Notice of Change

Form ‘B’
[See sub-rule (2) of rule 3]

Name and the address of the Establishment.

Take notice that the following changes have taken place with effect from ……………… in the particulars furnished by me in notice dated ………………… on Form ‘A’.

1) Name :

2) Address :

3) Name of the employer:

4) Nature of Business :

Place :

Date :…………..

Signature of the Employer with
name and designation.

To 

The Controlling Authority