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BEFORE THE HON_BLE LABOUR-CUM-CONCILIATION OFFICER OF TN AT COIMBATORE

Updated: Apr 7

BEFORE THE HON'BLE LABOUR-CUM-CONCILIATION OFFICER OF ……………………………….


Reference No: _____________ of 20…………...

………………………………………………………………………………………….………………Workmen 

Versus


………………………………………………….……………………………………………………….Employer/Respondent 



In the matter of -ABOVE MENTIONED- I/we hereby authorize  Shri __________________ to represent me in the above matter. 



Dated this ______. 



Signatures of person nominating the representative 



Address : 



Accepted 



Signatures of Representatives 



Address: 



________________________ 



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