Rule 53: In the place Andhra Pradesh Trade Union Regulations, 1927 made under the

53. In the place Andhra Pradesh Trade Union Regulations, 1927 made under the Trade Unions Act. 1926 (16 of 1926) which has been repealed under Section 104 of the Code, The Andhra Pradesh Trade Union Regulations are adopted as per the Appendix. 39 40 FORM-I (See rule 4) (MEMORANDUM OF SETTLEMENT ARRIVED AT IN THE COURSE OF CONCILIATION PROCEEDINGS OR OTHERWISE) Names of Parties: ……………………………….……………. Representing employer(s); …………………………….……………. Representing workers; Short recital of the case ……………………………………………………….. Terms of settlement ………………………………………………………. Signature of the parties Witnesses: (1) (2) *Signature of Conciliation Officer In case the settlement arrived at between the employer and his workers otherwise than in the course of conciliation proceeding the copy of the memorandum shall be marked to the concerned Deputy Commissioner of Labour of the State. FORM - II (see rule 11) Before the State Government Industrial Tribunal ----------------------------------------- -------------------------(place of the Industrial Tribunal having jurisdiction where dispute arises) (A) Name and Address of Applicant(s) Versus 40  41 (B) Name and Address of Opposite party(ies) Brief facts of the dispute (statement regarding specific issues of dispute may be mentioned) which are connected with and relevant to the dispute under sub- section (1) of Section 22 of Industrial Relation Code, 2020 (35 of 2020). Prayer: The applicant(s) pray(s) that instant application may be admitted for adjudication and request(s) to pass appropriate award in the matter. Name and signature of the worker(s) or Officer of Trade union, raising the dispute FORM III (See rule 19) (REGISTER FOR CERTIFIED STANDING ORDERS) PART I Industrial Establishment Unique and Name of the Nature of the Whether Date of adoption continuous industrial industrial standing order is or date of number establishment establishment (a) model deemed standing order, authentication or or date of (b) deemed certification / standing order authentication of or standing order (c) certified standing order (1) (2) (3) (4) (5) Date of Date and Amendment Date of the Any other filing nature of made on dispatch of the relevant detail appeal decision appeal, if any copy of 41 42 standing orders as settled on appeal (6) (7) (8) (9) (10) Part-II Should contain the certified copy of the Standing Orders electronically. FORM- IV (See rule 21) (NOTICE OF CHANGE OF SERVICE CONDITIONS PROPOSED BY AN EMPLOYER) 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 ................. 42  43 ANNEXURE (Here specify the change/changes intended to be effected) Copy forwarded to: 1. The Secretary of registered Trade Union, if any. 2. Concerned Deputy Commissioner of Labour. FORM-V (See rule 22) (AGREEMENT FOR VOLUNTARY ARBITRATION) Between ………………Name of the parties representing employer (s) And …………………. Name of the parties representing worker It is hereby agreed between the parties to refer the following dispute to the arbitration of ........................ [here specify the name(s) and address(es) of the arbitrator (s). (i) Specific matters in dispute. (ii) Details of the parties to the dispute including the name and address of the establishment or under taking involved. (iii) Name of the worker in case he himself is involved in the dispute or the name of the union, if any, representing the worker or workers in question. (iv) Total number of workers employed in the undertaking affected. (v) Estimated number of workers affected or likely to be affected by the dispute. *We further agree that the majority decision of the arbitrators) shall be binding on us in case the arbitrator(s)are equally divided in their opinion they shall appoint another person as umpire whose award shall be binding on us. The arbitrator (s) shall make his (their) award within a period of ........................ (here specify the period agreed upon by the parties) from the date of publication of this agreement in the Official Gazette by the State Government or within such further time as is extended by mutual agreement between us in writing. In case, the award is not made within the period afore mentioned, the reference to the arbitration shall stand automatically cancelled and we shall be free to negotiate for fresh arbitrator. Signature of the parties Representing employer/ any officer of the Trade Union / Representing worker /workers. 43 44 Witnesses: 1. .................................. 2. .................................. Copy to: (i) The Conciliation Officer [here enter office address of the Conciliation Officer for the area concerned]. (ii) The Principal Secretary, Labour, Factories, Boilers and Insurance Medical Services Department , Government of Andhra Pradesh, AP Secretariat, Velagapudi, Guntur District. FORM- VI (See rules 24, 43 and 44) (AUTHORISATION BY A WORKER, GROUP OF WORKERS, EMPLOYER OR GROUP OF EMPLOYERS TOBE REPRESENTED IN A PROCEEDING BEFORE THE AUTHORITY UNDER THE INDUSTRIALRELATIONS CODE, 2020). Before the Authority (Here mention the authority concerned) In the matter of:. (mention the name of the proceeding ) .............................................workers Versus…………......................................................................................Employer I/we hereby authorize Shri / Shrimati/Kumari ………………….to represent me/us in the above matter. Dated this......................day of..............................20.......... Signature of person(s) nominating the representative(s) Address Accepted. 