gbtk; vz; - 2

(Prescribed under Rules 4, 7 and 12 of the

Tamil Nadu Factoires Rules, 1950)

FORM NO - 2

__________Mz;bw;;F chpkj;ij gjpT nra;J toq;Ftjw;F my;yJ GJg;gpg;gjw;F tpz;zg;gk; 6 kw;Wk; 7 gphpTfspy;
Fwpg;gpl;Ls;s mDNghfk; gw;wpa mwptpg;Gk; (%d;W efy;fspy; nfhLf;fg;gl Ntz;Lk; )
Application for Registration & Grant of Renewal of Licence for the Year ________ and Notice of Occupation specified in
secions 6 and 7 (To be submitted in Triplicate)

Two Rupees Court Fee

stamp to be affixed

1. njhopw;rhiyapd; KOg;ngaUk; mJ Kd;dNu gjpT nra;ag;gl;bUe;jhy; njhopw;rhiy

chppk vz;Zk; jw;Nghija chpkk; mtUf;F my;yJ mth;fSf;F toq;fg;gl
Ntz;L;k;.
Full name of the factory with factory licence number, if already registered
before_____________the name of the person or persons to whom the present
licence is to be granted and issued
2. (v) njhopw;rhiyapd; KO mQ;ry; KfthpAk; mJ mike;Js;s ,lKk; (fjtpyf;f
vz;> kw;Wk; ey msit vz; Kjypait)
Full postal address and situation of the Factory
Door No
Survey No. Etc ...
(gp) njhopw;rhiy njhlh;ghd jfty;fs; mDg;gg;gl Ntz;ba KO Kfthp
Full address to which communication relating to the factory should be sent
(rp) njhop;wrhiy ve;jf; fhty;epiya mjpfhu tuk;gpw;Fs; mike;Js;sJ?
Police station in whose jrisdiction the factory lies........................
3. 93tJ gphptpy; Fwpg;gpl;Ls;s tsT my;yJ fl;blj;jpd; rh;gplq;fs; cs;spl;l mjd;
chpikahshpd; chpikahsh;fspd; tpguq;fs;
Particulars of the owner/s of the premises of building (including the precincts
thereof referred to in Section 93.
ngah; - Name
taJ - Age
,Ug;gpl Kfthp - Residential Address
jfg;gdhUila ngah; - Father's Name
4. njhopw;rhiyapd; mYty;fspd; KO eph;thf mjpfhuk; tfpg;gtUk; jd; ngahpy;
chpkk; mDg;ggl Ntz;LgtUkhd mDNghfjhuiug; gw;wpa tptuq;fs; gphpT 2 Ig;
ghh;f;fTk.
Particulars of the occupier of the factory who has ultimate control over the affairs
of the factory and in whose name the licence is to be issued (please see section
2(n))
ngah; - Name
taJ - Age ,
,Ug;gpl Kfthp - Residential Address
jfg;gdhUila ngah; - Father's Name
5. ,r;rl;lj;jpd; nray; Nehf;fq;fSf;fhf njhopw;rhiy Nkyhshiug; gw;wpa tpguq;fs;.
Particulars of the Managers of the factory for the purpose of this Act.
ngah; - Name
taJ - Age ,
,Ug;gpl Kfthp - Residential Address
jfg;gdhUila ngah; - Father's Name
6. cw;gj;jp eilKiw - cw;gj;jp eilKiwfspd; jd; ik.
Nature of manufacturing process / Processess
(v) fle;j fhyhz;lh; Mz;by; njhopw;rhiyapy; ele;j njhopy; (Vw;nfdNt nraypy;
cs;s njhopw;rhiyfspd; ngahpy;)
Carried on in the factory during the preceding calendar year (In the case of
factories already in existence)
(gp) ,e;j chpkk; ve;j fhyz;lh; Mz;Lf;F nra;J nfhs;sg;gLfpwNjh me;jf;
fhyz;lh; Mz;by; njhopw;rhiyapy elj;jg;gl ,Uf;fpw njhopy;
to be carried on in the factory during the calendar year for which this application for
licence is made
7. fle; j fhyz; lh; Mz; by; jahhpf;fg;gl;l Kf; fpa nghUl; fspd; tptuq;fs;
Particulars of principal products manufactured during the preceding calendar year
nghUspd; ngah;
njhlh; vz;.
Product Name
Sl.No.
(2)
(1)

kjpg;G
Value
(3)

