wage registers
TRANSCRIPT
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Name of The Establishment__________________________________
1 2 3 4
YES (ABOVE 15 YEARS)
Sr.No. Name of the Employees
Father's Name /
Husband's Name
Whether he has Completed
15 years of age at the
starting of accounting
Year.
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Form C Rule 4 Payment of Bonu
Bonus paid to Employees For the Accounting Year ending on __________________
___________
5 6 7 8 9 10
TRAINEE 278 43000 3500 NIL NIL
Total Salary or
Wages in respect
of the accounting
year
mount o
Bonus
payable
under S.10 or
11 as the
case may be
Pooja Bonus or
other customary
Bonus paid
during the year
Interim Bonus or
Bonus paid in
AdvanceDesignation
No. Of Days
worked in
the year
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Rules, 1975
No. Of Working days in the Year___________________
11 12 13 14 15 16
NIL NIL 3500 3500 Oct-10
Net Payment
Payable
Amount
actully paid
Date on Which
paid
Signature / Thumbs
impression of the
Employee
Deductions on a/c
of Financial loss if
any on a/c of
misconduct of the
employee
Total Sum
Deducted
9+10+11
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Leave WithName of the Worker..
Ticket No.. Occupation..
Name of the Factory
Department..
No. of Days worked during the Calender Year
January 26 0 0 0 26
February
March
April
May
June
July
August
September
October
November
December
Year
Month
No.
OfdaysWork
Performed
No.O
fdaysoflay-
off No.o
fdaysof
Maternityleave
withwages
No.o
fdaysLeave
withWages
Enjoyed
Tot
al
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gaes Register FORM NO. 20 ( See Rule 105)Father's Name .. DISCHAR
Normal Rate of Wages. Date
Page No. - Old / New Date and a
made in lie
Sr.No. From Adult/ Children Register Register
Date of Entry into Service Remarks
Leave with wages to Credit Leave With Wages
Enjoyed
10 1.3 11.3 NO NO NO NO 11.3
Lea
vewithWages
earnedduringthis
Year
Tot
al
Wh
etherLeavewith
wagesrefused
Wh
etherLeavewith
wagesnotdesired
duringthenextYear
BalanceofLeave
withwagesfrom
precedingyear
Fro
m
To Balancetocredit
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ED WORKER
mont of payment
of leave with
Cashequivalentor
acc
uringthrough
con
cessionalsaleof
foodgrainorother
articles
Rateofwagesforleave
wagesperiod
Normalrateofwages
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Name and adress of Contractor
Nature and Location of Work
Sr.No. Name of Workmen Sex
Date on which
overtime work
was put in
1 2 3 4 5 6
DINESHKUMAR PATIL BHARAT MALE HR EXECUTIVE
`
Father's /
Husband's
Name
Designation
and
department
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FORM XIX
(see rule 59 (2) (e)
Register of Overtime
Name and address of Establi
under which Contract is carr
Nature and address of Princi
Wages of
Overtime On
Each
Occasion
Total Overtime
Worked or
production in case of
piece- rates
Normal
Hours
Normal
rates
Overtime
rate
Normal
earnings
Overtime
earnings
Total
earnings
7 8 9 10 11 12 13 14
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shment in/
ied on :-
pal Employer
Date on which
overtime work
was put in
Innitials of
contractor or
his
representative
Initials of
Authorised
Representative or
Principal Employer
15 16 17
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Register of D
Name and address of Contractor_______________________
Nature and location of work ________________________
1 2 3 4 5
Sr. No. Name of Workmen
Father's Name /
Husband's Name Designation
Perticulars of
Damage or Loss
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FORM XVI
[ See Rule 59 (2) (d)
duction for Damage or Loss
Name and address of establishment in/
under which contract is carried ____________________
Name of the Principal Employer ____________________
6 7 8 9 10 11
Wheter Worker
cause against
Deduction
Name of the person in
whose presence
employee's explanation
was heard
Date of
First
Installment
Amount of
Deduction
imposed
No. Of
Installment
Date of Damage
or Loss
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_____________
____________
12 13 14
Signature of the
Employer or His
RepresentativeRemarks
Recovery of
Last
Installmen
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Name and address of Contractor _____________________
Name and address of establishment in/
under which contract is carried on _____________________
1 2 3 4 5
Name of Workman
Father's / Husband's
Name Designation
Act / Ommission
for which fine
imposedSr.No.
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FORM XVII
[ See rule 59 (2) (d)
Register of Fine
Nature and location of work _________________________________
Name and address of principal Employer_______________________
6 7 8 9 10
Date of Offence
Whether employee
Showed cause
Name of person in whose
presence employee's
explanation was heard
Rate of
wages
Amount of fine
imposed
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11 12
Remarks
Date on which
fine imposed
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Mater
Name of The Establishment :
Nature of the Establishment :
1 2 3 4 5 6
Sr.No. Name of the Women Date Of Appointment Dept. Nature of Work
Dates on
which sheis laid off
and not
employed
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Form X
[See rule 12(1) ]
nity Benefit Register
7 8 9 10 11 12 13 14 15
Date of
birth of
child
Date of
production
of proof ofpregnancy
under S.6
of the Act.
Date of
production of
proof ofDelivary/
Miscarriage /
Death
Date on
which
Maternity
Benefit is
paid in
advanceand the
amount
thereof
Total days
emploed
in the
Date on
which
womangives
payment
period
Date on
which
subseque
nt
payment
ofmaternity
benefit is
made
Date on
which
medical
bonus ispaid and
amount
thereof
Date on
which
wages on
account of
leave paidand
amount
thereof
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16 17 18 19
If women
dies Date
of Death,
Name of
person to
whomMaternity
benefit is
paid.
If Woman
dies and
child
survives,
the name
of the
person to
whom
maternity
benefit ispaid on
behalf of
child
Remarks
Columnsfor the
use of
Inspector
Name of
the
personnominated
by the
women
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FORM ' A'[ See rule 4 ]
Name of the Industry :
Name Of Employer :
Address :
Month and Year to which the
House rent allowance Relates :
1 2 3 4
This is to certify that I have today in the presence of witness testifying herewith paid the
the workmen employed by me and that each workmen employed by me and that each workman
Specified agianest his name above.
Witnesses
1.________________________
Sr.No Name of Workman
Wages for the Month
for which House - Rent
allowance is payable
House - Rent
allowance paid
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2.________________________
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5 6 7
mount of Rs.. In house-rent allowance to
has received the amount of house - rent allowance
Mode of Payment
Signature of
Workmen Remarks
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Signature of Employer
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FORM 'I'
[ See Rule 12 ]
Register of Workmen
Name of The Establishment :
Address
Nature of Industry
1 2 3 4 5 6
Signatur
Basic D.A.Sr.No. Name of Workmen Date of Appointment Designation
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7 8 9
of The Employer
Signature of
WorkmanTotal
Amount of H.R.A.
Paid
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FORM X( See rule 59 (
Register of A
Name & address of Contractor_________________
Nature Location of Work______________________
1 2 3 4
Sr.No. Name Of Workmen
Father's Name /
Husband's Name
Nature of
Employment
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VIII) (d)
vance
Name & address of establishment__________________
Name & address of Principal Employer______________
5 6 7 8 9
Earning During a
Wage period
Date and
Amount of
Advance
Purpose (s) for
which
Advance is
made
No. of installment
by which Advance
is repaid
Amount of Installment
repaid with date of
postponement
granted
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10 11
Signature or
thumb impression
of the worker
Date on which total
amount paid