CHANDIGARH ADMINISTRATION DEPARTMENT OF LABOUR e-JAN SAMPARK FORM F State for Registration of Establishment Under Section 13 of the Punjab Shops and Commercial Establishment Act 1958 (Rule 13 of the Punjab Shops & Commercial Establishment Rule, 1958) To, The Inspector Shop and Commercial Establishment .......... Circle I hereby submit this statement for the Registration/Renewal of my Establishment for the year ........ The information furnished hereunder is correct to the best of my knowledge. 1) Name and parentage of employer ................. 2) Name of the manager, if any ................. 3) Name of the Establishment ................. 4) Full Postal Address of the Establishment ................. ................. ................. 5) Nature of Business ................. 6) No. of Employees if any, Young persons ................. Other persons ................. 7) No. and date of previous Registration Certificate surrendered ........... Date ......... Signature of Employer (To be filled in by the authority) Registration No. ................ The Establishment mentioned above is hereby registered till 31st March, 20.... Inspector Shop & Commercial Establishment Date ........ .............. Circle Chandigarh Administration on the Net : http://chandigarh.gov.in Page : 1 of 4
