labour act 1978
TRANSCRIPT
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FORM NO. FORM DESCRIPTION
FORM I Application for Registration of Establishment Employing Contract Labour
FORM II Certificate of Registration
FORM III Register of Registration
FORM IV Application of LicenseFORM V Application for adjustment of ecurity !eposit
FORM VI RE"E#AL$ %VI&A ' () "otice of Commencement*completion of Contract #or+
FORM VII Application for Rene,al of License
FORM VIIIApplication for -emporary Registration of Establishments employing ContractLabour
FORM I. -emporary Certificate of Registration
FORM . Application for -emporary License
FORM .I -emporary License
FORM .II Register of Contractors
FORM .III Register of ,or+men employed by Contractor
FORM .IV Employment Card
FORM .V er/ice Certificate
FORM .VI Muster roll
FORM .VII Register of #ages
FORM .VIII Form of Register of #ages&cum&Muster Roll
FORM .I. #age lip
FORM .. Register of !eductions for !amage of Loss
FORM ..I Register of Fines
FORM ..II Register of Ad/ances
FORM ..III Register of O/ertime
FORM ..IV Return to be sent by the Contractor to the Licensing Officer
FORM ..V Annual Return of 0rincipal Employer to be sent to the Registering Officer
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FORM I
[See rule 17 (1))
Application for Registration of Establishment Emploing !ontract "abour
1$ "ame and location of the establishment$
2$ 0ostal address of the establishment$
3$ Full name and address$ of the principal employer %furnish father4s name in the
case of indi/iduals)$
5$ Full name and address of the manager or person responsible for the
super/ision and control of the establishment$
6$ "ature of ,or+ carried on in the establishment$
7$ 0articulars of contractors and contract labour 8
%a) "ames and addresses of contractors$
%b) "ature of ,or+ In ,hich contract labour is employed or is to be
employed$
%c) Ma9imum number of contract labour to be employed on any day through
each contractor $
I:%cc) Estimated date of commencement of each contract ,or+ under each
contractor$)
%d) Estimated date of termination of employment of contract labour under
each contracto;$
2:
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0rincipal employer
eal and stamp
Office of the Registering Officer
!ate of receipt of application$
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FORM II
[See rule 1# (1))
!ertificate of Registration
"o$ &&&&&&&&&&&&& !ate &&&&&&&&&&&&&&&&&
$o%ernment of In&ia'
Office of the Registering Officer
A certificate of registration containing the follo,ing particulars is hereby granted
under sub§ion %2) of ec$ < of the Contract Labour %Regulation and Abolition) Act>
1
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FORM Ill
(See rule 18 (3)]
Register of Registration
Si. Registration Name and address of Name of the T!e of "usiness# No. No. and date theesta"lishment !rin$i!al trade# Industr#
registered em!loment manufa$ture or
and his o$$u!ation#address %hi$h is $arried
on in the
esta"lishment
Total No. of%or&
men
dire$tlem!loed
'
Remar&s
11
1 3 *
+arti$ulars of $ontra$tor and $ontra$t la"our
Name and Nature of %or& Ma,imum No. of +ro"a"le durationaddress of in %hi$h $ontra$t la"our of em!loment of
$ontra$tor $ontra$t la"our to "e em!loed- $ontra$t la"our
is em!loed or on an da
is to "e
em!loed
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FORM I/
(See rule *1 (1))
Application of "icense
1$ "ame and address of the contractor %including his father4s name in case of indi/iduals)$
2$ !ate of birth and age %in case of indi/iduals)$
3$ 0articulars of establishment ,here contract labour is to be employed 8
%a) "ame and address of the establishment$
%b) -ype of business> trade> industry> manufacture or occupation ,hich is
carried on in the establishment$
%c) "umber and date of certificate of registration$ of the establishment under
the Act$
%d) "ame and address of the principal employer$
5$ 0articulars of contract labour 8
%a) "ature of ,or+ in ,hich contract labour is employed or is to be
employed in the establishment$
%b) !uration of the proposed contract ,or+ %gi/e particulars of proposed
date of commencing and ending)$
%c) "ame and address of the agent or manager or contractor at the ,or+
site$
%d) Ma9imum number of contract labour proposed to be employed in the
establishment on any date$
6$ #hether the contractor ,as con/icted of any offence ,ithin the preceding
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fi/e years$ If so> gi/e details$
7$ #hether there ,as any order against the contractor re/o+ing or suspending
licence or forfeiting security deposits in respect of an earlier contract$ If so>
the date of such order $
gi/e details of the principal employer> establishment and
nature of ,or+$
$ #hether a certificate by the principal employer in Form V is enclosed$
1:$ Amount of licence&fee&"ame of the =nion (an+> !emand !raft "o$ and
date$
1B$ Amount of security deposit&"ame and =nion (an+> !emand !raft "o$ and
date$?
