1.Name of the employer 2Full postal address of the employer 3The name, if any, of the establishment4Full postal address of the establishment5The category of the establishment 6The date of which the establishment commenced work7No. of employee/employees employed on the date of Application8In case of renewal of registration whether the Registration certificate of the previous year enclosed 9(enclosed) State if it is a shop, an establishment, residential hotel, Non-residential hotel, restaurant, boarding or eating house, theatre or other place of public amusement or entertainment. to Treasury, No. Signature of the Inspector, Shops and Commercial Establishment YesNo APPLICATION FOR REGISTRATION OR RENEWAL OF REGISTRATION OF AN ESTABLISHMENT An amount of Rs.(Rupees on under the head of account (vide challis No.dateDate. Signature of the Employer Received an application in Form No.1 with treasury challis No.Government of OrissaLabour & Employment DepartmentNo.Published on National Portal of India (india.gov.in) ) only has been paidYesNo/-Date FromTo
