Records kopt under thc provisions of thc Act rnd thcsc ptcs .iii1 uilicte.vca ior a piriod of two yoars frge tbc dste of tha last 'ontry nrdt ttorcin.
cvidcnce produccd bcforc by him, the ComPetcnt #r",ffi i:ii1ir;:[1',sititiiii';;]i*I;;,;:{{#"3'3*'*':T':
;*ftT":i,'**..";; u*li*i:ri*i;g;itil*'#j[:iryrfi ?"'*;3:t' H11l"x,!i3.ifl,T io'.'.
$ts*rt*ffirs*t$*g*{*,:,;:*r For- A 1 Bihar MaternitY Benefit Rules' rg64 [31 rORM A (Scc Rule 3) MUSTERROLL Name of Establishment"' Scrial number.
i#:ffi;;an and hcr father's (or, if married husband's) name.
Dato of appointment' Nature of work' irr which shc is employed' laid off and Detcs with months and Yeat not cBploYcd' N*tf daYs cmPloYcd.
ll l I i l.
2.
3.
4.
5.
Month.
No. of daYs laid off.
No. of days not emPloYcd. Renarks.
ffiG;_si.v.es notice under section 6.
6.
7, E.
9.
10.
u.
t2, i"i. "i at*l"rge/dismissal' if any' ffi" ; ft;Jon of prooi of presnancv utrder sectidn 6' Date of birth of child' Datc of production of proof of delivety/miscarriase/death' Datc of production orptoofoi illness ilferrcd to in section 10' Dete with tbc amouot of materoity benefit paid in advance of el' pectod deliverY' Ii 321 bihar Maternity Benefit Rules, 1964 I Forms b-e
13. Datc with the amount of subscquent payment of matcrnity benefit.
14. Date with the amount of bonus, if paid under section 8.
15. Datewith the amount of wages paidon account ofleave under section 9.
16. Date with the amount of wages paid on account of leaVe under Section 10 and period of leave granted.
17. Name of thc pcrson nominatcd by the woman undcr'section 6.
I 8. If thc tyoman dies, the date of her death, the name of the person to whom maternity bcnefit and/or other amount was paid,'thc tmount . thcreof, and thc date of paYment.
19, If thc woman dics and thc cbild survives, the name of thc person to whomthe amountof maternity benefit was. paid onbehalfof the , child and thc pcriod for which it was paid.
20. Signature ofihe employer of the establishment authenticating the entrics in the muster roll.
21. Rcnarks column for thc usc of the Inspector.
rORM B [sca Rulc 4 (l)] ?hir is to certify that I examincd...
wifc/daughter of,,. ...a wonran employee in,..
(nadrc of cstablishmcnt) or.., ...(date) and found/cannot discover tlat shc is prcgnant and is cxpected to be delivered of child within... ..'(mont[ and days) from tle ebovcmentioncd datc/has undergonc miscarriage/has been deliiered of a child on... ...(datc) or is sufering from... ...(date) from illness arising out of the prcgnancy/dolivcry/premature birth of a child or miscrrritgc- Datc- Signature, qualifcations and derignation of Medical Oficer/Medical PractitioDer.
Dednitions of "ChiJdt' and "Miscarriage" as in the Maternity B6nef t AEt, 1961.
1, "Child" ineludos a still-born child.
2. "Miscarriage" means oxpulsion of the contente of a pregnant ute.
ru8 at aoy period prior to or during the twenty-sixth week ofpre.
gnancy but does not include any miscarriage, the causing of whieh ls punishablc under the Indian Penal Code.
f,,oRM G [See Rule 4 (4)] This is to ieftify that Shrimatiwife/daughter of- -emPloYed in- (nane ofestablishment) expired onifter confinemcnt. The child died sn- Date- :
-before/durilg/ -/survives her.
Signature, qualifications aud desighetiotr of Medical Ofrcer/Medical Practitioner, ,x Forms H-I l \.\ Bihar Maternity Benefit Rules, 1964 [35 FORM-H ( See Rule l0 ) To, Thc Inspcctor, (Under the Maternity Benefit Act 196l) '..(Address) Sir, f,... ...(name of woman) employed in.., (name and full address of establishment) having futfilled the conditions iaici'courr in thc Maternity Benefit Act, 196l and the rules thereunder, am eotiued to Rs... ...being maternity benefit and/or Rs.,. ...being rhe med.ic.rl birbus and/or Rs... ...being wages for leave due under sectron 9 or lU but ttre same has been improperty withheld by the employer. He may, therefore be directcd to pay thc amount to me.
Datc...
