FORM 'C'

[See sub-rule (3) of rule 3]



Notice of Closure



Take notice that it is intended to close down the establishment with effect from ……………….. The other details are furnished below:

1. Name and address of the establishment.



2. Name and address of the Head Office, if any.



3. Name and designation of the employer.



4. Number of persons in employment.



5. Number of employees entitled to Gratuity.



6. Amount of Gratuity involved.



Place Signature of the employer

Date with name and designation



To

The Controlling Authority

……………………………

……………………………