FORM A : APPLICATION FOR THE REFERENCE OF AN INDUSTRIAL DISPUTE TO A BOARD OF CONCILIATION / COURT OF INQUIRY / LABOUR COURT / TRIBUNAL / NATIONAL TRIBUNAL (Rule 3) Section 10(2) WHEREAS an industrial dispute is apprehended / exists between ______________________ and _________________________ and it is expedient that the dispute / investigation and settle the matters specified in the enclosed statement which are connected with or relevant to the dispute should be referred for enquiry / adjudicating by a Board of Conciliation / Court of Inquiry / Labour Court / Tribunal / National Tribunal, an application is hereby made under sub-section (2) of section 10 of the Industrial Disputes Act, 1947, that the said matters / said dispute should be referred to a Board of Conciliation / Court of Inquiry / Labour Court / Tribunal / National Tribunal. This application is made by the undersigned who has / have been duly authorised to do so by virtue of a resolution (copy enclosed) adopted by a majority of the members present at a meeting of the _________________ held on the _________________________ 19 ________ . A statement giving the particulars required under rule 3 of the Industrial Disputes (Central) Rules, 1957 is attached herewith. Signature Dated Employer / agent / manager / principal officer of the corporation _____________________ President of the trade union Secretary of the trade union ___________________ OR Five authorised representatives_______ OR Workman _______________________ Workman in the same establishment Duly authorised_______________ To The Secretary to the Government of India, Ministry of Labour Statement required under rule 3 of the Industrial Disputes (Central) Rules, 1957, to accompany the form of application prescribed under sub-section (2) section 10 of the Industrial Disputes Act, 1947:- (a) Parties to the dispute including the name and address of the establishment or undertaking involved; (b) Specific matters in dispute; (c) Total number of workmen employed in the undertaking affected; (d) Estimated number of workmen affected or likely to be affected by the dispute; (e) Efforts made by the parties themselves to adjust the dispute. Copy to : (i) The Assistant Labour Commissioner (Central) _________________ (here enter office address of the Asstt. Labour Commissioner (Central) in the local area concerned. (ii) The Regional Labour Commissioner (Central) (iii) The Chief Labour Commissioner (Central). | 