OSH Code · Form II

Form II — Application for cancellation of Registration Certificate of establishment

Form II of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 3(10).

Rule: Rule 3(10) · Signed by: Occupier

What the form records

Registration No
Name and Address of Establishment
Name and Designation of employer
Full address to which communication relating to the establishment to be sent
Nature of work of the establishment
Establishment having registration No.
Dated
Is closed with effect from (Date)
Certificate from Employer: payment of all dues - registration no.
Certificate from Employer: payment of all dues - dated
Certificate from Employer: free from storage of hazardous chemicals - registration no.
Certificate from Employer: free from storage of hazardous chemicals - dated
Place
Date
Signature/ E-sign/digital sign of employer

Part of the Seventh Schedule to the OSH & Working Conditions (Central) Rules 2026. View the official form layout in the gazette, or open the OSH Code forms in MedFactory.

MedFactoryOpen the OSH Code statutory forms.