FORM XIII

[Under rule 17(1) of the Contract Labour (Regulation and Abolition) Central Rules,
1971]

APPLICATION FOR REGISTRATION OF ESTABLISHMENT EMPLOYING CONTRACT LABOUR

Acknowledgement Number: - Date of Application: -

Details of the Establishment

1. Name and location of the establishment: TECHNOTECH GLOBAL SERVICES, 402-B, 3RD
FLOOR LAL DORA VILLAGE, NORTH WEST DELHI, MOHAMMADPUR MAJRI, Delhi, North West,
110081
2. Postal Address of the establishment: 402-B, 3RD FLOOR LAL DORA VILLAGE, NORTH
WEST DELHI, MOHAMMADPUR MAJRI, North West, Delhi - 110081
3. Permanent Account Number (PAN)/ Goods and Services Tax Identification Number
(GSTIN)/ Labour Identification Number (LIN): AKVPT4572F
4. Full name and address of the Principal Employer: SHASHANK TRIPATHI,Director,
402-B, 3RD FLOOR LAL DORA VILLAGE, NORTH WEST DELHI, MOHAMMADPUR MAJRI, North
West, Delhi - 110081
5. Full name and address of the Manager or person responsible for supervision and
control of the establishment: SADAQAT ALI ,BUILDING NO 351/46, FLAT NO-D2, GALI
NO-2, NEAR RADHEY SHYAM MANDIR, SAIDULAJAB, South, Delhi - 110030
6. Nature of work carried on in the establishment: Electrical Work i.e Street Light
Pole Installation, Underground Cable Laying, Earthing etc.
7. Maximum Number of contract labour to be employed in the establishment on any day:
20
 Details of Contractors
Maximum
Number of
contract Estimated Estimated
Serial Name and PAN/GSTIN/LIN Mobile Nature of labour to be date of date of
e-mail ID
NumberAddress Number Number work employed in commencement
completion
the of work of work
establishment
on any day:
TECHNOTECH
KADAPA,
GLOBAL
ANDHRA
SERVICES
PRADESH,
Address :
Electrical
402-B, 3RD
Work i.e
FLOOR LAL
Street Light
DORA
Poles
1 VILLAGE, 2-5630-1553-2 9313122299 technotechglobals@gmail.com 20 16-08-2022 30-11-2022
Installation,
NORTH WEST
Underground
DELHI,
Cable Laying,
MOHAMMADPUR
Feeder Pillar
MAJRI,
Panel
North West,
Installation,
Delhi -
Earthing etc.
110081

8. Amount of Registration Fee : INR 60 ( Transaction Id : )

9. Jurisdiction Submitted Area : ALC NEW DELHI III ( ALCNEWDELHI3 )

Signature of the Principal Employer

(e-Sign/DSC)
Note: This is an online application summary applied on Shram Suvidha Portal.

Signature Not Verified

Digitally signed by
Date: 2022.09.28 15:46:50 IST