1/2/2016 FORM NO

FORM NO. 11
[Prescribed under Rule 791

Model Notice of periods of work for adults and children

Name of factory :

Place: District:

Periods of work :

Men Women Total Children Total

Description of
Groups Total number of men number of women number of children Remarks
Groups
employed employed employed
A B D E G H
C F I Group Nature
Relays
123 123 123 123 123 123 Letter of work
123 123 123
On working A
days
B
From
C
To
D
Fro
E
To
F
From
G
To
H
On Partial
working days

From

To

From

To

From

To

Date on which this notice first exhibited ............ ... (Signed)

Manager

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