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    महारा दुकाने व आ थापना (नोकर चे व सेवाशत चे व नयमन) नयम, २०१८ Form - ‘F'

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    preranayendhe731
    1. This document is an application form submitted to the Office of the Deputy Commissioner of Labour in Pune by Shivdas Dadasaheb Bhalekar for intimation regarding his furniture shop establishment called Pratibha Furniture. 2. The application provides details of the establishment such as its address, number of employees, nature of business, and self-declaration by the employer ensuring compliance with applicable labor laws. 3. Shivdas declares that the information provided in the application is true to the best of his knowledge and undertakes to abide by the provisions of the Maharashtra Shops and Establablishments Act and orders issued thereunder.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    महारा दुकाने व आ थापना (नोकर चे व सेवाशत चे व नयमन) नयम, २०१८ Form - ‘F'

    Uploaded by

    preranayendhe731
    26 views3 pages
    1. This document is an application form submitted to the Office of the Deputy Commissioner of Labour in Pune by Shivdas Dadasaheb Bhalekar for intimation regarding his furniture shop establishment called Pratibha Furniture. 2. The application provides details of the establishment such as its address, number of employees, nature of business, and self-declaration by the employer ensuring compliance with applicable labor laws. 3. Shivdas declares that the information provided in the application is true to the best of his knowledge and undertakes to abide by the provisions of the Maharashtra Shops and Establablishments Act and orders issued thereunder.

    Original Title

    110249372303

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    1. This document is an application form submitted to the Office of the Deputy Commissioner of Labour in Pune by Shivdas Dadasaheb Bhalekar for intimation regarding his furniture shop establishment called Pratibha Furniture. 2. The application provides details of the establishment such as its address, number of employees, nature of business, and self-declaration by the employer ensuring compliance with applicable labor laws. 3. Shivdas declares that the information provided in the application is true to the best of his knowledge and undertakes to abide by the provisions of the Maharashtra Shops and Establablishments Act and orders issued thereunder.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views3 pages

    महारा दुकाने व आ थापना (नोकर चे व सेवाशत चे व नयमन) नयम, २०१८ Form - ‘F'

    Uploaded by

    preranayendhe731
    1. This document is an application form submitted to the Office of the Deputy Commissioner of Labour in Pune by Shivdas Dadasaheb Bhalekar for intimation regarding his furniture shop establishment called Pratibha Furniture. 2. The application provides details of the establishment such as its address, number of employees, nature of business, and self-declaration by the employer ensuring compliance with applicable labor laws. 3. Shivdas declares that the information provided in the application is true to the best of his knowledge and undertakes to abide by the provisions of the Maharashtra Shops and Establablishments Act and orders issued thereunder.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    महारा दुकाने व आ थापना (नोकर चे व सेवाशत चे व नयमन) नयम, २०१८

    Form – ‘F’
    [See Rule 8]
    APPLICATION FOR INTIMATION

    Application ID 110249372303 Photo

    Registration Certificate / Intimation


    Receipt No. न दणी मांक / पावती मांक

    Division / वभाग Pune

    District / िज हा: Pune

    Office Name Office of the Deputy Commissioner of Labour,Pune, Address- Pune


    District Bunglow No.5, Mumbai - Pune Road, Shivaji Nagar, Pune-
    411005

    Name of the establishment / आ थापनेचे PRATIBHA FURNITURE


    नाव तभा फ नचर

    Previous details of establishment / Manual


    आ थापनेची पूव ची स व तर मा हती

    Old Registration No 106852101803

    Old Date of Registration 16/11/2018

    Expiry Date 27/10/2028

    Postal address and situation of the SHOP NO 2 GROUND FLOOR MILINDRAJ शॉप नं 2 ाउंड लोर मील दराज रे सड सी
    Establishment / ( आ थापनेचा प ा ) RESIDENCY S R NO 75/9 DHAYRI ROAD RAYKAR एस आर नं 75/9 धायर रोड रायकर माला
    MALA DHAYARI, DHAYRI, PUNE, , HAVELI, PUNE, धायर ,धायर ,पुण,े ,हवेल ,पुण,े 411041
    411041

    Mobile / मण वनी . 8010705639

    Email-id / ई - मेल आय डी [email protected]

    Date of commencement of business / 16/11/2018


    यवसाय सु के याचा दनांक

    Nature of Business / यवसायाचे व प FURNITURE SHOP फ नचर शॉप

    Whether establishment falls under Private


    public or private sector / आ थापना
    सावज नक े ात येते क खाजगी े ात येते

    Total No. of Employee Men Women Transgender Total

    1 0 0 1

    Name of the Employer / मालकाचे नाव SHIVDAS DADASAHEB BHALEKAR शवदास दादासाहेब भालेकर

    Residential Address of the employer / PUNE,PUNE,PUNE,,HAVELI,PUNE,411041 पुण,े पुण,े पुण,े ,हवेल , पुण,े 411041
    मालका या नवास थानाचा प ा

    Resident Since / वा त य 21

    Status / Designation OWNER

    Mobile No 8010705639

    E-mail ID [email protected]

    Aadhar No 233567875543

    Name of Manager / यव थापकाचे नाव

    Residential address of Manager /


    यव थापका या नवास थानाचा प ा

    Contact No
    Fax No

    Email-ID / ई - मेल आय डी

    Aadhar No

    Category Of Establishment / आ थापनेचे SHOP ( दुकाने )


    वगवार

    Category Of Establishment Type / फ नचर शॉप / FURNITURE & FICTIONS


    आ थापनेचे उपवगवार

    Type of organisation / आ थापनेचा कार Self Ownership (Proprietary)

    Name of the member of employer's Shivdas


    family employed in the establishment / शवदास
    आ थापनेत नोकर त असले या मालकां या
    कुटब
    ंु ातील इसमांची नावे Men / पु ष Women / ि या Transgender / इतर

    1 0 0

    Self Declaration / वघोषणाप

    I ANJANA, hereby solemnly affirm and state that the business which I ANJANA have started is not banned or prohibited by any
    Act, Rules, Law or Order of any Court of Law or any competent authority and the premises where I ANJANA, are conducting the said
    business is free from violation of any Act, Rules, Order of any Court of Law or any Competent Authority.

