
Creche
*
Select
Yes
No
Residential accommodation
*
Select
Yes
No
Security Deposit
*
Security Deposit to remit
*
Security Deposit
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Security Deposit Challan No. / Receipt No.
Challan date / Receipt date
Documents to be Upload
Certificate by the Principal Employer in Form VI
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload file
file_upload
Labour Welfare fund Contribute Receipt/ Self Certificate
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload File
file_upload
Registration Certificate
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
Upload File
file_upload
Proof copy GST Certificate/ Rental agreement/No objection Certificate from rental building owner/Building ownership document/EB Card/EB bill
*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
File Upload
file_upload
Self Declaration
I hereby declare that the details given above are correct to the best of my knowledge and belief
Pay
Reset
arrow_drop_up
