The Tamil Nadu Industrial Establishments (Conferment of Permanent Status

to Workmen) Act, 1981 & Rules, 1981

1 Name & address of the Industrial Establishment

2 Name and Address of the Employer

3 Nature of industry and date of commencement of

business

4 Total No. of workmen employed Male - Female –

5 No of Workmen made permanent Male - Female –

6 No of Non permanent workmen who have Male - Female-

completed 480 days of service in 24 calendar
months

Statement of Workmen - Referred in item (6)

S.No. Name of Father’s Address Date of Date of Nature of Signature Remarks

Workmen Name Joining Completion work
of 480 days
1
2

PERTAINING TO REGISTERS AND RECORDS

1. The register in Form 1 has not been maintained. [As per Section 10 read with Rule 6
(1)]

Other irregularities