12. Manner of making application for registration of unorganized worker.

Form I
Form I
[ See rule 12]
Name of the unorganised worker : ................................................................................... Father's/Husband's name : ............................................................................... Occupation : ....................................................................................... Present Address : ......................................................................................... : ......................................................................................... .................................................................................... Permanent Address : ...................................................................................... : ....................................................................................... Dependents : ................................................................................... (a) Father : ......................................................................................... (b) Mother : ......................................................................................... (c) Dependent Children : ......................................................................................... (d) Others : .........................................................................................
Name of the unorganised worker
:
...................................................................................
Father's/Husband's name
:
...............................................................................
Occupation
:
.......................................................................................
Present Address
:
.........................................................................................
:
.........................................................................................
....................................................................................
Permanent Address
:
......................................................................................
:
.......................................................................................
Dependents
:
...................................................................................
(a) Father
:
.........................................................................................
(b) Mother
:
.........................................................................................
(c) Dependent Children
:
.........................................................................................
(d) Others
:
.........................................................................................