Form III — Certificate of Registration of Establishment
Rule: Rule 3(2) · Signed by: State Authority · Under: OSH & Working Conditions (Central) Rules 2026
What the form records
- Registration No.
- Date
- Name of the establishment
- Nature of work carried on: (a) Factory
- Nature of work carried on: (b) Mining
- Nature of work carried on: (c) Dock work
- Nature of work carried on: (d) Contract Work
- Nature of work carried on: (e) Building or Other Construction Works
- Nature of work carried on: (f) any other work (not covered above)
- Total Number of employees engaged directly in the establishment
- Total Number of the employees engaged through contractor
- Total Number of Contractors and their details
- Number of inter-state migrant workers engaged
- For factories: Details of the manufacturing process
- For factories: Full postal address and situation of the factory
- For factories: Name and address of the occupier and manager
- For factories: Maximum number of workers to be employed on any day
- For mines: Name of Mineral(s)
- For mines: Lease extent of the mine (in Acres)
- For mines: Name and address of the owner
- For mines: Average Monthly output, targeted (Tonne)
- For mines: Maximum number of persons to be employed on any day
- For Dock work: Name of Dock Work / Major Port
- For Dock work: Types of Dock Works
- For Dock work: Name of the Cargo handled and stored along with quantity
- For Dock work: Name of the chemicals handled and stored along with quantity
- For Dock work: Name of the hazardous Chemicals handled and stored along with quantity
- For building or other construction work: Type of Construction work
- For building or other construction work: Probable period of commencement of work
- For building or other construction work: Expected period for completion of work
- For building or other construction work: Details of approval of the local authority
- Any Other establishment
- Remarks of registering officers
- Place
- Date
- Signature E-Sign/DSC of registering officer along with designation
This page opens the blank statutory form in MedFactory, ready to fill, save and print. See the Form III reference page for the rule and signatory detail.
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