8. (v) epWtg;gl;l kpd;rf;jpj; jpwd; gw;wpa tptuq;fs; ;

Particulars of power actually installed
njhlh; vz;.
Sl.No.
(1)

kpd; rf;jpapd; jd;ik

Nature of Power
(2)

msT (Fjpiuj; jpwdpy;)

Quantity (in HP)
(3)

Fwpg;Giufs; khw;W Vw;glh

vd;gd Nghd;w tptuq;fs;
Remarks (Whether
standby etc)
(4)

(gp) chpkj; jpw;fhd tpz;zg; gk; nra; jpUf; Fk; fhyhz; lh; Mz; by; $Ljy; kpd;rf;jp VNjDk; epWtf; fJjpapUg;gpd; mJ gw;wpw tptuq;fs; ;
Particulars of power proposed to be additionally installed if any, during the calendar year for which this application for lincence is made
Fwpg;Giufs; khw;W Vw;glh
kpd; rf;jpapd; jd;ik
njhlh; vz;.
msT (Fjpiuj; jpwdpy;)
vd;gd Nghd;w tptuq;fs;
Nature of Power
Sl.No.
Quantity (in HP)
Remarks (Whether
(2)
(1)
(3)
standby etc)

(rp) ,e;j chpkj;jpw;fhf tpz;zg;gk; ve;jf; fhyz;lh; Mz;by; nra;J

nfhs;sg;gLfpwNjh me;j fhyz;lh; Mz;by; xU rkaj;jpy; gad;gLj;jf;$ba NgusT
kpd;rf;jp (Fjpiuj;jpwdpy;)
Maximum quantity (in HP) that can be used at any one time during the calendar
year for which this application for licence is made.
9. (v) njhopw;rhiyapy; mOj;jfyd;fs; cs;sdth? Mkhk; vdpy; mOj;jf; fyd;fspd;
vz;zpf;ifia Fwpg;gplTk;.
Whether the factory is having any pressure vessels; if so the number of pressure
vessles may be indicated.
(gp) njhopw;rhiyfs; Ma;tfj;Jiwapy; mwptpf;if nra;ag;gl;l mYtyh;fshy;
mOj;jf;fyd;fs; Nrhjid nra;ag;gl> chpa fl;lzk; njhopw;rhiyfs; ephthf;jpduhy;
nrYj;jg;gl;ljh?
Whether the factory management had remitted fees for the testing of pressure
vessels by the notified persons of Factory Inspectorate
(rp) jkpo;ehL njhopw;rhiy tpjpfs;> 1950d; gb tpj 95d; fPo; ,e;j njhopw;rhiyapy;
mghafukhd njhopy;fs; eilngWfpd;wdth? Mk; vdpy;> njhopyhsh;fSf;F> rhd;wpjo;
toq;Fk; mWit kUj;Jtuhy; fhyKiwNjhWk; kUj;Jt ghpNrhjid nra;ag;gl>
fl;lzk; nrYj;jg;gl;ljh?
Whether the factory is engaged in dangerous operations as indidcated under Rule
95 of the Tamil Nadu Factoires Rules 1950; if so, whether the occupier of the
factory has paid fees for periodical medical examination of the persons employed,
by the Certifying Surgeon.
10. (v) chpkj;jpw;fhd tpz;zg;gk; ve;j fhyhz;lh; Mz;by; nra;J nfhs;sg;gLfpwNjh
me;j fhyz;lh; Mz;by; ahnjhU ehspy; epakpf;ff; fUjpAs;s XusT
njhopyhsh;fspd; vz;zpf;fif 4tJ tpjpapd; tptu ml;ltidapy; cs;s
tiuaiwfisf; fhz;f.
Maximum number of work ers proposed to be employed on any one day during the
calendar year for which this application for licence is made (Please see the slab
limits in the Schedule to Rule 4)