D-he amount of security or balance> if any> after adjustment of amount to be
refunded under rule 3B> if any> deposited ,ith treasury receipt number and date$D
!eclaration$&1 hereby declare that the details gi/en abo/e are correct to the best
of my +no,ledge and belief$
0lace 8
!ate 8
ignature of the applicant
%Contractor)$
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1:"ote$&-he application shall be accompanied by demand draft and the challan
for the appropriate amount and a certificate in Form V from the principal
employer date of the receipt of the application ,ith Ddemand draftD
and the challan for fees*security deposit$?
%f o be filled in the office of the Licensing Officer)
!ate of receipt of the application ,ith challan for fee of security deposit$
ignature of the Licensing Officer $
1Subs b $SR .+7' &ate& Ilth August' 1#7 (-ef **n& August' 1#7
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FORM /
[See rule *1 (*)0
Form of !ertificate b rincipal Emploer
Certified that I ha/e engaged the applicant %name of the contractor) as a contractor I my
establishment$ I underta+e to be bound by all the pro/isions of the Contract Labour %Regulation andAbolition) Act 1 and the Contract Labour %Regulation and Abolition) Central Rules> 1 in so
far as the pro/isions are applicable to me in respect of the employment of contract labour by theapplicant in any establishment$
0lace 8 ignature of 0rincipal
Employer
!ate8 "ame and address of
establishment
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A22E34RE
-he licence Is subject to the follo,ing conditions
1$ -he licence shall be non&transferable$
2$ -he number of ,or+men employed as contract labour in the establishment shall not&on any day>
e9ceed
3$E9cept as pro/ided in the rules the fees paid for the grant or> as the case may be> for rene,al ofthe licence shall be non&refundable$
5$ -he rates of ,ages payable to the ,or+men by the contractor shall not be less than the rates
prescribed for the schedule of employment under the Minimum #ages Act> 15> ,here applicable>and ,here the rates ha/e been fi9ed by agreement> settlement or a,ard> not less than the rates
fi9ed$
6$ In cases ,here the ,or+men employed by the contractor perform the same or similar +ind of ,or+
as the ,or+men directly employed by the principal employer of the establishment> the ,age rates>holidays> hours of ,or+ and other conditions of ser/ice of the ,or+men of the contractor shall be the
same as applicable to the ,or+men directly employed by the principal employer of the establishmenton the same or similar +ind of ,or+> pro/ided that in the case of any disagreement ,ith regard to the
type of ,or+ the same shall be decided by the Chief Labour Commissioner %Central) ,hose decisionshall be final$
7$ In other cases the ,age rate$> holidays> hours of ,or+ and conditions of ser/ice of the ,or+men of
the contractor shall be such as may be specified In this behalf by the Chief Labour Commissioner%Central)$
,ithin fifteen days of the commencement and completion of each
contract ,or+ submit a return to the Inspector appointed under ec$ 2 of the Act Intimating the
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actual date of the commencement or> as the case may be> completion of such contract ,or+ In FormVI&A$G
1Ins b $SR 5#' &ate& 1*th ,ul' 17#
6[FORM /IA
(See rule *+ (*) (viii)
Notice of commencement / completion of Contract Work
I*#e> hri*Messrs$ %name and address of the contractor) hereby intimate that the contract ,or+%name of ,or+) In the establishment of %name and address of principal employer) for ,hich
Licence "o&&&&&&&&& > dated&&&&&&&&& has been issued to me*us by the Licensing Officer %name ofthe headuarter)> has been commencedH completed ,ith effect from %date)*on %date)$
ignature of the Contractor %s)$
-o
-he inspector>
&&&&&&&&&&&&&&
&&&&&&&&&&&&&&
6[FORM /I8
(See rule #1(6)1
2otice of Commencement/completion of Contract Work
1$ "ame of the principal employer and address
2$ "umber and date of Certificate of Registration
