Form
for Memorandum of Settlement of Industrial Dispute between Employer and
Employees Form for Memorandum of Settlement

Names
of Parties

Representing
employer(s):

Representing
workmen:

Short
Recital of the Case

Terms
of settlement

Signature
of the parties

…………………………..

………………………………

Witness:

(1)

(2)

Conciliation
Officer

Signature
of ……………….

Board
of Conciliation

Copy
to:

1.    
Assistant
Labour Commissioner (Central) ……………………………. [Here enter
the office address of the Assistant Labour Commissioner (Central) in the local
area concerned].

2.    
Regional
Labour Commissioner (Central) ……………………………..

3.    
Chief
Labour Commissioner (Central), New Delhi.

4.    
The
Secretary to the Government of India, Ministry of Labour, New Delhi.

Conciliation
Officer

In
case of settlements effected by ………………..

Board
of Conciliation

In
case where settlements are arrived at between the employer and his workmen otherwise
than in the course of conciliation proceeding.

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