Form XII

MUSTER ROLL
[See Rule 77 (2)(a)]
Name and Address of Contractor:
Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

For the Month of

Total No of
Date / Units
Sl. No Name Of Employee Father's/ Husband's Name Gender days/Units Remarks
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Worked
1 2 3 4 5 6 6

Place:
Date: Signature of the Contractor
 FORM XIII
REGISTER OF WAGES
[See Rule 72 (2)(a)]

Name and Address of Contractor:

Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

For the Month of

Serial No. in Amount of Wages Earned Deduction Initials of
Units Signature/ initial of

Conveyance

Income Tax
the Register No.of Net Time and authorised

Other cash
Over Time

Allowance
Piece rate

allowance

payments
Dearness
Name and Surname of Designation/ nature of Wage of Total Place of thumb contractor or

Wages
Basic
Sl.No. of workmen working Total amount date of representative

HRA

Flat

ESI

PT
PF
Workmen work done rate work Deduction payment impression of his
employed by days paid payment of the pricipal
done workman representative
contractor. employed
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

Place: ………………………………
Date : ……………………………… Signature of the Contractor
 Form XV
[See Rule 77(b)]
Wage Slip

Name and address of contractor :

Name and address of Establishment in/ under which

contract is carried on :

Name of work and location of work :

Name and address of Principal Employer :

1

Name and Father's Name of the workman

For the week/fortniight/month
1. No. of days worked
2. Rate of daily wages/piece rate
3. No.of units worked in case of piece rate workers
4. Dates on which overtime worked wages
5. Overtime hours and amount of overtime
6. Gross wages payble
7. Deductions if any
8. Actually wages paid

Place :
Date : Signature of Contractor
 FORM IX (See Rule 74)
Register of Workmen Employed by Contractor
Name and Address of Contractor:
Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

Signature or
Date of Date of
Name and Surname of Nature of Employment/ Permanent Home Address of Workmen Thumb-
Sl.No. Age and Sex Father's/ Husband's Name Present Address Commencement Termination of Remarks
Workmen Designation (Village and Tahsil/ Taluk and District) Impression of
of Employment Employment
Workmen
1 2 3 4 5 6 7 8 9 10 11

.
 Form X
(See Rule 75)
Employment Card

Name and address of contractor :

Name and address of Establishment in/ under which contract is

carried on :

Name of work and location of work :

1

Name and address of Principal Employer :

1. Name of the workman :

2. S.No. in the register of workmen employed :
3. Nature of employment/Designation :
4. Wage rate (with particulars of unit in case of piece-work:
5. Wage period :
6. Tenure of employment :
7. Remarks :
Place :
Date : Signature of Contractor
 Register of Deduction for Damage or Loss
Form XVI [See Rule 77 (2)(d)]

Name and Address of Contractor:

Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

Date of Recovery
Name of Person
Whether
in whose
Designation/ Particulars Date of Workman Amount of
Father's/ presence No.of
Sl.No. Name of Workmen Nature of of Damage Damage or showed Deduction First Last Remarks
Husband's Name Employee's Instalments
Employment or loss loss cause aginst imposed Instalment Instalment
explanation was
deduction
heard

1 2 3 4 5 6 7 8 9 10 11 12 13

Place : ------------------ Signature of the Contractor

Date : ------------------
 REGISTER OF FINES
Form XVII [See Rule 77 (2) (d)]

Name and Address of Contractor:

Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

Name of person in
Act/Ommision whose presence Wage period Date on
Designation/nature Date od Amount of
Sl.No Name of workman Father's/Husband's Name for which fine employee's and wage which fine Remarks
of employment Offence fine imposed
imposed explanation was payable realised
heared
1 2 3 4 5 6 7 8 9 10 11
 REGISTER OF ADVANCES
Form XVIII [See Rule 77 (2)(d)]

Name and Address of Contractor:

Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

Date and Date and

Nature of Wage Peroid Purpose(s) for No of Instalments Date on which
amount of amount of each
Sl.No Name Of the Employee Father's/Husband's Name Employment/ and wages Which advance by which advance last instalment Remarks
advance instalment was
Designation Payable mace to be repaid was repaid
given paid
1 2 3 4 5 6 7 8 9 10 11
 Register of Overtime
Form XIX [See Rule 77(2)(e)]

Name and Address of Contractor:

Nature and Location of Work:
Name and Address of Principal Employer:
Name and Address of Establshment in/ under which Contract is Carried on:

Total overtime Date on which

Designation/ Nature of Date on which Normal Rate of Overtime rate Overtime
Sl.No. Name of Workmen Father's/ Husband's Name Sex worked or production overtime wages Remarks
Employment overtime worked Wages of Wages earnings
in case of piece rate paid
1 2 3 4 5 6 7 8 9 10 11 12