3$ I*#e hereby intimate that the contract ,or+ %name of ,or+) gi/en to %name and address of the
contractor) ha/ing Licences "o &&&&&&&& dated&&&&&&&&has been commenced*completed ,ith effectfrom %date)*on %date)$
ignature of the principal employer$
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FORM /II
[See rule * (*)1
Application for Rene-al of "icence
I$ "ame and address of the contractor&&&&&&&&&&&&&&&&&&&&&&&&&2$ "umber and date of the licence &&&&&&&&&&&&&&&&&&&&&&&&&&&&
3$ !ate of e9piry of the pre/ious licence &&&&&&&&&&&&&&&&&&&&&&5$ #hether the licence 4of the contractor ,as suspended or re/o+ed &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
6 "ame of the (an+> number and date of the demand draft enclosed$ !ate of receipt of theapplication ,ith demand draft number and date$)
0lace&&&&&&&&&&
!ate&&&&&&&&&&&
ignature of 4the Applicant$
%-o be filled In office of the Licensing Officer)
!ate of receipt of the application ,ith -reasury Receipt number and date$
ignature of the Licensing Officer$
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FORM /II
[See rule * (*)1
Application for Rene-al of "icence
I$ "ame and address of the contractor&&&&&&&&&&&&&&&&&&&&&&&&&2$ "umber and date of the licence &&&&&&&&&&&&&&&&&&&&&&&&&&&&
3$ !ate of e9piry of the pre/ious licence &&&&&&&&&&&&&&&&&&&&&&5$ #hether the licence 4of the contractor ,as suspended or re/o+ed &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
6 "ame of the (an+> number and date of the demand draft enclosed$ !ate of receipt of theapplication ,ith demand draft number and date$)
0lace&&&&&&&&&&
!ate&&&&&&&&&&&
ignature of 4the Applicant$
%-o be filled In office of the Licensing Officer)
!ate of receipt of the application ,ith -reasury Receipt number and date$
ignature of the Licensing Officer$
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FORM I3[See rule 6* (6)0
1[ 9emporar !ertificate of Registration0
"o&&&&&&&&&&&&& !ate&&&&&&&&&&&&&&&& !ate of e9piry&&&&&&&&&&&&&&
$o%ernment of In&iaOffice of the Registering Officer
A -emporary Certificate of Registration*containing the follo,ing particulars is hereby granted undersub§ion %2) of ec$ < of the Contract Labour %Regulation and Abolition) Act> 1 to/alid from to
1$ "ame of ,or+ carried on in the establishment2$ "ature of ,or+ in ,hich contract labour is to be employed
3$ Ma9imum number of contract labour to be employed on any day5$ Other particulars rele/ant to the employment of contract labour
ignature of Registering Officer ,ith eal$
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FORM 3
[See rule 6* (*)0
Application for 9emporar "icense
1$ "ame and address of the contractor %including his father4s name in case ofindi/iduals)2$ !ate of birth and age %in case of indi/iduals)$3$ 0articulars of establishment ,here> contract labour is to be employed
%a) "ame and address of the establishment$
%b) -ype of business> trade> industry> manufacture or occupation ,hich is carried on in the
establishment$
%c) 4"ame and address of the principal employer$
5$ 0articulars of contract labour8
%a) "ature of ,or+ in ,hich contract labour is to be employed in the establishment$
%b) !uration of the proposed contract ,or+ %gi/e particulars of proposed date of commencing
and ending)$
%c) "ame and address of the agent or manager of contractor at the ,or+& site$
%d) Ma9imum number of contract labour proposed to be employed in the establishment on any
date$
6$ #hether the contractor ,as con/icted of any offence ,ithin the preceding fi/e yearsJ if so> gi/edetails$
7$ #hether there ,as any order against the contractor re/o+ing or suspending licence or forfeitingsecurity deposits in respect of an earlier contract J If so the date of such order
gi/e details of the principal employer> establishment and nature of ,or+$
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2%$ Amount of licence fee paidname of the =nion (an+> !emand !raft "o$ and date
2: Amount of security depositname of the =nion (an+> !emand !raft "o$ and date> !ate of the
receipt of the application ,ith demand draft for fee*securitydeposits$?
