Application For Obtaining Authorization For Manufacturers of Lifts / Escalators

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Application for obtaining authorization for manufacturers of Lifts / Escalators

(Under Kerala Lifts and Escalators Rule 2013)

1 Name and address of applicant :

2 Legal status (whether individual firm or :


Company) (Registration Number and names of
partners or directors to be given in case of firm or
company, as the case may be)

3 Office address in Kerala with Contact No.: :

4 Whether certificate of authorization :


was obtained in the past in the same name. If so,
give number and date of certificate of
authorization.
5 Particulars of lifts. (Details of lifts :
Maintained erected during the previous year along
with details of License to be furnished)
6 Details of electrical contractor's license. :
7 Details of solvency certificate. :
(Copy to be enclosed)
8 Details of fee remitted
(Head of account 0043-800-98-Other Receipts)
9 Details of entire staff employed. :
(Copies of appointment letter, Proof for academic
qualification and field experience to be enclosed)

10 Details of machineries and equipments. :


11 Details of testing instruments. :
12 Details of Library Books. :
13 Details of safety gadgets/tools. :
14 Phone Number for registration of complaints :
15 Remarks. :

I / We hereby declare that the particulars stated above are correct to the best of my / our knowledge.

Place:
Date :

Signature
Name
Designation

Notes: (1) Application with relevent documents shall be submitted to the concerned district office for
verification.
(2) Any person who makes, procures to be made or assist in making any false statement for
the purpose of obtaining for himself or any other person a certificate of authorization for
and maintenance of lifts/escalators shall render himself liable to prosecution .
(3) If additional space is required for completing any items, additional sheet may be attached to
this form.

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