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APPLIGATION FOR INTIMATION
Appllcatlon lD 10038'1102003

Reglslration Certificate / ln mation

R€coipt No. ffi 6|Ti6, / q-{* rsr6

Dlvision / ft!{r4 Pune

District / FE : Sanglj

Offic€ Nem. Office of the Assistant Commissioner oi Labour, Sangli, Addrqrs_

LJdyog Bhavan, Vishrambaug, .Behind TATA Compound, Sangli.

Name ot the establlshm€nt / glr€mrt+ ADITI SUCCESS POINT

AET
Prevlous detalls ol establishment
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Po8tal addrsss and situatlon o, th€
Establishmont / ( 3rrFllv+sl q )
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/ New Registration
1, SHIVANUBHAV MANDAP ROAD, NEAR l,frtT{fir4 }icc fu,a-fisrrR atfr
NEELSAGER LODCiE, JAT, JAT , .]AT, SANGLI, {6,ars, fr, fr,€i4*,416404
416404

Mobilo / gr{qr:r* .. 774588680s

Emsil-id/*-e- ffc* anandpadolkarS055@gmail.com

D6te of comdencoment oI buslness / 03/01t2020

q{sru gr *mrEr Rdi*,

Nature of Buslness / zT{gfqfi €tq COi,4PUTER ACCESSORIES +rqcr der

Whether establishm6nt fslls under Private
public or private sector / grFIrrAI
srffia d'*rfr t& * srfrJ} d-drd +A

Total No. o, Employee Men Womgn T.gnsgender Totsl

3 2 0 5
Name of the Employor / rFFfrt aEI PRASHANT VASANT KOLI csria E.id 6H
R6idential Address o, the employor / l,MANGALWAR PETH.KOLI 1, {.rffil{ t6, qEtd ,rfr, dir , Bir,sir,
rraanuqr Bqrf{rxrdrsl TiI GALLI,JAT, JAT, JAT,SANGLI,4l 6404 €rrr&,4i6404
Residont Sinco / EIEr'{I 1998

Status / Designation CHAIRI/lAN

Moblle No 7745886805

E-mail lD padolkarsjath8o55@gmail_com

Asdhar No 581609896270

Name of Manaoer / <e+!ITtI6ri aTE

Residential addroas of Manager /

EtirtrT$Fralt B-srs{qarql EdI

Contact No

Fax No

Emall-lD/S-*agrc*
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Caregory Ot Establishmont Typo / srF5e{ t-d / CoMPUTER SALES
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Type of organisation / :Xftmrlql qrrR Self Ownership (Proprietary)

Namg of tha membsr of omployst s Jack-Brother

family employed in th6 establishmont / i6-dal{
srgrYid at6t-d ffifGqr qrfrfiiar
51irr+a rcsi+ arA Men / gET Women / kql Transgonder I Ifi{
1 0 0

S6lf Doclaration / Rstwsr

IANAND MASKU PADOLKAR, hereby solemnly atfirm and st3te that the business which IANAND MASKU PADOLKAR have
sianed is not banned or prohibited by any Act, Rules, Law or Order oI any Court of Law or any competent authority and
the premises
where I ANAND MASKU PADOLKAR, are conducting the said business is free from violation of any Act, Rules, order of any Coun
of
Law or any Compelent Authority.

I ANAND MASKU PADOLKAR, hereby declare that the information provided above is true and correct to the best of my/our personal
knowledge, information and belief. I ANAND MASKU PADoLKAR, am/are fully aware about the consequences of giving
false
information:'lf the information is found to be false, I ANAND MASltu PADoLKAR, shall be liable for procecution and punishment
under
the lndian Penal Code (45 of 1860) and /or any other law-.epplicabte thereto.

IANAND ITASKU PADOLKAR, have obtajned necessary ticenses, permissions, permit tor the conduct of lhis busioess and the place of
business lrom the appropriate Authority

I ANAND IVASKU PADOLKAR, shall be responsible and liable for legal action if the business is conducted without proper licence,
permission, permit from the appropriate Authority. l/we submit and declare that IANAND MASKU
PADOLKAR, will not undertake any
illegal activity or any business prohibited in taw in force in lndia.

IANAND MASKU PADOLKAR' declare that the place of business is not located in any area wherein commencing / running of such
business is prohibited by any law or order o, any Competent Authority.

I ANAND MASKU PADOLKAR, hereby declare that the copies attested by me are true copies of original documents. I ANAND MASKU
PADoLKAR' am/are well aware of th€ fact that if the copies are found false/forged, l/we shall be liable for procecution and punishment
under the lndian Penal Code (45 of '1860) and /or any other law applicable thereto.

I ANAND MASKU PADoLKAR, undertake to abide by the provisions of the Maharashtra Shops and Establishments (Regulation of
Employment and conditions of Service) Act, 2017 (Mah. LXI of 2017) and the Rules and orders passed thereunder by any
Authority.

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Sign \t.d\,

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PRASHANT VASANT KOLI
Name and Signature of the Employer