I hereby declare that the particulars gi/en abo/e are true to the best of my +no,ledge and belief$
ignature of the applicant
%Contractor)$
0lace&&&&&&&&&&&&&&
!ate&&&&&&&&&&&&&&
%-o be filled in the office of the Licensing Officer)
!ate of receipt of the application ,ith challan for fees*security deposit$
ignature of the Licensing Officer
1Subs' for the -or&s :Office of the "icensing Officer:' %i&e $SR 1.5' &ate& 1.th;ecember' 17*
* Subs b $SR .+7' &ate& 11th August' 1#7 (-ef **n& August' 1#7)
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FORM 3I
[See rule 6* (6)0
$o%ernment of In&ia
Office of the "icensing Officer
Licence "o &&&&&&&& !ate&&&&&&&&&&&&&&&& Fee paid Rs&&&&&&&&&&&&&&
ignature of the Licensing Officer
E9pires
on&&&&&&&&&&&&&&&&&&&&&
-emporary Licence
License is hereby granted to &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& under ec$12 %2) of theContract Labour %Regulation and Abolition) Act> 1 subject to the conditions specified in Anne9ure$
-he licence shall remain in force till$
ignature and eal of the Licensing Officer$
!ate&&&&&&&&&&&&&&&&&&
A22E34RE
-he licence is subject to the follo,ing conditions
1$ -he licence shall be non&transferable$
2$ -he number of ,or+men employed as contract labour in the establishment shall not> on anyday> e9ceed
3$ E9cept as pro/ided in the rules the fees paid for the grant of the licence shall be non&refundable$
5$ -he rateK of ,ages payable to the ,or+men by the contractor shall not be less than the
rates prescribed for the schedule of employment under the Minimum #ages Act> 15> ,hereapplicable> and ,here the rates ha/e been fi9ed by agreement> settlement or a,ard> not less
than the rates fi9ed$
6$ In cases ,here the ,or+men employed by the contractor perform the same or similar +indof ,or+ as the ,or+men directly employed by the principal employer of the establishment> the
,age rates> holidays> hours of ,or+ and other conditions of ser/ice of the ,or+men of thecontractor shall be the same as applicable to the ,or+men directly employed by the principal
employer of the establishment on the same or similar +ind of ,or+ pro/ided that in the case of
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any disagreement ,ith regard to the type of ,or+ the same shall be decided by the ChiefLabour Commissioner %Central) ,hose decision shall be final$
7$ In other cases the ,age rates> hoidays>hours of ,or+ and conditions of ser/ice of the
,or+men of the contractor shall be such as may be specified in this behalf by the Chief LabourCommissioner %Central)
1:
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FORM 3III
(See rule 7+)
Register of -or
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FORM 3I/
(See rule 7.)
