GOVERNMENT OF MEGHALAYA
LABOUR DEPARTMENT

RENEWAL APPLICATION FOR LICENSE FOR CONTRACTORS UNDER THE CONTRACT LABOUR ACT 1970

Please ensure you have following enclosures before proceeding to apply

1. EPIC - Voter Id Card/Epic (mandatory)

2. Trading license granted by the respective District Counsil (only for non tribals) (optional)

3. License copy / latest renewal copy (mandatory)

Renewal License

License No for which renewal is required *

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License Issued Date *

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License/ Renewal valid up to Date *

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Contractor's Details

Title

Name of the contractor *

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E-Mail ID of the contractor *

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Mobile Number of the contractor *

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Father's Name of the contractor(in case of individuals)

Upload Contractor's Photo(Min 20Kb and Max 250Kb) * Min file size 20 KB, Max file size 250 KB

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Applicant's Address

State *

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District *

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Locality *

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Village/ Town *

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Nearest Landmark

Pincode *

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Post Office *

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Police Station/Outpost *

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DOB( in case of individuals)

By Date

By Age

Age *

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Date Of Birth *

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Particulars of establishment where contract labour is to be employed (Principal Employer)

Establishment name *

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Address of the establishment

District *

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Village/Town *

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Locality *

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Nearest Landmark

Post Office *

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Police Station/Outpost *

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Pincode *

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Type of Business, Trade, Industry, Manufacture or occupation, which is carried out in the establishment *

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Registration number

Registration Date

Name and address of principal employer

Title

Principal Employer's Name *

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State *

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District *

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Village/Town *

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Locality *

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Nearest Landmark

Police Station/Outpost *

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Post Office *

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Pincode *

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Directors/Partners Details

Directors/Partners

Title

Full Name

Address

Title

Full Name

Address

Manager or person details responsible for the supervision and control of the establishment

Manager

Title

Full Name

Address

Title

Full Name

Address

Particulars of Contract Labour

Name & Address of Agent or Manager of Contractor at the worksite

Name of the agent or manager

Address of the agent or manager

Name,Nature and location of work in which contract labour is employed / is to be employed in the establishment *

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No of days of contract labour

Number of contract labour approved in the existing License *

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Maximum number of contract labour proposed to be employed now *

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Other Details

Whether the contractor is convicted of any offence within the proceeding five years *

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Yes

No

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Details *

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Whether there was any order against the contractor revoking or suspending license or forfeiting Security Deposit in respect of an earlier contract. *

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Yes

No

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Order Date *

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Whether the contractor has work in any other establishment within the past five years *

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Yes

No

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Establishment's Details *

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Principal's Employers Details *

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Nature of work *

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License Renewal Details

Renewed From Date:

Renewal Valid upto date:

No of Years Renewed:

Fine (in Rs.):

Amount of License fee to be paid (in Rs):

Security Deposit to be paid(in Rs):

Total Amount to be paid (in Rs):

Declaration

I do hereby declare that the details given above are true to the best of my knowledge and belief.

I Agree *

** Application once submitted cannot be modified , hence please fill up all the fields correctly .