Labour Complaint Form

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EMBASSY OF INDIA, RIYADH

[Labour Wing ]

Name of the applicant as per passport


Permanent address in India

Tel No.

Present address in KSA Place/City


PO Box City/Area Code No.
Contact Phone No. Mobile No.

Passport No. Date of Issue Place of Issue

Iqama No. Date of Issue Place of Issue

Date of arrival in the Kingdom

Name of the Employer/Company


Address of the Employer/Company Place/City
PO Box City/Area Code No.
Telephone No. Fax No./Email ID
Mobile No.

Name of the Recruiting Agent in India

Complete address of the Recruiting agent

Telephone No. Fax No. Mobile No.

For official use : -


Complaint against the sponsor (in brief)

i) Sponsor not found


ii) Iqama not prepared / renewed
iii) Salary not paid for ………………. months / years
iv) Illegal deductions from the salary
v) Salary and job not given as per contract
vi) Ill-treatment and harassment
vii) Reported by the sponsor as runaway (Huroob)
viii) Not sending on vacation / emergency leave (Exit-re entry visa)
ix) Not providing medical treatment
x) Not sending on final exit after settling dues and ESB
xi) Others : ______________________________________________________________
___________________________________________________________________________
xii) Remarks : ______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Complaint against the recruiting agent (if any)

I paid Rs. __________ to the Recruiting Agent through Mr. ______________________


______________________________ (Mobile No. ______________ Tel No. _______________ ) but I
did not get job and salary as promised in India.

Promised Job : Actual Job :


Promised salary : Actual Salary :

Note: Please attach photocopy of passport (including visa endorsement and emigration stamped page)
Iqama and employment agreement.

Signature of the applicant

Place :
Date :

Note : Duly completed Labour complaint form may please be submitted in the Labour Wing of the
Embassy between 9.00 AM and 12:30 PM on all working days for further follow up Attaché (Labour) or
TS (Labour) may be contacted.

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