Get CA DLSE 810 2023-2024

03/02 Application For Registration Garment Manufacturing Industry English page 1 of 6 9. An Examination is Required. This Examination is Given Only in The Languages Listed Below. Clear State of California Department of Industrial Relations Print Division of Labor Standards Enforcement APPLICATION FOR REGISTRATION GARMENT MANUFACTURING INDUSTRY INSTRUCTIONS Answer all questions. 15b. If yes provide the following name s and address es of the businesses date s of operation garment registration number s and date s of registration.. 16. List the names and addresses Number Street City State Zip Code of all firms engaged in the garment manufacturing industry with whom you have done business such as manufacturers contractors subcontractors and leasing companies etc. during the past 3 years. I hereby certify that I am aware of the wage provision of Labor Code 2673. 1. Under that provision I as a garment manufacturer guarantee payment of my proportionate share of any unpaid minimum and overtime wages owing to any employees of the contractors with whom I contract for work performed by the contractor s employees on my behalf. Signature of Sole Proprietor Partner Member or Corporate Officer Name and Title clearly printed Date PRIVACY ACT NOTICE We ask for the information on the Application for Registration Garment Manufacturing Industry DLSE 810 REV. Was a bond required 15a. If you checked New in question 2 b have you your immediate family members any person listed in items 11 a through c or 12 or any of their immediate family members operated in any capacity in the garment manufacturing industry This includes but is not limited to manufacturing and contracting operations as well as the exercise of direct or indirect control over garment workers wages hours and working conditions. 15b. If yes provide the following name s and address es of the businesses date s of operation garment registration number s and date s of registration.. 16. List the names and addresses Number Street City State Zip Code of all firms engaged in the garment manufacturing industry with whom you have done business such as manufacturers contractors subcontractors and leasing companies etc. during the past 3 years. Use Attachment if Necessary Name Address entered into a settlement agreement for unpaid wages 1 Name of the Person and Business that Was Issued Judgment or that Entered into the Settlement Agreement. 2 Date the Judgment or Settlement Agreement was Entered 3 Court Entering Judgment 4 Case Number 5 Amount Due According to Judgment or Settlement Agreement 6 Has this Amount Been Paid 7 If Paid Date of Payment 18a. Has any person listed in items 11 a through c or 12 had a garment registration revoked or an application for registration denied at any time 1 Name And Address of Business 2 The Period of Revocation or Date of Denial 3 The Reason s for the Revocation or Denial 19. All requested information must be clearly typed or printed in ink. If the question is not applicable to you put NA.