FORM 19





[SEE RULE 155 (1) (B)] FORM OF IDEMNITY BOND



To,

The President of India,

I/We..................…………….. Carrying on business as manufacturer(s) of fireworks

And/or gunpowder and having a factory or shop at. …………………………and

Sureties on his/their behalf hereby jointly an severally agree and undertake that we shall pay to the President of India, his successors and assigns on demand a sum of Rs …………for which payment to be well and truly made we bind ourselves, our respective heirs, executors, administrators and assigns. I/We agree that the aforesaid amount may be utilised for the payment of compensation awarded to the dependents of such workers as may die as a result of accidents occurring in the factory or shop above mentioned and that such compensation amounts shall be a first charge on the immoveable properties mentioned in the Schedule hereunder and that the above undertaking shall remain in force until all compensation payable hereunder have been fully paid and shall be binding upon us, our respective heirs, executors, administrators and assigns.

We, our heirs, executors, administrators and assigns jointly and severally undertake to keep the President of India indemnified against all claims that may be made on behalf of workers dying as a result of accidents. In case the compensation awarded is paid to the dependents by us or by our heirs, executors, administrators and assigns the above written bond shall be void but otherwise it shall remain in full force and virtue.

It is hereby agreed that the liability of the sureties hereunder shall not be discharged by reason of time being granted or any other indulgence shown to the Principal(s) nor shall it be necessary for the President of India to sue the Principal(s) before suing the sureties for the amounts due hereunder.

SCHEDULE ABOVE REFERRED TO

(Here full description of the immoveable properties should be given).

In witness whereof these presents have been duly executed on the day of 19

Full signature of licensee

Father's name in full

Age

Profession.

Residence

Full signature of Surety

Father's name in full

Age

Profession.

Residence

Full signature of Surety

Father's name in full

Age

Profession.

Residence

Station

Date

Executed in my presence

District Magistrate.