(gp) fle;j fhyhz;lh; Mz;by; ahnjhU ehspy; epakpf;fg;gl;l NgusT

njhopyhsh;fspd; vz;zpf;if
Maximum number of work ers actually employed on any one day during the
proceding calendar year
(rp) njhopw;rhiyapy; rhjhuzkhf epakpf;fg;gltpUf;Fk; njhopyhsh;fspd;
vz;zpf;if
Number of work ers to be ordinarily employed in the factory
11. chpkk; Ntz;b mDkjpj;j my;yJ GJg;gpj;j elg;ghz;Lfspd; vz;zpf;if (rhpahd
elg;ghz;Lfis ,q;F Fwpg;gplTk;)
Number of calendar year for which grant or renewal of licence is required (indicate
the exact calendar year / years)
12.,e;j tpjpfs; nraYf;F tuj; njhlq;fpa ehSf;F gpd;dh; fl;lg;gl;l my;yJ
tphpTgLj;jg;gl;l njhopw;rhiy xd;iwg; nghWj;jtiu
In the case of a factory constructed or extended after the date of the
commencement of the rules
( v) njhopw;rhiy gioa fl;blkhfapUe;jhYk; Gjpa fl;blkhapUe;jhYk;
fl;Ltjw;fhftpUe;jhYk; rhp> njhopw;rhiyia tphpTgLj;Jtjw;fhfapUe;jhYk; rhp
mjw;fhd kid tiuglq;fSf;F muR my;yJ jiyik Ma;thsh; xg;Gjy; mspj;j
ehSk;> Fwpg;Giu vz;Zk;
Reference number and date of approval of the plans for site whether for
old or new buildings and for construction or extenson of factory by the state
Government / Chief Inspector
(gp) njhopw;rhiy fopT nghUis mfw;Wtjw;F Vw;ghLfs; vJTk;
nra;ag;gl;bUe;jhy; mjw;F xg;Gjy; msppj;j ehSk; Fwpg;Giu vz;Zk; mjw;F
Vw;;gspj;j mjpfhhpapd; ngaUk;
Reference number and date of approval of the arrangements, if any,made for the
disposal of trade waste and effluents and the name of the authority granting such
approval

13.

fl;lzk; &. ________________________________________________________________________________________________

ehsppy;

tq;fpapy; fUt+yj;jpy; _______________________________________________________ &gha; nrYj;jg;gl;lJ_____________________ ehspl;l

vz;_______________________________________________________________

fUt+yr; rPl;L (m) tiuNthiy ,izf;fg;gl;Ls;sJ.

Amount of fee Rs.________________(Rupees____________________________________________________________________Only)

paid
in __________________________________Bank / Treasury / Sub Treasury______________________________________________on Vide
Challan
No.____________________________________dated______________________________(Demand Draft No.____________________ dated) is

Nkyhshpd; ifnahg;gk; - Signature of the Manager

(ngah; nghpa vOj;Jfspy; - Name in Capital Letters)

njhopw;rhiy chpikahshpd; ifnahg;gk; - Signature of the Occupier

(ngah; nghpa vOj;Jfspy; - Name in Capital Letters)

ehs; - Date __________________

ehs; - Date __________________

14. jkpo;ehL njhopyhsh; ey epjp

fle;j Mz;bw;fhd njhopyhsh; eyepjp jkpo;ehL
njhopyhsh; ey thhpaj;jpw;F nrYj;jg;gl;L tpl;ljh? Mk; vdpy;> nrYj;jg;gl;l
njhif> nrYj;jg;gl;l ehs;> nrYj;jpa Kiw (fhNrhiy %ykhf> gzkhf> ryhd;
%ykhf) Mfpa tptuq;fisf; nfhLf;fTk;.
Tamil Nadu Labour W elfare Fund - W hether contribution to the Labour W elfare
Fund for the previous year has been remitted and if so, furnish the details of
amount remitted, date of remittance and mode of remittance (by
Cheque/Cash/Challan)