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Place* |
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Name of the Principal Employer * |
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Name of the establishment * |
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Address of the Principal Employer * |
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Postal Address of the Establishment * |
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Name of the Director/Partner |
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Name of Manager * |
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Address of the Director/Partner
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Address of Manager * |
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Name of work carried on in the establishment * |
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Contractor Name * |
Contractor Address * |
Nature of Work * |
Date of commencement of work * |
Date of
termination * |
Mobile Phone* |
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No of Migrant Workman * |
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Email* |
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No of Male Employees * |
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Mobile Number * |
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No. of Female Employees |
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*Mandatory fields |
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