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State of Chattisgarh - Section

Section 13 in Chhattisgarh Private Placement Agencies (Regulation) Rules, 2014

13. Identity card for domestic workers.

- The Agency shall issue an identity card to every domestic worker in Form-VIII, it shall contain a full-face colour-photo, name of the agency, name of the domestic worker, designation, identification number and the period of validity and the photo identity card shall be maintained upto date and any change in the particulars shall be entered therein and in a situation where an employee is no longer engaged or employed by the agency, the photo identity card issued to domestic worker/supervisor shall be returned to the agency issuing it, once domestic worker is no longer engaged or employed by it.Form-I[See rule 3]Application for New Licence/renewal of Licence to Engage in the Business of Private Placement AgencyTo,The Controlling Authority..........................................................................................................................
The undersigned hereby applies for obtaining alicense to run their business in the area of Private PlacementAgencies :
1. Full name of the applicant  
2. Nationality of the applicant  
3. Son/Daughter/Wife of  
4. Residential Address  
5. Address where the applicant desires to start hisAgency  
6. Name of the private placement Agency  
  (NOTE :Registration Number of the Agencyalso be indicated)  
7. Name and Address of Proprietor, Partner,Majority shareholder, Director and Chairman of the Agency  
  (NOTE :Nationality of each partner,Majority Shareholder, Director and Chairman of the Agency beindicated)  
8. Name and extent of Facilities available  
9. Qualification of staff engaged for impartinginstruction :  
  Name:................................................  
  Age:.................................................  
  Designation:.........................................  
10. Particulars of the uniform including colour, incase the applicant intends to use any uniform for the privatedomestics work and supervisors of the Agency.  
11. Does the applicant intends to operate in morethan one district? If so, please mention name of the districts -  
  1.........................................  
  2.........................................  
  3........................................  
  4........................................  
  5........................................  
12. Does the applicant intend to operate in theentire state ? (Yes/No)  
13. Does the applicant possess the training facilityon its own or will get it on outsourcing basis? The details oftraining facility should be furnished (as annexure)  
Enclosure : -    
  Addressof applicant
  Telephonenumber of the applicant
  Dateof application
  1. Copy of current Income Tax ClearanceCertificate.  
  2. Affidavit as prescribed in sub-section (2) ofSection 7 of the Act.  
  3. Other enclosures.  
Form-II[See rule 4]Form for verification of Antecedents
*Thumb Impression* of theApplicant............................................................................   Recent Passport SizePhotographAttested By AClass-IGazetted Officer
Signature of theApplicant....................................................................................
For official use only    
Form Number Name of the police station, sent for policeverification Date
     
Fee Amount Rs.....................Cash/D.D..........................Name of Bank and Branch.............................................D.D. No.....................Date of Issue....................;....N.B. : Please read the instructions carefully before filling the form. Please fill in BLOCK LETTERS :(Note : Please furnish correct information. Furnishing of incorrect information or suppression of any material information in the form will render the candidate unsuitable for grant of license)