OSH Code · Form XXIII

Form XXIII — Experience Certificate of Contract Labour

Form XXIII of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 100.

Rule: Rule 100 · Signed by: Manager

What the form records

Name of contractor/employer
LIN/PAN No. of the contractor/employer
Email Id of the contractor /employer
Mobile No. of the contractor/employer
Nature and location of work
Name of principal employer
LIN/PAN No. of the principal employer
Email Id of the principal employer
Mobile No. of the principal employer
Name of the labourer
UAN / Aadhaar No.
Mobile No.
Serial Number in the employee register
Registration number, date and name of the Board where the building or other construction work is registered as a beneficiary
Period of employment
Designation
Work performed
Seal and Signature of Contractor

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.