FORM - X

(REQUISITION FOR ENDORSEMENT OF ELECTRICAL SUPERVISOR (GENERAL) AND

WIREMAN PERMIT)
(Rule 35 )
TO:
The Member Secretary,
Licensing Advisory and
Examination Board,
O/O Chief Electrical Inspector Govt.,
Bangalore.
Dear Sir,

Sub: Endorsement of Electrical Supervisor permit No. ________________

I, _______________ hereby declare that I propose to be / an already employed as

part time / Supervisor / Wireman under __________________
M/s__________________________. Hence my permit No___________________. Valid up to
___________________ may kindly be endorsed in favor of my above employer.

In case there is any change in the above position, I shall be notifying the same
to you as early possible but not later than 24 hours of the change coming into effect.

SIGNATURE OF THE APPLICANT

Certified that Sri _________________ is employed as a part time Supervisor /

Wireman in my / our concern / firm from the date mentioned below. Hence his
Supervisor / wireman permit may kindly be endorsed in favor of my / our firm with
effect from ___________________.

Signature of the employers

With date of Employment,

Seal, full address and

Licence /Special wiring permit No. and Validity

 FORM - X

(REQUISITION FOR ENDORSEMENT OF ELECTRICAL SUPERVISOR (GENERAL) AND

WIREMAN PERMIT)
(Rule 35 )
TO:
The Member Secretary,
Licensing Advisory and
Examination Board,
O/O Chief Electrical Inspector Govt.,
Bangalore.
Dear Sir,

Sub: Endorsement of Electrical Wireman permit No. ________________

I, _______________ hereby declare that I propose to be / an already employed as

part time / Supervisor / Wireman under __________________
M/s__________________________. Hence my permit No___________________. Valid up to
___________________ may kindly be endorsed in favor of my above employer.

In case there is any change in the above position, I shall be notifying the same
to you as early possible but not later than 24 hours of the change coming into effect.

SIGNATURE OF THE APPLICANT

Certified that Sri _________________ is employed as a part time Supervisor /

Wireman in my / our concern / firm from the date mentioned below. Hence his
Supervisor / wireman permit may kindly be endorsed in favor of my / our firm with
effect from ___________________.

Signature of the employers

With date of Employment,

Seal, full address and

Licence /Special wiring permit No. and Validity