An application under sub-section (2) of section 10 for the reference of an industrial dispute to a Board, court, Labor Court, Tribunal or National Tribunal shall be made in Form A and shall be delivered personally or forwarded by registered post to the Secretary to the Government of India in the Ministry of Labor and Employment (in triplicate), the Chief Labor Commissioner (Central), New Delhi, and the Regional Labor Commissioner (Central), and the Assistant Labor Commissioner (Central) concerned. The application shall be accompanied by a statement setting forth-
(a) the parties to the dispute;
(b) the specific matters in dispute;
(c) the total number of workmen employed in the undertaking affected;
(d) an estimate of the number of workmen affected or likely to be affected by the dispute; and
(e) the efforts made by the parties themselves to adjust the dispute.