Form 6 ( See rules 7) APPLICATION FOR REGISTRATION AND GRANT OR RENEWAL OF FACTORY LICENCE AND NOTICE OF OCCUPATION (FOR THE YEAR......) ( to be submitted in triplicate) 1) Name of the Factory 2) Factory Licence number, if already registered 3) Full Postal address of the factory 4) Postal Address to which communication relating to the factory should be sent 5) Names of items manufactured / to be manufactured (principal product & other product) a) in the factory in the last twelve months (in case of factories already in existence); and b) in the factory during next twelve months (in case of all factories) 6) a) Maximum number of workers proposed to be employed on any one day during the year. b) Numbers of workers to be ordinarily employed in the factory. 7) Nature and amount of power to be used (in KW or H.P) i) Installed or ii) Proposed to be installed 8) Full Name and residential address of the person who shall be the Manager of the factory for the purpose of the Act & Rules. 9) Full name and residential address of the Occupier - a) the proprietor of the factory in case of a private firm of proprietary concern. b) the partners in case of partnership firm. c) the Directors in case of public limited company or firm. d). the Directors in case of private limited company or firm. e). the Shareholders in case of a private company f). the Chief Administrative Head in case of Government factory or a factory run by local authority or by any statutory corporation or by body. g) president / secretary and other shareholders in case of Co-op. society. 10). Full name and Address of the owner of the premises or building including the precincts thereof referred to in Section 93. 11). a) Reference number and date of approval of the plans for site whether for old or new building or for construction or extension of factory by the Chief Inspector; and b). Reference number and date of approval of the arrangements, if any, made for disposal of trade wastes and effluents and the name of authority granting such approval. 12). a). Amount of fee paid : Rs. ........... b).Challan Number & date of payment in Treasury ( Original copy of Challan to be enclosed) Signature of Manager Signature of Occupier Date Date Note :- 1). This form should be completed in Ink in Block letters or typed. 2). If any of the persons named against item no.9 is minor, the fact should be clearly stated.
