OSH Code · Form XVII
Form XVII — Annual Return
Form XVII of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rules 72(5), 74.
Rule: Rules 72(5), 74 · Signed by: Occupier, Manager
What the form records
- Labour Identification Number
- Period of the Return (From - To)
- Name of the Establishment
- Email ID (employer)
- Telephone No. (employer)
- Mobile number (employer)
- Premise name
- Sub-locality
- District
- State
- Pin Code
- Geo Co-ordinates
- Hours of Work in a day
- Number of Shifts
- Number of hours in a shift
- Maximum No. of employees employed in the establishment in any day during the year
- Average No. of employees employed in the establishment during the year
- Maximum number of Migrant Worker during the year (Section 59 of OSH&WC Code)
- Number of fixed term employee engaged
- Name with LIN of the Contractor
- No. of Contract Labour Engaged
- Whether facility of Canteen provided (section 24(v) of OSH&WC Code, 2020)
- Crèches (section 67 of Code on Social Security Code, 2020 and section 24 of the OSH&WC Code 2020)
- Whether Crèches allowance under Rule of Social Security Code given
- Ambulance Room (section 24(2)(i) of OSH&WC Code, 2020)
- Safety Committee (section 22(1) of OSH&WC Code, 2020)
- No. of safety officers appointed (section 22(2) of OSH&WC Code, 2020)
- No. of Qualified Medical Practitioner appointed (section 12(2) of OSH&WC Code 2020)
- Is the Works Committee has been functioning (Section 3 of IR Code, 2020)
- Date of its constitution
- Whether the Safety Redressal Committee constituted (Section 4 of IR Code, 2020)
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.
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