FORM-VI

(See Rule 25(1))

Office of the Licensing Officer: Deputy Commissioner of Labour, Ongole
Licence No. 1092 –CL/DCL/ONGOLE Date: 22-11-2017

01. Licence is hereby granted to
Under section 12 (1) of the
Contract labour (R&A) Act
Subject to the conditions
Specified in annexure
LICENCE
: AMARAVATHI MAN POWER SERVICES
PLACMENTS SERVICES
SRI. SHAIK. MAHABOOB SAHEB
S/O. RAMTHULLA
PEDDA DORNALA(V), DORNALA (M)

02. This Licence is for doing the : OUT SOURCE AGENCE

Work of

In the Establishment of : D.NO: 4-268

OPP.POLICE STATION
DORNALA
Work Spot : D.NO: 4-268
OPP.POLICE STATION
DORNALA
03. The Licence shall remain in force : 22-11-2017 TO 21-11-2018
till

Date:- 22-11-2017

RENEWAL
(See Rule 29)

Date of Fee paid for Renewal Date of Signature of the Licensing Officer
Renewal Expiry
 COPY OF APPLICATION SUBMITTED ONLINE FOR ALLOTMENT OF REGISTRATION NUMBER
(Acknowledgement Number 9999982162)

(Note Allotment of Registration Number will be subject to verification of the PAN)

Name of the Establishment : AMARAVATHI MAN POWER SERVICES

PAN of the Establishment : ABKFA2524L
Address: Line 1 : D.NO: 4-268
Line 2 : OPP.POLICE STATION
City : DORNALA
State : ANDHRA PRADESH
District : PRAKASAM
Pin : 523331
Country : INDIA
Phone Number : 9441442440
Fax Number :
Email Address : seeds456@gmail.com
Web Address :
Document chosen as proof of Address : -Copy of bank passbook/Statement
-Any license/Certificate /number issued by any Govt.authoriy

SETUP DETAILS
Date of setup of Establishment : 25/01/2017
Document Name : OTHERS
Reference Number : 147 OF 2017
Date of Issue of Document : 15-11-2017
Issued By, Place : REGISTRAR OF FIRMS, MARKAPUR

BUSINESS ACTIVITY AND OWNER’S DETAILS

Establishment Type (Whether a factory) : NO

Coverage under Section : 000001 (4)

Primary Business Activity : OUT SOURCE SERVICES

 FACTORY DETAILS
S.No License Number Date Issued By Authority, Place Date of Trial
Production

s.no Name ,Gender Status Date of Father’s Address Mobile, Position

Designation Birth Name Email date

LICENSE DETAILS
S.No License Under License Number Date Issued By Palce of issue
51602 OTHERS 147 OF 2017 17/11/2011 REGISTSRAR MARKAPUR
OF FIRMS

Whether Establishment covered Under ESIC :

ESIC Number :
Labour identification Number(LIC) :
Whether Establishment covered working through AID of Power :
OWNER’S DETAILS
S.NO Ownership Type Registration / Date of Issued by CIN
Letter Number Registration /Place

01. PARTNERSHIP BY 0391034 15/11/2017 SUB

FIRMS REGISTRAR
MARKAPUR
PARTICULARS OF OWNERS
S.NO Name ,Gender PAN, Date of Father’s Address Mobile, Position
Designation DIN Birth Name Email date

SK.MAHABOOB BWZPS 15/06/ SK.RAHAM DORNALA 944144 15-11-2017

01. SAHEB 9394B 1972 THULLA 2440
02. SK.NASEEM DQIPS 29/12/ SA MARKAPUR 944144 15-11-2017
SULTHANA 4692M 1971 SATTAR 2440

PARTCULARS OF LESSEE
Whether Establishment is on Lease :
Leased From – To Date :
s.no Name ,Gender Status Date of Father’s Address Mobile, Position
Designation Birth Name Email date

-To Date
 EMPLOYEE DETAILS
Number of the Employees as on Date of Application : 10
Date on Which the Employment Strength crossed :
Number of Excluded Employees : 0
Date of Agreement between Employer and Employees : 20-11-2017
Any Subsequent date mentioned in the Agreement : 20-11-2017
Date from which ACT will be applied : 20-11-2017

BANK DETAILS
S.No Bank Name Branch Ifsc Code Account Account Type
Number
01. STATE DORNALA SBIN011117 37365236110 CURRENT
BANK OF ACCOUNT
INDIA

BRANCH DETAILS
Whether the Establishment is having a single unit or has Several Units(Branches) :

DECLARATION
Certified that online application for the allotment of code number for -----------------------------------------------
------------------------- , was submitted by the undersigned.