Emploment !ar&
"ame and address of contractor
"ame and address of establishment in*under ,hich contract is carried on
"ature of ,or+ and location of ,or+ "ame and address of principal employer
1$ "ame of the ,or+man
2$ erial number in the register of ,or+men employed
3$ "ature of employment*designation
5$ #age4 rate ,ith particulars or unit> in case of piece ,or+
6 #age period
7$ -enure of employment
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FORM 3/
(See rule 77)
Ser%ice !ertificate
"ame and address of contractor &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of> establishment in*under ,hich contract is carried on
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ature and location of ,or+&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&"ame and address of principal employer&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of the ,or+man&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&Age or date of birth&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Identification mar+s&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Father4s*usband4s name$&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
r$"o$
-otal period for ,hich employedFrom -o
"ature of ,or+done
Rate of ,age%,ith particulars
of unitin case ofpiece,or+)
Remar+s
1 2 3 5 6 7
ignature&&&&&&&&&&&&&&&&
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FORM 3/I
1[See rule 7# (1) (a) (i)0
Muster roll
"ame and address of contractor &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of establishment in*under ,hich contract is carried on&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ature and location of ,or+ &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&"ame and address of principal employer &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
For the month of &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
r$
"o$
"ame of ,or+man
"o$Father4s*usband4s
namee9 !ates Remar+s
1 2 3 5 6
12 3 5
6
7
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FORM 3/II
1[See rule 7# (1) (a) (i)0
Register of =ages
"ame and address of contractor &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of establishment In*under ,hich contract is carried on &&&&&&&&&&&&&&&&&&&&&&
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ature and location of ,or+ &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of principal employer&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
#age period Monthly &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
1 Subs b $SR 5#' &ate& 1*th ,ul' 17#
r"o$
"ame of,or+man
erial "o$ in theregister of ,or+men
!esignation*
nature of ,or+done
"o$ of days,or+ed
=nits of ,or+done
!aily rate ,ages*pi
rate
1 2 3 5 6 7
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(asic
,ages
!earnessallo,ance
O/er&time Othercash
payments%nature of
paymentto be
indicated)
-otal !eductionIf any
%Indicatenature)
"etamount
paid
ignature*thumb&
Impressionof ,or+man
Initials of contractor the
representati/e
1B 11 12 13 15 16 17
FORM 3/III
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1ISee rule 7# (1) (a) (I)0
Form of Register of =agescumMuster Roll
"ame and address of contractor
"ame and address of establishment in*under ,hich contract is carried on
"ame and address of principal employer#age period #ee+ly*Fortnightly From to
"ature and location of ,or+
l
"o$
L$"o$in
registerof
,or+men
"ame ofemployee
!esignation*
nature of,or+
!aily
attendance*units
,or+ed
-otal
attendance*unitsof ,or+ done
!aily rateof,ages*piecerate
1 2 3 5 6 7 "et ignature* Initials(asic !earness O/er& Othercash
,ages allo,ance time payments
%nature of
payment
to beindicated)
if anyamount
%indicatepaid
nature)
thumb&
impres&
sion of
,or+man
of con&tractor
or the
representati/e
1B 11 12 13 15 16 17
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1 Subs b $SR 5#' &ate& 1*th ,ul' 17#
FORM 3I3
1[Seerule 7# (1) (b)0
=age Slip
"ame and address of contractor &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and father4s*husband4s name of the ,or+man&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&"ature and location of ,or+ &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
For the ,ee+*fortnight*month ending &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&1$ "umber of days ,or+ed &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
2$ "umber of units ,or+ed in case of piece rate ,or+ers &&&&&&&&&&&&&&&&&&&&&&&&
3$ Rate of daily ,ages*piece rate &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&5$ Amount of o/ertime ,ages &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
6$ ross ,ages payable a &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&7$ !eductions> If any &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
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FORM 33
1[Seerule 7# (1) (a) (ii)0
Register of ;e&uctions for ;amage or "ou
"ame and address of contractor &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
"ame and address of establishment in*under ,hich contract Is carried on &&&&&&&&&&&&&&&&&&&&&&&&
"ature and location of ,or+ "ame and address of principal employer&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
r$"o$
"ame of
,or+man
Father4s*usband4s
name
!esignation*"ature of
employment
0articulars ofdamage or
loss
!ate ofdamage
or loss
#hether ,or+ mansho,ed cause again
deduction
1 2 3 5 6 7
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FORM XXI
1[See rule 78 (1) a) (ii)]
Register ! Fi"es
Name and address of $ontra$tor
Name and address of esta"lishment in6under %hi$h $ontra$t is $arried on
Nature and lo$ation of %or& Name and address of !rin$i!al em!loer
Sr.
No.
