Application Form For Renewal of Registration And Grant of Factory Licence And Notice Of Occupation

Help and Advisory Section

1. This is an auto-renewal form. All the license details will be fetched automatically once the applicant enters the Application Reference Number and User Business Identification Number (UBIN) of their existing license and click on "fetch details" button.

2. Only the fields "Maximum number of workers proposed to be employed on any day during the year" and the fields tallying the "Total Power Installed" field are editable. Since, this data could change at the time of renewal.

3. If the Maximum number of workers proposed to be employed on any day during the year and the Total Power Installed have changed at the time of the auto-renewal. The Applicant may enter the updated numbers.

4. At any time during random inspection, if the information furnished in this application form are found to be incorrect, then the renewal license issued would be immediately cancelled.

Service Specific Information

Application Ref. No. of the current License *

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UBIN Number *

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User Business Identification Number (UBIN) Details

Applicant's Full Name *

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Designation *

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Office Address *

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Mobile Number *

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E-Mail *

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Telephone-Number

Name of the Industrial Unit *

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Factory Details

Name of the Factory

Postal Address of the Factory :

Address Line 1 *

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Address Line 2

Address Line 3

Country

State

District

Postal / Zip Code

Principal/Primary Product being manufactured in the factory *

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Name of the Primary Occupier *

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Payment and Related Information

Type of factory *

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Maximum number of workers proposed to be employed on any day during the year *

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Number of workers to be ordinarily employed in the factory *

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Nature and amount of power to be used:

Enter the Power (Unit) in *

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a) Amount of Power used by the already installed Systems *

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b) Amount of Power used by the systems to be installed *

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Total Power Installed *

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Power generating capacity of the station *

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Installed capacity of the generating station including auxiliary units *

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Validity of the license (as sought by the applicant) *

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Amount Payable *

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Amount Payable (Hidden) *

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Details of the Renewed License to be issued (This section will be hidden)

Details of the existing License

Expiry Date of the current license

License Number *

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Details of the License to be issued

Issue Date of the license to be issued *

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Expiry Date of the license to be issued *

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Valid for:

Annual Year:

Declaration

All the above information is correct to the best of my knowledge and belief. If the information furnished in this form are found to be incorrect at any time in the future, the license shall be cancelled.

I Agree *