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lABOUR dEPARTMENT hARYANA

Registration Form For Government Employee

Note:- Please select your Department from the Establishment list or call Government Department to add your Department name(If missing) on ---------- or Email at: systemanalaystlabour@gmail.com

Fields marked * are mandatory.

1. Name of Establishment(Department Name) *:
2. State :
  District*:
  Tehsil* :
  Village* :
  Plot No./Milestone/Village/Street :
  Colony/Sector/Road/Post Office* :
3. Pincode* :
4. Phone :
5. Mobile No* :
6. Fax :
7. Email * :
8. Password* :
9. Confirm Password* :

(The Email Id and Password entered above will be used for logging into the site at home page)

Details of Principal Employer

10. Name* :

Please specify the name as on your aadhar card

11. Aadhaar Number * :
12. Father's Name*:
13. Plot No./Milestone/Village/Street :
  City/Sector/Road/Post Office :
  State :
  District*:
  Tehsil* :
  Village* :
14. Pincode :
15. Phone No (with STD Code) :
16. Mobile No* :
17. Fax :
18. Email* :
19. Nature of work of Principal Employer:
23. Circle of Concerned Deputy Labour Commissioner in which the Unit is located* :
  Circle of Concerned Assistant Labour Commissioner in which the Unit is located* :
  Name of Concerned Assistant Labour Commissioner in which the Unit is located :
  Circle of Concerned Labour Inspector in which the Unit is located* :

DECLARATION :-

I do hereby declare that the statement given above is true and correct to the best of my knowlege. In case any information is found to be concealed, my registration number may be cancelled and I shall be liable for furnishing false information

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