FORM II

[Under rule 21(1) and rule 29 (2) of the Contract Labour (Regulation and Abolition) Central
Rules, 1971]

APPLICATION FOR LICENCE UNDER THE CONTRACT LABOUR (REGULATION AND

ABOLITION) ACT, 1970 (37 OF 1970)

Acknowledgement Number: 21112303112571 Date of Application: 21-11-2023

Details of Contractor

1. Full Name of Contractor: DRONACHARYA SEWA TRUST through VIJAY KUMAR TRIPATHI

2. Full Address of Contractor : 103 New Jaamdeeh Pandey Colony, KAILLY ROAD BASTI, JAMDEEH

PANDEY, Basti, Uttar Pradesh, - 272001

3. LIN/PAN No. of Contractor: 1-6554-0790-7 / AAETD3334J

4. Email Id of Contractor: dstbasti@gmail.com

5. Mobile No. of Contractor: 8707220114

Particulars of Establishment where workman is to be employed

6. Name of PE's Establishment: DRONACHARYA SEWA TRUST

7. Name of Principal Employer: VIJAY KUMAR TRIPATHI DIRECTOR, DRONACHARYA SEWA TRUST,103

New Jaamdeeh Pandey Colony, KAILLY ROAD BASTI, JAMDEEH PANDEY, Basti, - 272001

8. Number and Date of Certificate of Registration of the Establishment under the Act:

UP06278237708497V Dated 13-01-2023

 Particulars of the Contract Labour

9. Nature of work in which workman is employed or is to be employed in the Establishment:

DRONACHARYA SEWA TRUST

10. Location of Work : ALL INDIA RADIO, KAMARAJAR, SALAI,MYLAPORE,CHENNAI, Chennai, Tamil

Nadu - 600004

11. Duration of proposed Contract Work -

1. Date of Commencement of work: 04-11-2023

2. Date of Completion of work: 04-11-2024

12. Name and Address of the Agent or Manager of Contractor at the work-site: RAJESH, ALL INDIA RADIO,

KAMARAJAR, SALAI,MYLAPORE,CHENNAI, Chennai, Tamil Nadu - 600004

13. Maximum number of workmen proposed to be employed on the Establishment on any date: 20

14. Whether a certificate by the Principal Employer, in Form III enclosed: No

15. Work Order Number: GEMC-511687766171223

16. Amount of Licence Fee : INR 15

17. Amount of Security Deposit : INR 1800

18. Jurisdiction for Licensing Officer : ALC I Chennai ( ALCCHENNAI1 )

Signatur of Contractor
(eSign/DSC)
Note: This is an online application summary applied on Shram Suvidha Portal.
 EMPLOYEES' PROVIDENT FUND

(A statutory Body under the Ministry of Labour and Employment,

www.epfindia.gov.in

PROVIDENT FUND CODE NUMBER INTIMATION

No : 10001282599GKP Date : 26/07/2023

To
VIJAY KUMAR TRIPATHI
Trustee
DRONACHARYA SEWA TRUST
103 New Jaamdeeh Pandey Colony Near District Hospital
Basti BASTI
UTTAR PRADESH - 272002

Sub: Allotment of Code Number to establishment M/s DRONACHARYA SEWA TRUST under Employees' Provident Fund
and Miscellaneous Provisions Act, 1952-regarding.

Sir/Madam ,

Based on the information submitted online by you, your establishment is registered with Employees' Provident Fund
Organisation with the following code number :

Code Number : UPGKP3014617000

This code number is allotted based on the following declarations by you:

1. Name of Establishment : DRONACHARYA SEWA TRUST

2. PAN of Establishment : AAETD3334J

3. Date on which employment : 12/07/2023

strength crossed 19
4. Section under which : 0000001(4)