SignatureofanAttestorincasethe worna is SignatureorthumbimDre, udable to sign and affixes thumb impression, ssiou of rhe wornan, FOR I ( See Rule l0 ) To, The Inspector (Under the Maternity Benefit Act, l96l) Sir, I,... ...(name), a person nominated under employed in...
(namc-and full addrcss of establishment), bave to complain that the said woman having fulfilled the conditions laid down in the Maternity Benefit Act, 196l and the rules thereunder is entjtled to Rs...
bcing maternity benefit andlor Rs. ...bcing the mcdical bonus and/or Rs... being wages for leave duc under scction 9 or l0 but the same has been improperly withheld by the cmploycr. Hc may, therefore, be directed to pay the amount to me...
Datc...
Signature of an attestor in case the nominee/ Signature or thumb imprc- Iegal representative is unable to sign and ssion of the nominee/lcgzri afrxps thumb inrpression. representatiYe.
Full address of the nominee/legal reprcsentativc.
f$iril.e ost uDDeo9.!8ry tprtiarr.
I i 361 Bihar Maternity Benefit Rules, 1964 I Forms J.K Form K.1 Blbar MaternitY Beneflt Rules, 1964 . ':
131 FORM J (See Rule I l) To Thc Competent AuthoritY (appointed under the Maternity Beneft Act' l96l) : (Address) Sir, Shri- -, Inspector, having directed under' subsection (2) of section 17 to pay the Maternity Benefit or other amoui{t'-being -(nature of aurount) which- (name of womari) is said to be enfitletl, I prefer this appeal under sub-section
(3) of section 17.'In view of the facts mentioned in the memorandum attached lieieto and other documents filed herewith it is submitted that the wom4n is not entitled to the maternity benelit or the said amount and hence the decisioo of the Inspector in this behalf, copy of which is ericlosed, rnay be sct aside, Date- - - Signature ol aggrieved person, Full address- Proviiled tbat the qualiiying period of one hundred and eixty day-s afore' said shall noi appi, ,o o'*oiJ*"rfno nas im*igrated into the $tate of Assam uoa *itpt.goo'i,t it the time of the immigration :
Provided further that where a woman dics -du-ring the period for which ,"t.roii't.n.diit piv"ui. io lii, tt," tt"efit shall- be pavable onlv for the aiv, ,rl-i" ura inctirding i6; i;i'of her death'. However' where thc wonlan havine been delivered or " "-nifa,ii..
auiing trer deliv.ery or during tle'Pe{qd of six?eeks immediately following ihe date of her delivery' leavrng Deilnq In iitfiii *ri1r,t child, th6 ..ii"y.itiirlt u" liab.le for the pavment- of paternitv il;;iii;; ih; ;ii; pi.ioi'oTii* we.-[s i*-"oiately foll,owing -the.day. of her ;;ii;;;y briniii" "r,iia "r* ,iil''ariios the s1i{- p6riod then, for the davs up 6-;;Ail"hdirg the day of the death of the child'
(2) The amount of maternity benefit for the period preceding th9 dltg of her 'exoected deliver-v shall be paid in advance by qhe employer Io Ine *o-u, on'production of a certificate in Form.'B' statins that she ls pregnant J"a i, iii,-.[tJi" i" a"uu...o .i;-;iiid ;iihin six week-s of the date of pro-- au"doo df m. certificate, ,;i th; "r"rrt due - for the subsequent^period shall ;il;;; ;y i;;;;;i;t;'io'i-t" *ori' within fortv.-eiqht hours of production of rhe certificate in Form Je:i. Fo;-'D;iiatil' ihul sbe has been delivered oi i "tlia-ip oi"duition oIu .i.iin.J extract fr6m. a birth registei maintained ;;d;ih; piovisions of any law for the time being in forcc'
4.(l)Anvwomanemployedinanestablishmentandentitledto.materoitv i=",#/ ili.;"il;"p*;f ili.'"iitii Act mavqive 19ti11in y-*l:E::
Foim 'A; t" nii.-ptoy.i stating tha' her mat:rnity b:n:tit-1,1d.:ll-1t:::
amount to which shl may be entltled under this Act ntay ge palg to IIer or to .r"U p"t.ort ".
tn" .ry-oominate in the notice.and that she will not work ln ,iiv "ititiiii.til d;.i;s il;;;oa-roi *ni.n she receives maternity benefit.
(2) In the case of a woman who is pregnant'- such notice shall state the date f|-o| ;;i.h rh; rrill b;';b.;;i i.;; *;rk-, not being a date earlier than six weeks frbm the date ofher expected delivcry'
(3) Any woman who has not given the..notics whcn she was pregnant -ay givi: noti6e as soon as possible after thc delivcry'
(4) On receipt of the notice the eTployer shall dermit such woman to absentherselffro-ttreesia'tll-sir-eJuntil'thc expiry 6f six weeksaftcrthe day of her delivery.
