Form! [APPLICATION FOR REGISTRATION OF ESTABLISHMENTS EMPLOYING BUILDING (OR) OTHER CONSTRUCTION WORKERS Particulars of the Establishment Nome of Establishment: 4I APPS SOLUTIONS PRIVATE LIMITED Repistvation Number {iatrendyregatred) (@) Location ofthe Establishment where building or other construction is to be carried on Survey Wo Sy No: 20007 ‘Door NoTPIotNo./RS = Atshaya HG Street! Road: 2nd For, OMR ‘rea Locality achipatur Town /Vilage —:Posur ‘Local Body name Dietrict henna state Tam na ‘Address for communications Door Ne: 20871, ‘Phone Numbor 2nd or Aghaya HO, OR, Kazhipatr,Padur, Choma Distt obi Numer sorrasasan ‘arm Nad, na “603108 Fee Number Email 1D apps com Website Particulars of the employer Name Serenata ioe 7 Gondor ise Date of Birth; 04021875 Father Name: Musosan Present Adsross Permanent Address ‘ear No 21514, Natesan Colony, Door No 215, Natesan Colony. {Truvarmyr, Kota, "Truvaeryer, Kotivesam, Kancheopuras Dat Tar Nady, cia 600081, | -Kancheopurar Dist, Tani Nadu, Ind - 600084 mai Ta pap Phone Nombor . Mobile Number ssrrn6a8 Fax Number ‘IN Number ‘Adress Proot Number: 7784057540 ‘Addross Proof Furnished nthar Cos ‘Aadhar No. (UID) Nationality vn ‘Vis Type (foreigner) 0 Passport Number (ifforsigner) Visa valid upto (if foreigner) Particulars of Manager / Person incharge of construction work. Nene EN ‘ge = ‘Gondor Moo Date of Bah = 0505000 Father Name © ALAVAOHAR Permanent Address Present Adaress Door No. 1581 ‘Door No: 1/541, VEMPUL! AMIMAAN KOVIL STREET, KOTTIVAKKAM, TIRUVANMIYUR, KOTTVAKKAM, TIRUVANMIYUR, FANCHEEPURAM Dist, Tar Nady, nia 600061, | KANCHEEPURAM Dist, Tart Nad, xs 600041 Email reonaiappecr ‘Phone Number Mobile Number soe0508 Fax Numbor Address Proof Furnished otor ca Address Proot Number: 25010013612 Nationality tn Ascher No. (UID) essport Number (ifforeigner) Visa Typo (ifforeigner) —:0 Visa valid upto (if foreigner)