Industrial Relations Form IV: notice of change in service conditions

Employer notice of a proposed Third-Schedule service-condition change under section 40.

(See rule 19) · Industrial Relations (Central) Rules, 2026 · Central-sphere scope

Download and read the completed example

Completed fictional notice of change in service conditions concerning Illustration Central Engineering Ltd (fictional), 14 Example Works, New Delhi 110001. The selected legal route and inapplicable alternatives are identified below.

Fictional, unsigned completed illustration. It demonstrates this form’s fields; it is not a filed return, medical opinion, official order or proof of an actual transaction.

When and how this form is used

Rule 19 specifies service to affected workers and conspicuous display; union/negotiating-body service is additional where one exists. The prescribed form refers to Third-Schedule matters.

Section 40 ordinarily prevents effecting the notified change within 21 days of notice, subject to its exceptions. The illustrative 26-day interval is a timing demonstration, not approval of every proposed change or permission to alter conditions during protected proceedings.

The completed fields

Notice and annexure

Prescribed field / section	Completed fictional entry
Employer / address	Illustration Central Engineering Ltd (fictional), 14 Example Works, New Delhi 110001
Notice / proposed effective date	20 October 2026 / 15 November 2026
Affected workers / matter	Twelve production workers; proposed change of shift-allowance rate from ₹2,000 to ₹2,200 per month
Annexure: exact change	For eligible full-month shift duty, rate increases by ₹200; eligibility conditions otherwise as documented; no reduction or retrospective recovery
Signature / designation	Kavita Shah, authorised director; Unsigned fictional illustration; no seal, filing acknowledgement or authority act executed
Copies / display	Concerned union/negotiating body and Deputy Chief Labour Commissioner (Central); display at main entrance and designated electronic portal as Rule 19 requires

Supporting records and reconciliation

Exact existing/proposed conditions, affected list, authorisation, actual service/display dates and any applicable settlement/proceeding restrictions.

Worked calculation: 20 October to 15 November = 26 elapsed days; monthly increase ₹200 × 12 workers = ₹2,400 if all are eligible.

Official source and version

Official Ministry of Labour Gazette PDF, Form IV, PDF pages 76–76

Industrial Relations Code 2020, actual relevant sections; Gazette Act 35 of 2020

Act 1 of 2026, section 2 substitutes section 104 repeal/authority continuity

Download the official source pages containing this form. Adjacent prescribed forms can share a source page; use the heading and rule identified above.

These are Central Rules. Use the actual appropriate government and authority. The 2026 amending Act substitutes section 104’s repeal/continuity provisions and continues existing Tribunals/statutory authorities until the Code authorities function: https://egazette.gov.in/WriteReadData/2026/270186.pdf. Enacted Code: https://egazette.gov.in/WriteReadData/2020/222118.pdf

Practical questions

Can I submit the sample as my own completed form?

No. Replace the fictional facts with accurate records, use the competent filing or record-keeping route described above and complete genuine signatures or certifications where required.

What makes the example specific to this form?