Fill online: Application for prior permission for lay-off, retrenchment or closure, establishments with 300 or more workers

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Name of the company

Fills 3 places in the document. Appears later in the document.

CIN of the company

Appears later in the document.

Registered office address

Appears later in the document.

DD.MM.YYYY (1)

Appears later in the document.

Time

Appears later in the document.

Place of the meeting

DD.MM.YYYY (2)

Name and designation of the officer who placed the note

Undertaking, unit or department concerned

Address of the establishment

Factory / mine / plantation

Average workers per working day, preceding twelve months

DD.MM.YYYY (3)

State Government of State / Central Government

Lay-off of Number workers / retrenchment of Number workers / closure of the undertaking

Intended date of the action

Estimated cost in Rs

78 / 79 / 80

Industrial Relations (Central) Rules 2026 / rules made by the State Government of State under the Code

Name of the authorised signatory

Designation of the authorised signatory

The workers concerned / the representatives of the workers

Pay lay-off compensation under section 67 of the Code / serve on each worker three months' notice in writing indicating the reasons for retrenchment or pay wages in lieu of notice, pay at the time of retrenchment compensation of fifteen days' average pay for every completed year of continuous service or any part in excess of six months, and contribute fifteen days' wages last drawn of each retrenched worker to the worker re-skilling fund under section 83 / pay each worker compensation of fifteen days' average pay for every completed year of continuous service or any part in excess of six months

Name of the director

DIN of the director

DD.MM.YYYY (4)

Place of signing

Name of the establishment

Reference number

DD.MM.YYYY (5)

Secretary, Department of Labour, Government of State / authority specified by the appropriate Government under Chapter X

Address of the authority

Lay-off / retrenchment / closure

In Form-XIV of the Industrial Relations (Central) Rules 2026 / in the form prescribed by the rules of the State Government / in the content of Form-XIV, the State Government not having prescribed a form at the date of this letter

At least fifteen days before the intended lay-off / at least sixty days before the intended retrenchment / at least ninety days before the intended closure

78(5) / 79(4) / 80(3)

Name of the contact person

Designation of the contact person

Telephone number

E-mail address

DD.MM.YYYY (6)

Registered office, CIN and PAN

Registration or licence number

Nature of the industry

Appropriate Government and basis

Persons employed by category

Unions and negotiating union

Standing orders applicable

Settlement, award or agreement in force

Expected duration of the lay-off

Number and categories of workers affected

Position under section 71

Notice under section 79(1)(a)

Scope of the closure

Earlier applications and outcome

Set out the reasons in numbered paragraphs, specifically and with dates and figures: the cause, when it arose, what the establishment has done about it, why it cannot be overcome without the action, and why the number and categories of workers proposed are no more than the cause requires. Refer to the documents in Annexure 2.

Financial year 1

Revenue, year 1

Profit or loss, year 1

Net worth, year 1

Capacity, year 1

Workers, year 1

Financial year 2

Revenue, year 2

Profit or loss, year 2

Net worth, year 2

Capacity, year 2

Workers, year 2

Financial year 3

Revenue, year 3

Profit or loss, year 3

Net worth, year 3

Capacity, year 3

Workers, year 3

DD.MM.YYYY (7)

Revenue, current year

Profit or loss, current year

Net worth, current year

Capacity, current year

Workers, current year

State each alternative considered, for example redeployment to another unit, transfer within the same town or village, short-time working, a voluntary separation scheme, reduction of overtime and contract labour first, deferment of the action, and why each was not adopted or was adopted in part. State the contract labour engaged in the same work and what is proposed for it.