    I ANJANA, hereby declare that the information provided above is true and correct to the best of my/our personal knowledge, information
    and belief. I ANJANA, am/are fully aware about the consequences of giving false information. If the information is found to be false, I
    ANJANA, shall be liable for procecution and punishment under the Indian Penal Code (45 of 1860) and /or any other law applicable
    thereto.

    I ANJANA, have obtained necessary licenses, permissions, permit for the conduct of this business and the place of business from the
    appropriate Authority.

    I ANJANA, shall be responsible and liable for legal action if the business is conducted without proper licence, permission, permit from
    the appropriate Authority. I/We submit and declare that I ANJANA, will not undertake any illegal activity or any business prohibited in law
    in force in India.

    I ANJANA, declare that the place of business is not located in any area wherein commencing / running of such business is prohibited
    by any law or order of any Competent Authority.

    I ANJANA, hereby declare that the copies attested by me are true copies of original documents. I ANJANA, am/are well aware of the
    fact that if the copies are found false/forged, I/We shall be liable for procecution and punishment under the Indian Penal Code (45 of
    1860) and /or any other law applicable thereto.

    I ANJANA, undertake to abide by the provisions of the Maharashtra Shops and Establishments (Regulation of Employment and
    Conditions of Service) Act, 2017 (Mah. LXI of 2017) and the Rules and orders passed thereunder by any Authority.

    मी अंजना, या वारे गांभीयपूवक ढकथन करतो/ करते आ ण असे नमूद करतो/ करते क , मी/ आ ह सू केले या यवसायावर कोणताह अ ध नयम,
    नयम, कायदा कंवा कोण याह वधी यायालयाचा अथवा कोण याह स म ा धका याचा आदेश या वारे बंद घाल यात आलेल नाह कंवा मनाई कर यात
    आलेल नाह आ ण मी अंजना या जागेत उ त यवसाय कर त आहे/ आहोत तेथे कोणताह अ ध नयम, नयम, कोण याह यायालयाचा अथवा कोण याह
    स म ा धका याचा आदेश यांचे उ लंघन झालेले नाह .

    मी अंजना, या वारे असे घो षत करतो/करते क , वर अजाम ये नमूद केलल


    े मा हती, मा या आम या वैयि तक ानानुसार, मा हती माणे व व वासानुसार खर
    व बनचूक आहे. चुक ची मा हती दे या या प रणामाची मला/आ हाला पूण जाणीव आहे. दलेल मा हती चुक ची आढळून आ यास मी अंजना भारतीय दंड सं हता
    (1860 चा 45) अ वये कंवा यासंबधं ात लागू असले या इतर कोण याह काय या वये खटला भर यासाठ व श ेसाठ पा आहे/ आहोत.

    मी अंजना, अजात नमूद केले या जागेत यवसाय कर यासाठ संबं धत समु चत ा धका याकडून आव यक ती अनु ती, परवानगी, परवाना ा त केला आहे.

    मी अंजना, अनु ती, परवानगी, परवाना न घेता यवसाय कर त अस यास कायदेशीर कारवाईसाठ पा व जबाबदार राहू.

    मी अंजना, असे घो षत करतो/करते क , भारतातील लागू असणा या काय यांतगत मनाई असलेले बेकायदेशीर कृ य अथवा यवसाय करणार नाह .

    मी अंजना, असे घो षत करतो/करते क , जेथे असा यवसाय सु कर यास कंवा चाल व यास कोण याह काय या दारे कंवा कोण याह स म ा धका या या
    आदेशा वारे मनाई केलल
    े आहे या कोण याह े ाम ये माझे/ आमचे यवसायाचे ठकाण ि थत नाह .
    मी अंजना, असे घो षत करतो/करते क , अजासोबत सादर केले या वयं-सा ां कत द ताऐवजा या ती या मूळ द तऐवजा या स य ती आहेत. या ती अस य
    कंवा बनावट अस याचे आढळून आ यास भारतीय दंड सं हता (1860 चा 4 5 ) आ ण / कंवा यासंबध
    ं ात लागू असले या कोण याह इतर काया या वये
    मा या/आम या व द यायालयीन खटला भर यासाठ व श ेसाठ मी अंजना पा आहे/ आहोत याची मला/आ हाला पूण जाणीव आहे.

    मी अंजना, महारा दुकाने व आ थापना (नोकर चे व सेवाशत चे व नयमन) अ ध नयम, 2017 (2017 चा 61) व याअंतगत तयार केले या नयमातील
    तरतुद ंचे आ ण स म ा धकार यांचक
    े डून नग मत कर यात आलेले आदेश यांचे पूणत: पालन कर याची हमी देतो/देत.े

    Sign

    SHIVDAS DADASAHEB BHALEKAR


    Name and Signature of the Employer

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