Pre-filing check
Confirm jurisdiction, signatory, limitation/notice period, copies and annexures.
Form IV — See Rule 19
Filing identity
Exact Gazette format
Exact Gazette text extracted from the official English notification
FORM- IV
(See rule 19)
(NOTICE OF CHANGE OF SERVICE CONDITIONS)
Name of employer................................................................................................
Address...............................................................................................................
Dated the ............................................ day of ................................. 20..............
In accordance with sub-section (1) of section 40 of the Industrial Relations Code, 2020 (35 of 2020), I/We
hereby give notice to all concerned that it is my/our intention to effect the change/changes specified in the annexure,
with effect from ............. in the conditions of service applicable to workers in respect of the matters specified in the
Third Schedule to the said Code.
Signature.....................
Designation .................
ANNEXURE
(Specify the change/changes intended to be effected)
Copy forwarded to:
1. The Secretary of registered Trade Union, if any/Secretary, negotiating union/constituent of negotiating
council.
2. Concerned Deputy Chief Labour commissioner(Central).Service proof
Retain portal acknowledgment, email headers, speed-post proof or receipt required by the rule.
Data quality
Reconcile worker counts, UAN/CMPFO details, dates, wages and establishment identity to source records.
Post-filing
Diary hearing/decision dates and preserve the final order with implementation evidence.