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FORM A





(To be submitted in triplicate) [See Rule 3 (1)]



Complaint under CJ. (a) of sub-section (1) of Ser- 7 of the Equal Remuneration Act, 1976 (25 of 1976



To

The Authority appointed under sub-section (1) of Sec. 7.

...............................................................(Address)

A………………………………………..Complainant (s)

Full address Versus

B……………………………. Opposite Party

Full address

The complainant(s)begs/beg to complain that the opposite party has been guilty of a contravention(s) of the provisions of the Equal Remuneration Act,1976 (25 of 1976) as shown below:

(Here set out briefly the particulars showing the manner in which the alleged contravention(s) has/have taken place and the grounds supporting the complaint.)

The complainant(s) accordingly prays/pray that the Authority.……., may be pleased to decide the complaint set out above and pass such order or orders thereon as it may deem fit and proper.

The number of copies of the complaint (along with its annexure) as required under sub-rule (1) of rule 3 of the Equal Remuneration Rules, 1976 are submitted herewith.

The complainant(s) does/do solemnly declare that the facts stated in this complaint are true to the best of his/her/their knowledge, belief and information.

Signature(s)/thumb impression(s) of the complainant(s )

*1I have been duly authorised in writing by……….. [Here insert the name of the worker(s)], to appear and act on his/her/their behalf.

Signature of the legal practitioner/

official of a registered

Trade Union duly authorised

Station…………….

Date……………….

1. Strike out this portion if inapplicable.



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