FORM K-3
[See Rule 62 (2)]

APPLICATION UNDER SECTION _________ , OF THE  INDUSTRIAL DISPUTES ACT, _________

_________        VERSUS _________

Sir,

The applicant/claimant _________ with the respondents and he be entitled to receive from the respondent of _________ /- mentioned in the statement hereto annexed.

It is, therefore, prayed that the hon’ble court may kindly be pleased to determine the amount due to the applicant/claimant.

Dated: _________                                         CLAIMANT

Through A.R.
_________, _________