Format of Application for Industrial Disputes Claim
BEFORE THE PRESIDING OFFICER INDUSTRIAL TRIBUNAL, CUM- LABOUR COURT, NO_________.
Mr./Ms. _________ S/o,D/o
Shri _________, Resident of _________, District, State _________
………. APPLICANT/CLAIMANT
VERSUS
_________ Address _________, _________ Through its _________, _________
……….RESPONDENT
APPLICATION UNDER SECTION _________ , OF THE INDUSTRIAL DISPUTES ACT, _________
Sir,
It is respectfully submitted as under: –
1- That the respondent appointed the applicant/claimant on __________________.
1- That the applicant/claimant __________________.
2- That on __________________.
3- That the claimant __________________.
4- That __________________.
2- That the _________ other dues which are outstanding against respondent are fully mentioned in the Annexure-A enclosed herewith.
3- That the applicant/claimant is entitled to receive _________ from the respondent as annexed in Annexure-A.
It is, therefore, prayed that the application of the applicant may kindly be accepted and order may kindly be passed to make the payment of __________/- with interest to the applicant/claimant which is fully mentioned in Annexure–A.
Applicant/Claimant
_________ S/o/D/o _________ Resident _________
Through A.R.
_________
Seat No. _________, _________
_________ Courts, _________
VERIFICATION:
Verified that the contents of my above application from Paras No. _________ to _________ are true to best of my knowledge and belief.
Verified at _________ on_________
Applicant/Claimant