Estimated lay-off compensation

Estimated notice pay

Estimated retrenchment or closure compensation

Estimated re-skilling contribution

Estimated gratuity

Estimated wages and other dues

Estimated total dues

Held in the Company's bank account with Bank name / to be met from Source of funds

DD.MM.YYYY (8)

DD.MM.YYYY (9)

Month 1

Working days, month 1

Worker-days, month 1

Average, month 1

Month 2

Working days, month 2

Worker-days, month 2

Average, month 2

Month 3

Working days, month 3

Worker-days, month 3

Average, month 3

Month 4

Working days, month 4

Worker-days, month 4

Average, month 4

Month 5

Working days, month 5

Worker-days, month 5

Average, month 5

Month 6

Working days, month 6

Worker-days, month 6

Average, month 6

Month 7

Working days, month 7

Worker-days, month 7

Average, month 7

Month 8

Working days, month 8

Worker-days, month 8

Average, month 8

Month 9

Working days, month 9

Worker-days, month 9

Average, month 9

Month 10

Working days, month 10

Worker-days, month 10

Average, month 10

Month 11

Working days, month 11

Worker-days, month 11

Average, month 11

Month 12

Working days, month 12

Worker-days, month 12

Average, month 12

Total working days

Total worker-days

List the documents, for example audited financial statements for the last three years, the customer's letter terminating the contract dated DD.MM.YYYY, the supplier's force majeure notice, the pollution control board's closure direction, the plant engineer's report on the condition of the machinery, minutes of meetings with the union.

Affected worker 1

Affected worker 1 category

DD.MM.YYYY (10)

Affected worker 1 years

Affected worker 1 wages

Affected worker 1 compensation

Affected worker 2

Affected worker 2 category

DD.MM.YYYY (11)

Affected worker 2 years

Affected worker 2 wages

Affected worker 2 compensation

Affected worker 3

Affected worker 3 category

DD.MM.YYYY (12)

Affected worker 3 years

Affected worker 3 wages

Affected worker 3 compensation

DD.MM.YYYY (13)

Name of each worker concerned as listed in Annexure 3, or for a closure, the President and General Secretary of the negotiating union and of each registered trade union of the workers

DD.MM.YYYY (14)

Place for inspection

Hours

Place of display

Person served 1

By hand / Registered post / Speed post / E-mail (1)

Date and time of service 1

Acknowledgement 1

Person served 2

By hand / Registered post / Speed post / E-mail (2)

Date and time of service 2

Acknowledgement 2

Person served 3

By hand / Registered post / Speed post / E-mail (3)

Date and time of service 3

Acknowledgement 3

DD.MM.YYYY (15)

DD.MM.YYYY (16)

DD.MM.YYYY (17)

DD.MM.YYYY (18)

The acknowledgement number / the inward stamp / the portal acknowledgement

Date of deemed permission

Jurisdiction of the Conciliation Officer

78(7) / 79(6) / 80(5)

Order number

Date of the order

Date of receipt of the order

DD.MM.YYYY (19)

Refused / granted only in respect of Number workers / granted only for the period stated in it

Thirty

The order does not consider the documents at Annexure 2 to the application, in particular state the document, which establish the cause.

The order proceeds on a fact that is not correct, namely state it; the correct position, with the supporting record, is state it.

Circumstances have changed since the application: state the change, for example the loss of the remaining customer contract on DD.MM.YYYY.

The order gives no reasons, or reasons that do not address the genuineness and adequacy of the reasons stated by the employer and the interests of the workers, as section 78(4), 79(3) or 80(2) requires.

DD.MM.YYYY (20)

Name of the preparer

Designation of the preparer

DD.MM.YYYY (21)

Name of the reviewer

Designation of the reviewer

DD.MM.YYYY (22)

Chapter X establishments only: a factory, mine or plantation, not seasonal, that employed 300 or more workers (or the higher number notified) on an average per working day in the preceding twelve months. Nothing is done to the workers until permission is granted or deemed granted

This format contains the timetable (Part 1), the board resolution approving the application (Part 2), the covering letter (Part 3), the application with its annexures (Part 4), the letter serving the copy on the workers or their representatives (Part 5), the letter recording deemed permission (Part 6) and the application for review (Part 7). Make one application for each action. Where permission is granted for a retrenchment, serve each worker the three months' notice using the "Notice of retrenchment" in the Exit and IR formats, record any departure from last in, first out with the "Board resolution approving a retrenchment and recording reasons for departure from LIFO", and deal with the re-skilling contribution using the "Letter to the State labour department seeking directions on the worker re-skilling fund" where no fund has been constituted. For a lay-off that is permitted, compute compensation with the "Notice of lay-off and lay-off compensation computation" in this pack.

Part 1. Timetable and checks before filing

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