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Shops and Establishments Act declaration format
A declaration by the owner of a shop, office or restaurant giving the details asked for when registering under the state Shops and Establishments Act.
What it is for
Use it when the labour department asks for a declaration or undertaking with the Shops and Establishments registration or intimation. Choose your state and city: the format names your state's Act and prescribed form where an official page was read, and says to check locally where not.
Who signs
The employer (owner, partner, director or authorised person) signs the declaration and the verification.
Licences that need this format
Attach these
- Owner's ID and address proof
- Proof of the premises (ownership proof or rent agreement with landlord NOC)
- Photo of the owner
- Any list of workers the form asks for
Fill it in, then download
Fill in the form. The document on the right changes as you type. Download it as Word or PDF, print it, or copy the text. Nothing is sent anywhere.
Ready-to-use template based on current law. For property sale, partnership or high-value agreements, get it checked by an advocate before signing.
Last reviewed: 30 Oct 2026
Preview. Blanks you have not filled in are highlighted in yellow on screen, and print as plain lines.
DECLARATION FOR REGISTRATION UNDER THE SHOPS AND ESTABLISHMENTS ACT
(Before the Labour Department or the Inspector or Registering Officer, ________)
I, ________, the ________ of the establishment named below, do hereby solemnly affirm and declare as follows:
1. That I am the ________ of the establishment described below and I am competent to make this declaration.
2. That the particulars of the establishment are: name: ________, trading as ________; nature of business: ________; address: ________; premises: ________; date of starting business: ________.
3. That the number of persons employed in the establishment, including part-time, contract and casual workers, is ________.
4. That the establishment keeps a weekly holiday on ________, and the hours of opening and closing are ________.
5. That the information given in my application for registration or intimation under the ________ (prescribed form: ________) is true and correct to the best of my knowledge, and nothing material has been concealed.
6. That I shall display the registration certificate or acknowledgement at a prominent place in the establishment.
7. That I shall give my workers the weekly holiday, working hours, rest, wages, leave and other conditions of service required by the law and shall keep the registers and records that the law requires, and shall show them to the Inspector when asked.
8. That I shall not employ any person in contravention of the law as to age, hours or conditions of work.
9. That I shall inform the Labour Department in writing, within the time the law allows, of any change in the name, address, nature of business or ownership of the establishment, or in the number of workers where the law requires it, and of the closing of the establishment.
10. That I shall pay the registration fee and renew the registration, where renewal is required, within the time the law allows.
11. That I understand that giving false information may lead to refusal or cancellation of the registration and to action under the law.
DEPONENT: ______________________
Name: ________
Mobile: ________
VERIFICATION
Verified at ________ on this the ________ that the contents of paragraphs 1 to 11 of this declaration are true and correct to my knowledge and belief, that nothing material has been concealed, and that no part of it is false.
DEPONENT: ______________________
Name: ________
Sworn and signed before me, the Notary Public, at ________, on the date written above.
DECLARATION FOR REGISTRATION UNDER THE SHOPS AND ESTABLISHMENTS ACT
(Before the Labour Department or the Inspector or Registering Officer, ________)
I, ________, the ________ of the establishment named below, do hereby solemnly affirm and declare as follows:
1. That I am the ________ of the establishment described below and I am competent to make this declaration.
2. That the particulars of the establishment are: name: ________, trading as ________; nature of business: ________; address: ________; premises: ________; date of starting business: ________.
3. That the number of persons employed in the establishment, including part-time, contract and casual workers, is ________.
4. That the establishment keeps a weekly holiday on ________, and the hours of opening and closing are ________.
5. That the information given in my application for registration or intimation under the ________ (prescribed form: ________) is true and correct to the best of my knowledge, and nothing material has been concealed.
6. That I shall display the registration certificate or acknowledgement at a prominent place in the establishment.
7. That I shall give my workers the weekly holiday, working hours, rest, wages, leave and other conditions of service required by the law and shall keep the registers and records that the law requires, and shall show them to the Inspector when asked.
8. That I shall not employ any person in contravention of the law as to age, hours or conditions of work.
9. That I shall inform the Labour Department in writing, within the time the law allows, of any change in the name, address, nature of business or ownership of the establishment, or in the number of workers where the law requires it, and of the closing of the establishment.
10. That I shall pay the registration fee and renew the registration, where renewal is required, within the time the law allows.
11. That I understand that giving false information may lead to refusal or cancellation of the registration and to action under the law.
DEPONENT: ______________________
Name: ________
Mobile: ________
VERIFICATION
Verified at ________ on this the ________ that the contents of paragraphs 1 to 11 of this declaration are true and correct to my knowledge and belief, that nothing material has been concealed, and that no part of it is false.
DEPONENT: ______________________
Name: ________
Sworn and signed before me, the Notary Public, at ________, on the date written above.
How to execute this document
- Stamp paper: Plain paper is usually enough. Use stamp paper only if the office that receives it asks for it.
- Notarisation: Not needed unless the office asks for it.
- Registration: Not needed.
- Who signs: The employer (owner, partner, director or authorised person) signs the declaration and the verification.
- Witnesses: none needed unless the office asks.
- ID and photos: Carry an original ID of the person who signs. Never write an Aadhaar number on the document.
- Where to submit: The office or portal that asked for it, together with the other documents in the checklist.
Common mistakes
- No date or signature.
- No copy of the signer's ID attached.
- Sending an unsigned copy.
Clause guide
Each part of the document in simple words.
Who makes the declaration
State and form
Workers, holiday and hours
Verification
Mistakes to avoid
Common questions
Is a declaration compulsory for Shops Act registration?
Does it need stamp paper or a notary?
Which Act does it refer to?
Is this document reviewed by an advocate?
What is a Shops Act declaration used for?
What documents go with the Shop Act declaration?
Is this the official Shop Act form?
Can I download the Shops Act declaration as Word or PDF?
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Yahi jaankari, Hinglish mein.