THE INTER-STATE MIGRANT WORKMEN (REGULATION OF EMPLOYMENT AND CONDITIONS OF SERVICE) ACT, 1979 - REGISTRATION
Details of 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)
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Nature of Business*
If Other Business,Specify*
Details of organizational setup*
If Other Business,Specify*
Date of Commencement of Establishment*
Is there any Manager/Authorized Person responsible for the supervision and control of the establishment*
Is there any Managing Agent or Directors Appointed for Establishment*
Address of Establishment (Worksite)
State*
District*
Taluk*
Town / Village*
Street 1*
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)
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Details of the Employer / Proprietor
Name*
Designation*
Father / Husband*
Date of Birth*
Age*
Gender*
State*
District*
Taluk*
Town/ Village*
Street 1*
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)
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Residential address of the employer of the establishment*
(Maximum file size should not exceed 1 MB.File should be pdf,jpeg,bmp format)
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Details of the Partner
Name*
Age*
Father / Husband*
Address*
Partnership Deed Copy*
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
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Managing Agent/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)
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Certified List of Directors *
(Maximum file size should not exceed 2 MB.File should be pdf,jpeg,bmp format)
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Number of Employees Working at Present
 
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
Particulars of Contractors and Migrant Workmen
Establishment Name*
Name*
Age*
Father / Husband*
Address*
Nature of work assigned to migrant workmen *
Maximum number of migrant workmen to be employed*
Nature of Business*
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)
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Documents To Be Uploaded
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)
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Self Declaration