FORM I-A (See Rule 2-A (1) APPLICATION FOR REGISTRATION OF A PLANTATION 1. Name and location of Plantation. 2. Full Name and particulars including percentage and residential address and postal address of (i) The employers of the Plantation in case of a private firm/proprietary concern. (ii) Directors in the case of company/Firm (iii) The Chief Administrative head of the Department in the case of a Government of Local fund Plantation. 3. Full name and address of the Manager or parson responsible for the supervision and control of the Plantation. 4. (a) Area of the Plantation indicating khasra number and area of each khasra. (b) Area of land actually under Plantation in the khasra number and their areas. 5. Maximum number of workers employed on any day during the last twelve months. 6. Particulars of treasury receipt enclosed...............(Name of treasury amount and rate) I hereby declare that the particulars given above are true to the best of my knowledge & belief. Employer. Place Dated
