(ONLY FOR ONE
PERSON/LABOURER WHO IS REQUIRED TO BE BROUGHT IN )
1. Name of applicant/Sponsor who want to bring :
the peron/labourer etc. with address
2. Father’s/Husband’s name :
3. Name of person/ labourer to be brought in :
( In Block Letter )
4. Father’s/Husband’s name :
5. Relationship with the sponsor :
6. Permanent Address (Block Letter ) :
(a) Village :
(b) Post Office :
( c) Police Station :
(d) District/ State :
7. Nationality :
8. Age :
9. Religion
10. No. of persons/labourers already with the applicant :
( Give ILP No. with issue date ).
11. Mention place where persons are proposed to be :
kept/ engaged
12. Purpose (Mention clearly ) :
13. In case of agricultural purpose mention cultivable :
areas owned by the applicant (Certificate to be
obtained from the village authority )
14. In case of Businessman/ Contractor mention the :
type of Business shop with Trading Licence No.
and location of establishment.
15. Purpose duration to keep the person/ labourer :
with the applicant.
Recommended by :- Signature of the Applicant
Admn. Officer/ Head of Office