FORM NO. 14 (Prescribed under Rule 87) Notice of period of work for adult workers Name of factory... Address.

District.. "irst day of #ee$.. Periods of #or$ +rou)s Relays 1n #or$ing days "rom (o ... "rom (o "rom (o "rom (o "rom (o Date on #&ic& t&is notice is first e4&ibited 5 * Describe t&e grou)s 6 24)lain t&e nature of #or$ against identification letter mar$ed A0/0!0D02 * National ndustrial !lassification (N !) Signature of Manager Name (In block letters 'en (otal number of men em)loyed A / ! ,-. ,-. ,-. Registration No.. Licence No... *N ! !ode No. (As gi%en in t&e licence).. dentification of t&e Remar$s +rou) Al)&abet assigned A0/0! etc. A Nature of #or$

D ,-.

*omen (otal number of #omen em)loyed A / ! D ,-. ,-. ,-. ,-.

/ ! D 2 3