Form K – Industrial Disputes (Central) Rules, 1957

FORM K : Discharge, Dismissal, Etc. Pending Proceedings

[Rule 60(2)]

Before _________________________________ (Mention Conciliation Officer / Board / Labor Court / Tribunal or National Tribunal)

Application under sub-section (2) of section 33 of Industrial Disputes Act, 1947, in the matter of Ref. No _____________________

________________________ Applicant

Address _________________________

Versus ________________________ Opposite Party (ies)


The above-mentioned applicant begs to state as follows:

(Set out the relevant facts and circumstances of the case)

The workman / workmen discharged / dismissed under cl. (b) of sub-section (2) of section 33 has / have paid wages for one month.

The applicant prays that the Conciliation Officer / Board / Labor Court / Tribunal / National Tribunal may be pleased to approve of the action taken namely :

[(Mention the action taken under clause (a) or clause (b) of sub-section (2) of section 33)]

Signature of the applicant              


Signature of the person verifying                                    

Dated this _____________________ day of _____________ 19 ___________

Date (on which the verification was signed) ______________________________

Place (at which the verification was signed) _______________________________ 

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