Name of
%or&manFather-s7
us"and-s
name
esignation Nature
of em!loment2$t6Omission for
%hi$h fine im!osedate of
offen$e9hether %or&man
sho%ed $ause against
fine
Name of
!erson in
%hose
!resen$e em!loee-s
e,!lanation
%as heard
1 3 * ' 8
9age !eriods and %ages
!aa"le2mount of fine Im!osed ate on %hi$h fine reali:ed Remar&s
/ 10 11 1
1 Subs b $SR 5#' &ate& 1*th ,ul' 17#
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FORM XXII
1(See rule 78 (1) (a) (ii)]
Register ! #$%a"&es
Name and address of $ontra$tor
Name and address of esta"lishment in6under %hi$h $ontra$t is $arried on
Nature and lo$ation of %or&
Name and address of !rin$i!al em!loer
Sr.
No.
Name Father-s6
us"ands
name
Nature of
em!loment6
designation
9age !eriod
and %ages
!aa"le
ate and
amount
of ad4an$e
gi4en
+ur!os
for %h
ad4an
mad
1 3 * '
No. of installments " %hi$h ad4an$e to "e
re!aidate and amount of ea$h installment
re!aidate on %hi$h lastinstallment
%as re!aidRemar
8 / 10 11
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FORM XXIII
1[See rule 78 (1) (a) (iii)]
Register ! O%erti'e
Name and address of $ontra$tor
Name and address of esta"lishment in6under %hi$h $ontra$t is $arried on
Nature and lo$ation of %or&
Name and address of !rin$i!al em!loer
Sr
No.
Name of %or&man Father-s6us"and-sname
Se, esignation6Nature ofem!loment
ate on %hi$ho4ertime%or&ed
Total o4ertime %or&ed or
!rodu$tionin $ase of!ie$
1 3 - * '
Normal rate of %ages O4ertime rate of %ages O4ertimeearnings
ate on %hi$ho4ertime%age!aid
Remar&s
8 / 10 11 1
1. Su"s. " ;.S.R. /8# dated 1th
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FORM XXI
[See rule 8 (1)]
Retur" t *e se"t *+ t,e C"tra&tr t t,e -i&e"si"g O!!i&er
alfear ending
1. Name and address of the $ontra$tor
. Name and address of the esta"lishment
3. Name and address of the !rin$i!al em!loer
. uration of $ontra$t From to
*. Num"er of das during the halfear on %hi$h
(a) the esta"lishment of the !rin$i!al em!loer had %or&ed
(") the $ontra$tor-s esta"lishment had %or&ed '. Ma,imum num"er of $ontra$t la"our em!loed on an da during the half ear
Men 9omen =hildren Total
. (I) ail hours of %or& and s!reado4er
(II) (a) 9hether %ee&l holidas o"ser4ed and on %hat da
(") If so# %hether it %as !aid for
(III) Num"er of manhours of o4ertime %or&ed
8. Num"er of man das %or&ed ">
Man 9omen =hildren Total
/. 2mount of %ages !aid>
Man 9omen =hildren Total
10. 2mount of dedu$tion from %ages# If an?Man 9omen =hildren Total
11. 9hether the follo%ing ha4e "een !ro4ided
(I) =anteen(II) Restrooms
(III) rin&ing %ater
(I@) =rA$he
(4) Firstaid
(if the ans%er is -es- state "riefl standards !ro4ided)
Signature of =ontra$tor.
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+la$e
ate
FORM 33/
[See rule #* (*))
Annual Return of rincipal Emploer to be sent to the Registering Officer
>ear en&ing 61st ;ecember
1$ Full name and address of the principal employer
2$ "ame of the establishment
%a) !istrict
%b) 0ostal address
%c) "ature of operation*Industry*,or+ carried on
3$ Full name of the manager or person responsible for super/ision and control of the establishment5$ "umber of contractors ,ho ,or+ed in the establishment during the year %i/e details in Anne9ure)
6$ "ature of ,or+*operation on ,hich contract labour ,as employed
7$ -otal number of days during the year on ,hich contract labour ,as employed
If any> in the management of the establishment> Its location> or any other particulars
furnished to the Registering Officer> In the application for registration indicating also the dates
0rincipal Employer$
0lace
!ate
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A22E34RE 9O FORM
"ame and
address of
the cont ractor
0eriod of
contract
From -o
"ature of
,or+
Ma9imum number
of ,or+ers
employed by & each
contractor
"umber of
days
,or+id
"umber of
man&days
,or+ed
1 2 3 5 6 7