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lABOUR dEPARTMENT hARYANA

Registration Form For Government Employee

Note:- Please select your Department and then office for which you are seeking Registration Certificate. If you do not find your Department and then Office in dropdown please call on 0172-2702136 (9.00 AM to 5 PM on working days only) or Email at: systemanalystlabour@gmail.com to add your Department name and your Office in that Department.

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. Date of Commencement *:
8. Email * :
9. Password* :
10. Confirm Password* :

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

Details of Principal Employer

11. Name* :

Please specify the name as on your aadhar card

12. Aadhaar Number * :
13. Father's Name*:
14. Plot No./Milestone/Village/Street :
  City/Sector/Road/Post Office :
  State :
  District*:
  Tehsil* :
  Village* :
15. Pincode :
16. Phone No (with STD Code) :
17. Mobile No* :
18. Fax :
19. Email* :
20. Nature of work of Principal Employer:
21. 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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