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1 Step 1
WORKPLACE ASSESSMENT APPLICATION FORM
BASIC INFORMATION
Name of the Organisation
Owner Name
Owner's PhoneMobile Number
Organisation's WebsiteURL
Organisation's PhoneLandline Number
CONTACT INFORMATION
Name of the SPOC Person
SPOC Designation
SPOC Mobile Number
Alternate Mobile Number
Unit Address
City
Pin Code
State
District
OTHER INFORMATION
NIC sector
No. of people employed
No. of Employees in Shift 1
No. of Employees in Shift 2
No. of Employees in Shift 3
No. of Employees in General Shift
Product(s) Manufactured
Types of services provided
Other:(mention type of Activity)
Critical Processes(In-house)
Critical ProcessesOutsourced
If yes, please indicate the type of audit/certification
Proposed Assesment Date
PAN Number
GSTIN Number
TAN Number
Terms & Conditions
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