44  45 FORM- VII (See rule 26) (APPLICATION UNDER SUB-SECTION (1) OF SECTION 59 OF THE INDUSTRIAL RELATIONS CODE,2020) To, (1) The Principal Secretary, Labour, Factories, Boilers and Insurance Medical Services Department, Government of Andhra Pradesh, AP Secretariat, VELAGAPUDI, Guntur Dt. (2) The Deputy Commissioner of Labour (here insert the name of the District). Sir, I/We have to state that I am/we are entitled to receive from M/s ................................... a sum of Rs..............(in words) on account of ................ under the provisions of Chapter IX and X of the Industrial Relations Code,2020 (35 of 2020) /in terms of the award dated the.................... given by..................... /in terms of the settlement dated the ..................... arrived at between the said M/s ......................... and their worker through........................... the duly elected representatives. I/We further state that I/we served the management with a demand notice by registered post on .....................for the said amount which the management has neither paid nor offered to pay to me/us even though a fortnight has since elapsed. The details of the amount have been mentioned in the statement hereto annexed. I/We request that the said sum may kindly be recovered for the management under sub-section (1) of section59 of the Industrial Relations Code, 2020 (35 of 2020) and paid to me/us as early as possible. Signature of the applicant(s) Address(es) Station: Date:. ANNEXURE [(Here indicate the details of the amount(s) claimed.)] 45 46 FORM- VIII (See rule 26) (APPLICATION BY A PERSON AUTHORISED BY A WORKER OR BY THE ASSIGNEE OR HEIR OF ADECEASED WORKER UNDER SUB-SECTION (1) OF SECTION 59 OF THE INDUSTRIAL RELATIONSCODE, 2020) To (1) The Principal Secretary, Labour, Factories, Boilers and Insurance Medical Services Department, Government of Andhra Pradesh, AP Secretariat, VELAGAPUDI, Guntur Dt. (2) The Deputy Commissioner of Labour (here insert the name of the District). Sir, I Shri/Shrimati/Kumari..............................................................have to state that Shri/Shrimati/ Kumari.......................................................................... is/was entitled to receive from M/s........................................................ a sum of Rs. ..............................(in words) on account of............................. under the provisions of Chapter IX and X of the Industrial Relations Code, 2020 (35 of 2020) /in terms of the award dated the............................ given by ...................../in terms of the settlement, dated the.....................arrived at between the said M/s..................... and their worker through.................. the duly elected representatives. I further state that I served the management with a demand notice by registered post on.....................for the said amount which the management has neither paid nor offered to pay to me even though a fortnight has since elapsed. The details of the amount have been mentioned in the statement hereto annexed. I request that the said sum may kindly be recovered from the management under sub-section (1) of section 59 of the Industrial Relations Code, 2020 (35 of 2020), and paid to me as early as possible. I have been duly authorised in writing by.....................(here insert the name of the worker) to make this application and to receive the payment of the aforesaid amount due to him. I am the assignee/heir of the deceased worker and am entitled to receive the payment of the aforesaid amount due to him. Station......................... Signature of the authorized person/assignee/heirs Date……………......... Address......................... ANNEXURE (Here indicate the details of the amount claimed.) 46  47 FORM- IX (See rule 26) (APPLICATION UNDER SUB-SECTION (2) OF SECTION 59 OF THE INDUSTRIAL RELATIONS CODE,2020) Before the State Government Industrial Tribunal at. ……….................................... Between......................... 1. Applicant(s) and. 1. Opposite Party (Employer) (1) Name of the applicant(s) …………………………………………………………………. (2) Name of the employer ……………………………………………………………………. The petitioner(s) .......................................... a worker of ......................M/s. ..............................of.........................................The petitioner(s) undersigned, worker/workers of ............................ is/are entitled to receive from the said M/s. .................................. the money /benefits mentioned in the statement hereto annexed. It is prayed that the Tribunal may be pleased to determine the amount /amounts due to the petitioner (s). Signature or Thumb Impression (s) of the applicant(s) Address (es) …………………………………………………….. Place...................................................... Date......................................................... ANNEXURE (Here set out the details of the money due or the benefits accrued together with the case for their admissibility.) 47 48 FORM- X [See rule 26] (APPLICATION BY A PERSON WHO IS AN ASSIGNEE OR HEIR OF A DECEASED WORKER UNDER SUB SECTION(2) OF SECTION 59 OF THE INDUSTRIAL RELATIONS CODE, 2020) Before the State Government Industrial Tribunal at ................................ Between (i) Name of the applicant/applicants ………………………………………………. (ii) Name of the employer ………………………………………………………………….. I am/We are the assignee(s) of the deceased worker and am/are entitled to make an application on his behalf. Shri/Smt................... former worker of M/s .......................... of........................is entitled to receive from the said M/s............................ the money/benefits mentioned in the statement hereto annexed;