Rule Form IX Form IX
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORMDefined in rule 2(c): Form means the forms set forth in the Schedule to these rules - IX (See rule 24)
[(APPLICATION TO TRIBUNAL UNDER SECTION 59(2) OF THE INDUSTRIAL RELATIONS CODEDefined in rule 2(a): Code means the Industrial Relations Code, 2020 (35 of 2020), 2020 BY WORKER)]
Before the Central Government Industrial Tribunal at. ..........
............................................................. between......................... and. .........................................................................................
(1) Name of the applicant(s) ..................................................................................
(2) Name of the employer .....................................................................................
The petitioner(s) .................... a worker of ......................M/s. ..............................of .........................................The petitioner(s) undersigned, worker/workers of ............................ is/are entitled to receive from the said M/s. .................................. the money /benefits mentioned in the statement hereto annexed.
It is prayed that the Tribunal may be pleased to determine the amount /amounts due to the petitioner (s).
Signature or thumb impression (s) of the applicant(s) Address (es) .............................................................. Place...................................................... Date.........................................................
ANNEXURE (Specify the details of the money due or the benefits accrued together with the case for their admissibility.)