FORM
No. 4
(Prescribed under Rule 5)
Licence to work a factory
Name of Industry. :
Registration No. :
Licence No. :
NIC Code Number :
Licence is hereby granted to
..
for the premises known as
situated at
.
.. for use as a factory within the limits stated herein after
subject to provisions of the Factories Act, 1948 and the rules made thereunder
for following manufacturing processes:
1. ( NIG Code number for each process)
2.
The ..19 . issuing authority
Details or Licence
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Valid for |
Fee paid |
Excise |
Additional |
Date of payment |
Signature of the issuing authority |
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Calendar year |
Maximum number of workers on any one day |
Maximum installed power in kilowatts |
Rs. |
Rs |
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Granted under Rule 5 |
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Renewed under Rule 7 |
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Transfers
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To whom |
Date of transfer |
Transfer fee paid and date of payment |
Signature of the |
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Amendments
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Date when |
Amended |
Installed |
Amendment fee paid and date of payment |
Additional fee paid and date of payment |
Signature of the issuing authority |
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