I hereby declare that the particulars given above are true to the best of my knowledge and belief.

Principal Employer

Seal and Stamp

Time and date of receipt of application

With Treasury Receipt [* * *] [Certain Words omitted by G.S.R. 870, dated 26.7.1974.]

Office of the Registering Officer.

FORM IX

[See rule 32(3)]

Date of Expiry ...................

Temporary Certificate Ofregistration

No.............................................................

Date...........................................

Government of India Office of the [Registering] [Substituted by G.S.R. 1649, dated 16.12.1972] Officer A Temporary Certificate of Registration containing the following particulars is hereby granted under sub-section (2) of section 7 of the Contract Labour (Regulation and Abolition) Act, 1970, and the rules made thereunder, to ......... valid from ............... to ..........