Signature of Employer : ___________________

Seal of the Establishment Name:- ________________________________

Designation _____________________________
Note: This application copy is to be submitted along with the documents listed below to the EPFO Office mentioned
in the Code Allotment Letter. The code number is allotted after verification of the PAN and name of the
Establishment. A Username and Password of EPFO ECR Portal (http:// esewa.epfoservicse .in) shall be sent
over SMS and Email to enable you to download the code allotment letter (Under menu option Downloads).

In the Code number is allotted, following documents are required to be submitted along with this application
form duly signed by the employer.

1. Copy of PAN
2. Copy of the document’s selected as Address Proof
3. Copy of Document’s selected as proof of date of set up.
4. Copies of all licenses declared.
5. Copy of ESIC Code allotment number , if applicable
6. Documents as proof of Ownership type
7. Copies of Bank Pass Book/Statement ( Not older than last 3 months).
8. Code allotment letter generated online and downloaded through the ECR portal after login
9. Form 5A generated online with the code allotment letter.
10. Specimen signature card of the Employer (S) and Authorized signatory if any.
 EMPLOYEES PROVIDENT FUND ORGANISATION
( A statutory Body under the Ministry of Labour and Employment, Government of India)
www.epfindia.gov.in

PROVIDENT FUND CODE NUMBER INTIMATION LETTER

Validity of this letter is of three wage months from date of issue. Based on remittance , inspection and
submission of all documents certificate of coverage will be made available in unified Portal’s Establishment
Login.
No. 999992172 GNT Date: 20/06/2017
To,
SHAIK. MAHABOOB SAHEB
MANGING PARTNER
AMARAVATHI MAN POWER SERVICES
D.NO: 4-268
PEDDA DORNALA (V)
DORNALA (M)
PRAKASAM Dt. A.P,

Sub: Allotment of Code Number to Establishment M/S ______________________________

______________________________ under Employees Provident Fund and Miscellaneous Provisions Act
1952-regarding.

Sir/Madam
Based on the information submitted online by you, your establishment is registered with employees
Provident Fund Organization with the following code number:
Code Number: GRGNT160925700
This code number is allotted based on the following declaration by you:
1. Name of the Establishment : AMARAVATHI MAN POWER SERVICES
2. PAN of Establishment : ABKFA2524L
3. Date of Which Employment strength : --
Crossed 19
4. Section under which covered : 000001 (4)
5. Primary Activity : OUT SOURCES SERVICES
6. Ownership Type : PARTNERSHIP FIRM
7. The address proof of the :
-Copy of Bank Passbook/statement
Establishment is
-Any license/Certificate/Number issued by any Govt.Authority

Application Number: Page 1 of 2

Code Number:
 8. The proof of date of Set up 25/01/2017 is Others
9. As at the time of application your establishment is having the following license and registrations:
S.NO LICENSE UNDER LICENSE DATE ISSUED BY PLACE OF
NUMBER ISSUES
51601 OTHERS 143 OF 15/11/2017 REGISTRAR MARKAPUR
2017 OF FIRMS

10. As on date of your application your establishment is not registered with ESIC.
11. As on date of your application your establishment is not having LIN.
REGIONAL OFFICE
GUNTUR
8-48 POLERAMMA TEMPLE GUNDAMCHARLA 523329
venkateswarluryapati@gmail.com

Please note that this intimation letter is generated with the Owners Details in Form 5A and the intimated
letter will be valid only if the Form 5A is enclosed.

Important information:

1. By virtue of the sections 1(3)(a) and 1(3)(b) of the Act, it applies on an establishment on its own
volition and you as an employer are required to comply with the provisions of the Act accordingly.
The obligations/duties/responsibilities cast upon you as an employer of this establishment and
penalties on account of non-Compliance with the same are explained on our website
www.epfindia.gov.in you are required to go through them carefully.
2. Remittance of dues under the provisions of the ACT is to be made only through a challan generated
through the Unified portal.( The Process for registration on the portal preparation of the ECR txt file
related information is available on the website and the portal).

3. In case this letter is produced as a proof of the code number of the establishment before any
person including any inspector from EPFO the Form 5A generated through the portal at the
time of registration should be a part of this letter. The remittance details of the establishment
will be available on the EPFO website through the link “Establishment Search” where from
December 2016 on wards all payments with the names of employees are available on the link is
cases of remittance made after uploading the ECR.

4. Please quote the code number GRGNT1609259000 for all the future correspondence with EPFO.

This is a system generated letter and needs no signature.

Employees Provident Fund Organization
Dated: 20/11/2017

Application Number: Page 2 of 2

Code Number: