Annexure C - Inspection Report Format

Inspection Report Format
Shram Suvidha Portal

Ministry of Labour and Employment
Establishment Profile
Part A – Basic Particulars
Inspection ID generated by SSP:
Date & Time of inspection:
LIN:
EPF No. ESIC No. PAN* Bank Account(s) details with IFSC
(if available) Code (attach copy of cancelled
cheque)*
Name of the establishment:

E-mail(s)
Mobile No.
PresentAddressLine1:
City/Village:
Pin Code:
State:
District:
Police Station
Geo-tagging of establishment’s location*:
Photo of the establishment*
Details of Branches/Parent company of

Establishment*
Nature of Activity/work (link with NIC Code/SSP
Industry Classification)*
Details of employer/ his representative present during inspection:
Name
Designation
Email I.D.
Mobile No
Present Address
City/Village:
Pin Code:
State:
District:
Page 1 of 5
Report of Desk review Enclosed (Y/N)
Part B
Documents verified/collected during Inspection*
Registers produced and checked Period Remarks

From - To
Register of Employee Form A-- (Yes/No); DDMMYYY- DDMMYYY
Register of wages Form B -- (Yes/No); DDMMYYY- DDMMYYY
Attendance Register Form D -- (Yes/No); DDMMYYY- DDMMYYY

Details of Appointment/ Relieving& Past DDMMYYY- DDMMYYY
Employment (Form 5/10& 11)
Register of Contractors-- (Yes/No); DDMMYYY- DDMMYYY
International Worker Return-- (Yes/No); DDMMYYY- DDMMYYY

Trial Balance-- (Yes/No); DDMMYYY- DDMMYYY
Balance sheet and Annexure-- (Yes/No); DDMMYYY- DDMMYYY

Tax Returns of establishment for DDMMYYY- DDMMYYY
specified period
Form 24Q, Form 26 Q and Form 26 AS of DDMMYYY- DDMMYYY
establishment-- (Yes/No);
Bank statement-- (Yes/No); DDMMYYY- DDMMYYY
Form 5A and Details of authorised DDMMYYY- DDMMYYY

signatory/DSC (if not already submitted)
Others--(Please Specify) DDMMYYY- DDMMYYY
Page 2 of 5
Part C
I. Reason for inspection – (Complaint/Periodic/Default Category as per SOP/ABRY/Closure/etc.)
II. Compliance Status in latest ECR

Last Contributory Wage Month (LCWM)
UANs in LCWM
Amount remitted in LCWM
III. Default details

Default Period
Probable UANs in Default
Probable Amount in Default
IV. Inspection
1 Number of employees as per record: *
Engaged Directly* Engaged on contract Excluded Total Employees*

[A] or through a employees* [E]
contractor* [B] [C] A+B+C
Whether the establishment is a Principal Employer:

If yes, the details of contractors:
Name of contractor EPF Code Duration of Total contract No of employees ECR filed (Y/N)
& Address * number of contract* value* engaged* *
contractor*
(add rows for multiple entries)

Whether the establishment is a contractor:
If yes, the details of Principal Employers:
Name of PE & EPF Code Duration of Total contract No of employees Whether
Address* number of PE (if contract* value* provided* separate ECR
covered) * filed (Y/N) *
2 Total number of employees found eligible but not enrolled as members:(enter number) *
Particulars of employees found eligible but not enrolled as members:

S. No. Name of Gend Id card Aadhaar Father's Date of Date of Monthly Aadhaar UAN (if
Employee er* type Number Name* Birth* Joining* Wages* linked generated/linked
* and mobile no. during the
number course of
* inspection)
Page 3 of 5
3 Declaration for previous employment in accordance with Para 34 of the EPF Scheme 1952, not
furnished in respect of following members:*
S. No. Name of the employees Date of Birth Date of Joining Wage as on DOJ
4 Details of Employees whose statement are recorded during inspection:- *

S. No. Name of the Employees UAN
5 Number of employees in respect of whom remittance is made in the month of report

Engaged Directly* Engaged on contract or through a contractor*
6 Drop in Membership:*
a) Average reduction in Membership.
b) Percent drop in Membership.
c) Reasons for drop in Membership.
7 Drop in Remittance:*
a) Average drop in amount remitted in:
b) Percent drop in remittance:
c) Reasons for drop in remittance.
8 A. Dues report (Month-wise)*
Period No. of Wages Contributions & admin charges due Amount Balance Due
employees remitted
EPF EPS EDLI Admin Total
Charges
B. UAN wise detailed sheet to be enclosed*
9 A. Whether the unit is closed*? (Yes/No)
B. If Yes, whether the documentary proof uploaded by the employer?* (Yes/No)
C. If Yes, the date of closure and details of documents verified including verification of
exit details of all employees in the unified portal.
D. Whether minimum admin charges is due*.(Yes/No)
E. If yes, whether remitted?* (details of TRRN)
10 A. In case of first inspection post registration, whether the documents in support of

commencement of business / production and monthly employment strength
declared for registration / coverage verified? (Yes/No) *
B. If Yes, Is there any change in date of coverage proposed & documentary proof
thereof
11 Whether any member /representative of the Workers Union of the Factory / Establishment were
Page 4 of 5
contacted? If so:
1. Brief description of the points discussed:
2. Name (s) of the Union (s):
3. Name of the Office Bearer (s):
12 Documents attached to inspection form by Inspecting Officer:
(a)
(b)
13 List of pending recovery certificate against the establishment: (Y/N/NA)(if Y,Auto-Populated/Editable)
14 List of pending assessment cases (Section 7A/14B of the EPF Act): Y/N/NA (if
Y,Auto-Populated/Editable)
15 List of pending Court cases - Court wise and Periodicity wise: Y/N/NA (if Y,Auto-Populated/Editable)
16 Whether there is any short/ excess remittance in establishment ledger:): Y/N/NA (if Y,Auto-
Populated/Editable)
17 List of pending Prosecution cases: Y/N/NA (if Y,Auto-Populated/Editable)
18 Details of current demand Auto-Populated/Editable
19 Details of arrears demand Auto-Populated/Editable
20 Any other point which the Inspector desires to bring to the notice
of RPFC*:
(Note: Fields marked with * are to be filled mandatorily by the Inspecting official)
Date:
Signature of Inspecting Official:
Name & Seal of Inspecting Official:
Copy to:
M/s ________________________________________ (for information, records and necessary
compliance)
Page 5 of 5

Annexure C - Inspection Report Format

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Inspection Report Format

Shram Suvidha Portal

Name of the establishment:

Details of Branches/Parent company of

Registers produced and checked Period Remarks

Attendance Register Form D -- (Yes/No); DDMMYYY- DDMMYYY

International Worker Return-- (Yes/No); DDMMYYY- DDMMYYY

Balance sheet and Annexure-- (Yes/No); DDMMYYY- DDMMYYY

Form 5A and Details of authorised DDMMYYY- DDMMYYY

I. Reason for inspection – (Complaint/Periodic/Default Category as per SOP/ABRY/Closure/etc.)

II. Compliance Status in latest ECR

III. Default details

Engaged Directly* Engaged on contract Excluded Total Employees*

Whether the establishment is a Principal Employer:

(add rows for multiple entries)

(add rows for multiple entries)

Particulars of employees found eligible but not enrolled as members:

4 Details of Employees whose statement are recorded during inspection:- *

5 Number of employees in respect of whom remittance is made in the month of report

8 A. Dues report (Month-wise)*

B. UAN wise detailed sheet to be enclosed*

9 A. Whether the unit is closed*? (Yes/No)

B. If Yes, whether the documentary proof uploaded by the employer?* (Yes/No)

D. Whether minimum admin charges is due*.(Yes/No)

E. If yes, whether remitted?* (details of TRRN)

10 A. In case of first inspection post registration, whether the documents in support of

Signature of Inspecting Official:

Name & Seal of Inspecting Official:

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