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FORM NO.

4
[See Rule 4 (6)]

REGISTRATION AND LICENCE TO WORK A FACTORY


Registration No.

Sl. No.

Fee Rs.

License is herby granted to _________________________________________,

valid only for the premises described below for use as factory employing not more then __________

________________________ persons on any one day during the year and using motive
power not exceeding ___________ Subject to the provisions of the Factories Act, 1948 and the Rules

made there under.

This license shall remain in force till the 31st December 20…..

Date: CHIEF INSPECTOR OF FACTORIES

DESCRIPTION OF THE LICENCEED PREMISES


The licensed premises shows on plan No.

Are situated in:

And consist of:

Sl.No. Date of Renewal Date of Expiry Signature of Licensing Authority

NB: - THE LICENSE SHALL BE KEPT IN CONSPICUOUS PLACE OF THE FACTORY PREMISES

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