HrformatsI have Attached P.F. Forms
| Proforma for Coverage | ||||||||||
| (To be submitted by an Employer along with one or more of the documents mentioned below for obtaining Code Number) | ||||||||||
| 1. | Name of the Factory / Establishments and Address | |||||||||
| 2. | Details of Head Office & Branches with Address | |||||||||
| 3. | Date of Incorporation / Set up | |||||||||
| (Please furnish any one of the documents mentioned overleaf in | ||||||||||
| support of the proof of date od set up of the Estt. / Factory) | ||||||||||
| 4. | Details of the Code No. if ant allotted to the Head Office | |||||||||
| 5. | Name and complete address of the persons having over all | |||||||||
| control on the affairs of the establishment | ||||||||||
| (Partner / Directors / M.D. / Proprietor) | ||||||||||
| 6. | Employement Strength | |||||||||
| (i) At Present | ||||||||||
| (ii) Monthwise total employement strength form the date of | ||||||||||
| set up may be furnished in separate statement.(Maximun | ||||||||||
| number of employees to be shown during the month) | ||||||||||
| (iii) The date on which first time more than 19 employees | ||||||||||
| are present. | ||||||||||
| 7. | Nature of Business Activity / Manufacturing Activity | |||||||||
| 8. | Details of Leagal set up of establishment. (Please mention whether it is | |||||||||
| an Incorporated, Private, Public Limited Company, Society, Partnership | ||||||||||
| or Proprietory Concern. Enclose Copy of Ist Partnership Deed, Mamorandum | ||||||||||
| and Article of association and Ist Annual Report) | ||||||||||
| 9. | Details of Employers / Ownership particulars etc. (Names, Designations | |||||||||
| & Address of M.D./Partners/Secretary to be furnished) | ||||||||||
| 10. | Wages disbursed for the month | |||||||||
| 11. | Details of Bankers (Including Bank Branches & Account Numbers) | |||||||||
| 12. | In case of Contractor Establishment the details of Contract Agreements | |||||||||
| / Job Orders with full particulars of the Principal Employees. | ||||||||||
| 13. | Income Tax Permanent Account Number | |||||||||
| 14. | Details of Employees furnished below (List Enclosed) | |||||||||
| 20 Employyes are present at date | ||||||||||
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| 15. | Details of Bank Draft amountin to the contribution and administrative | Name of the Bank & Branch | ||||||||
| charges paid in r/o the above employees (Rate of Contribution at prsent is | ||||||||||
| 12% by Employees and Employer + 0.50 % towards EDLI contribution and 1.11 % | Draft Number & Date | |||||||||
| towards administrative charges.) | ||||||||||
| Amount | ||||||||||
| Verification | ||||||||||
| It is verified that the details furnished above are correct to the bes of our knowledge and belief. It is clearly understood that we | ||||||||||
| are liable for coverage from a date antecedent to the date of st up furnished above and other legal consequences in the event of | ||||||||||
| furnishing of false information. | ||||||||||
| (Signature Employer with Rubber Stamp) | ||||||||||
| Essential Document (s) to be submitted (For other than Proprietory Concern) | ||||||||||
| 1. | A Copy of Memorandum & Articles of Association and the Certificate of In-Corporation issued by the Registrar of Companies, | |||||||||
| in the case of Public & Private Limited Companies. | ||||||||||
| 2. | A Copy of Partnership Dep in the case of Partnership. | |||||||||
| 3. | A Copy of Registration Certificate issue by the Registrar of Co-Operative Societies. | |||||||||
| 4. | A Copy of Registraion Certificate issue dby registrar in the case of Societies register under Societies Registration Act along with | |||||||||
| a copy of the objects and rules of the society. | ||||||||||
| 5. | Partition Deeds cerating HUF. | |||||||||
| 6. | Any agreement of other legal documents in the cas eof Association of persons as defined in Income Tax Act. | |||||||||
| A List of documents which can be submitted as Proff of date of set up | ||||||||||
| 1. | First Sales Voucher | |||||||||
| 2. | Any proof regarding dat eof Trial Production. | |||||||||
| 3. | Incorporation certificated issued by the Registrar of Companies together with the proof of Managing Directors to the Share | |||||||||
| Holders in the Annual Report. | ||||||||||
| 4. | Commencement of Business Certificate issued by the Registrar of Companies. | |||||||||
| 5. | Certificate of Registration issued by the Registrar of Co-Operative Societies. | |||||||||
| 6. | Certificate of Registration issued under Societies Registration Act. | |||||||||
| 7. | Certificate issued by Reserve Bank of India registering newely set up and Non-Banking financial companies. | |||||||||
| 8. | License issued by the Health Authorities. | |||||||||
| 9. | License / Permission issued by the Municipal / Corporation Authorities. | |||||||||
| 10. | Permission / Approval granted by the apprppriate State Government Authorities in the case of Educational Institutions. | |||||||||
| 11. | Certificated issued by the Fire Authorities in the case of establishment coming under Explosives Act. | |||||||||
| 12. | First Assessment order issued by the Sales Tax Authorities. | |||||||||
| 13. | First Assessment order issue dby the Income Tax Authorities. | |||||||||
| 14. | Certificate issue dby the Small Scale Industries Authorities registering the establishment. | |||||||||
| 15. | Reports / Returns to Central Excise Authorities. | |||||||||
| 16. | Sanction / Connection of Power like H.T. Connection, L.T. Connection etc. | |||||||||
| 17. | Any other certificate issue dby any authority under any law for the time being in force to the commencement of Business | |||||||||
| Activity / Manufacturing Activity. | ||||||||||
| 18. | Contractor establishments to submit documentary evidence as to the existance of Office / Factory Premises, if any the particulars | |||||||||
| of the sent Receipt / Copy of Lease Deed / Title Deed / Electric Connection Bill / Telephone Connection etc. | ||||||||||
| 19. | Contractors establishment to submit documentary evidence in regard to other Licence / Certificate / Copy of Application / | |||||||||
| Latest Return submitted to the Appropriate authority which may be the requirement for carrying out the work under the law. | ||||||||||
| 20. | A Copy of documents in support of ownerships of the factory premises is learn Deed / Allotment Letter / Agreement Letter. | |||||||||
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