Form XXVII — Notice to employer for composition of a first offence

Form XXVII of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 182(1).

What the form records

• Notice No.
• Date
• Name of the establishment (of which you are employer)
• Registration No.
• Name of the person
• Name and Address of the establishment
• Registration No. of the establishment
• Particulars of the offence
• Provisions of the Code/Scheme/Rules/Regulations under which the offence is committed
• Amount required to be paid for compounding of the offence
• Name and details of account for depositing the amount specified in serial no. 6
• Part-II Name and designation of Officer
• Part-II Date
• Part-II Place
• Part-III Ref: Notice No.
• Details of the compounding amount deposited (Copy of the electronically generated receipt to be attached)
• Details of the prosecution, if any filed in respect of the violation of the above-mentioned offences
• Whether the present offence is a first offence or whether the applicant has committed any other offence prior to this offence, if so, then, full details of such offence
• Any other information which the applicant desires to provide
• Signature of the applicant (Name and Designation)
• Part-IV Ref: Notice No.
• Offence under sub-section of section 114
• Applicant (Sh/Smt) name
• Name and registration number of the establishment
• Amount compounded dRs (Rupees)
• Part-IV Name and Designation of the Officer