OSH Code · Form XXII (Form 22)
Form XXII — Proforma of Licence
Form XXII of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rules 89(1), 90(2).
Rule: Rules 89(1), 90(2) · Signed by: State Authority
What the form records
- Licence No.
- Reg. No.
- Date of Reg.
- Licence is hereby granted to
- for the premises known as
- situated at
- nature of work
- The ______ 20.. (date of issue)
- Issuing Authority
- Sl.No.
- Period of issue
- Valid For - Maximum number of Contract labour on any one day
- Fee
- Date of Payment
- Excess fee for late payment
- Date of payment (late fee)
- Signature of the Issuing Authority
- Amendments - Year when Amended
- Amendments - Maximum number of Contract labour on any one day
- Amendments - Date of payment of amendment fee
- Amendments - Date of Payment
- Amendments - Signature of the Issuing Authority
- E-sign/digital sign of the designated authority
OSH Code Form XXII is the 22th form of the Seventh Schedule, so it is also written OSH Code Form 22. Both refer to this same form: Proforma of Licence.
Part of the Seventh Schedule to the OSH & Working Conditions (Central) Rules 2026. View the official form layout in the gazette, or open Form XXII in MedFactory.
MedFactoryOpen Form XXII to fill, save and print.
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