5. Primary Activity : COMPANIES/SOCIETIES/ASSC/CLUBS/TROUPES FOR PERFORMANCES

6. Ownership Type : FIRMS RUN BY TRUST

7. The address proof of the : - Any license/certificate/number issued by any Govt.

establishment is

Application Number : 10001282599 Page 1 of 2

Code Number : UPGKP3014617000

8. The proof of date of set up 13/01/2023 is Registration Certificate issued by Registrar of Societies

9. As at the time of application, your establishment is having the following licenses and registrations:

S.No. License Under License Number Date Issued By Place of Issue

12920 GOODS AND SERVICE 09AAETD3334J1ZO 25/05/2023 Gst Basti Basti

42 TAX IDENTIFICATION
NUMBER
10. As on date of your application, your establishment is not registered with ESIC.

11. As on date of your application, your establishment is not having LIN.

SUB REGIONAL OFFICE
GORAKHPUR
103 New Jaamdeeh Pandey Colony Near District Hospital 272002
dstbasti@gmail.com

Please note that this intimation letter is generated with the Owners' Details in Form 5A and the intimated letter will be valid
only if the Form 5A is enclosed.

Important information:

1. By virtue of this registration, you are required to comply with the provision of the EPF & MP Act 1952. The
obligations/duties/responsibilities cast upon you as an employer of this establishment and penalties, on account of non-
compliance with the same, are explained on our website www.epfindia.gov.in. You are required to go through them
carefully.
2. Remittance of dues under the provisions of the Act is to be made only through a Challan generated through the Unified
portal. (The process for registration on the portal, preparation of the ECR txt file and related information is available on the
website and the portal).

3. In case this letter is produced as a proof of the code number of the establishment, before any person including
any Inspector from EPFO, the Form 5A generated through the portal at the time of registration should be a part of
this letter. The remittance details of the establishment will be available on the EPFO website through the link
"Establishment Search" where all payments from December 2016 onwards with the names of employees are
available.

4. Please quote the Code Number UPGKP3014617000 for all the future correspondence with EPFO.

This is a system generated letter and needs no signature.

Employees' Provident Fund Organisation

Dated: 26/07/2023

Application Number : 10001282599 Page 2 of 2

Code Number : UPGKP3014617000

PDF SIGNER DEMO VERSION
 Government of India
Form GST REG-06
[See Rule 10(1)]

Registration Certificate

x
Registration Number : 09AAETD3334J1ZO

Ta
1. Legal Name DRONACHARYA SEWA TRUST

2. Trade Name, if any DRONACHARYA SEWA TRUST

es
3. Additional trade names, if any

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4. Constitution of Business Society/ Club/ Trust/ AOP

5. Address of Principal Place of 3, 101, VIJAY KUMAR TRIPATHI, Kailly Road, District
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Business hospital Ruchi Dawakhana, New Jamdeeh Colony, Basti,
Basti, Uttar Pradesh, 272002
Se

6. Date of Liability 11/05/2023

7. Period of Validity From 11/05/2023 To Not Applicable

8. Type of Registration Regular

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an

9. Particulars of Approving Centre

Signature Signature Not Verified

Digitally signed by DS GOODS AND
SERVICES TAX NETWORK 07
ds

Date: 2023.05.25 12:45:16 IST

Name Virendra Kumar Kureel

oo

Designation Superintendent

Jurisdictional Office Basti Sector-1

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Date of issue of Certificate 25/05/2023

Note: The registration certificate is required to be prominently displayed at all places of business in the
State.

This is a system generated digitally signed Registration Certificate issued based on the approval of application granted
on 25/05/2023 by the jurisdictional authority.
 Annexure A

Goods and Services Tax Identification Number: 09AAETD3334J1ZO

Details of Additional Place of Business(s)

Legal Name DRONACHARYA SEWA TRUST

x
Trade Name, if any DRONACHARYA SEWA TRUST

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Total Number of Additional Places of Business in the State 0

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rv
Se
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 Annexure B

Goods and Services Tax Identification Number: 09AAETD3334J1ZO

Legal Name DRONACHARYA SEWA TRUST

Trade Name, if any DRONACHARYA SEWA TRUST

x
Ta
Details of Members of Managing Committee

1 Name VIJAY KUMAR TRIPATHI

Designation/Status DIRECTOR

es
Resident of State Uttar Pradesh

2 Name GEETA TRIPATHI

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Designation/Status Director
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Resident of State Uttar Pradesh
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