' 5. (l) Everv woman entitled to maternity benefit under th^e Act shall ufro U-"'"niiifrla'i.".."iu" iro- her employer a-lnedical bouns of twenty-five irp*., if ,- pre-natal confinimgnt and po-st-natal care is provided for by the ;;';l"i';;
-lre'., or "nure..*1h"';.di."i bonut shall be paid along with the si'ond instal-ent of a maternity benefit'
(2) In case of miscarriage. a woman shall, on production :f .l-9^t::il;
cate iri Form ,B' or Fcrm .D' be entirled to leave with wages at thc ratc oI maternity benefit, for a periodof six weeks immediately following ll" d1J.Pl her miscirria5e. i'he wales shall be paid within 48 hours of production ol tne certificate in Form 'B' oi Form 'D'.
(3) A woman suffering from illness arising out of pregnancy, delivery, p..uu't,ir. Uiith or miscarr-iage shall, on production ola certifcate in Form ilFORM K (See Rule 15) (Abstract of the Maternity Benefit Act, 1961, and the rules made thercunder,) l. No employer shall knowingly employ a woman during the six weeks immedia'ely, following the day of her delivery or miscarriage and no woman rhall work in any establishment during the said period.
2. No pregnant woman shallon arequestbcingmade.by-her inthis behalf. be required by her emp.loyer to do during thc period of onc month immediately ire 'cding the period of six wceks before thc date of-her e-x-pccted diliv"tv aod ulso lor any period during this period of six wecks for which she aoir not avail of leave of -abscnce, any work which is of an arduous naturc or which involves long hours of standing, or which in any rray is likcly to interfere with her pregn-ancy or the norrnal devclopment -of t-he -foetu-s, or is likcly to cause her riliscarriage or otherwise to advcrscly affect her health.
3. (l) Subiect to the provisions ofthc Act, cvery woruan who has tctuallv workcd'in an establishment of the cmploycr whom she claims maternity beiefit for a period of not less than one hundrcd and sixty-days, incJuding-thc davs durins whi.h sh. was laid otr, shall be entitlcd to, and her cm loyer shall be'liable fo-r the Davment of maternity benefit at the race of her average daily orrr"r. o. on" ruple a day, whichever is higher, for the p riod of her actual abs-ence not exceeding six weeks irnmediately preceding and including the day of her delivery and for thp six weeks ipmediately foIqwtng that day i I I I l I I q ,, ,/ 34 j ilihar Maternitv beneft Rules, 1964 FORM T FORM OF RECEIPT OF MATERNITY BENEFIT' I See Rule 5 (3.1 ] To, ...(Name of esta'biishment') I,... ..., the undersigned, a *woman- employee/the nominee of... woman employee/legal ,epresentative"-' -. - '::
woman employee deceased in... (name of establishmen^t)
4t... ...1n ...district received maternity benelt and/or other amount due under the Maternity Benefit Act, t961, ttom thc emt'loyer of the establishn:ent referred to above, as detailed below :-
(2) The Inspector may, of his own motion or on receipt of a complaint in Form 'H'orI' make an inquiry or cause an enquiry to be madc and if satisfied that payment has been wrongfullywithheld, may direct the payment to be made in accordance with his orders.
(3) Any person aggrieved by the decision of the Inspector may, within thirty days from the date on which such decision is communicated to such person, appeal to the Chief Inspector of Factories.
(4) Thedecisionof theChieflnspector of Factoties where an appeal has bcen preferred to him or of the Inspector where no such appeal has been preferred, shall be final.
10. (a) The employer shall supply to every woman employcd by him at her request free of cost copies of Forms 'B', 'C'; 'D','E', 'F', 'G', 'H', and 'I'.
(b) The failure to submit a notice, appeal or complaint in tte prescribed form will not affect the right of woman entitled to receive maternity bcnefit or ary other amount due under the Act. Where a notice, appeal or complaint has been received in a form other than the prescribed form, thc authority concerned shall within fifteen days of the ieceipt of such notice appeal or complaint, require the woman to submit the notice, appeal or complaint, as the case may be in the prcscribed tbrm.
tt. (a) (l) Theemployerofeveryestablishment in which women are employed shall prepare and maintain a muster roll in Form 'A'and shall enter theirein particslars of all woman workers i[ the establishment.
(2) All entries in the muster roll shall be made in ink and mainraincd up to aate and it shall always be available for inspection by the Inspcctor during working hours.
(b) Theemployerofevery establishment shall or or before thc 21st day oi'January, ln each 3'ear snbmit tothe ChieflnspectorofFactories,a rerurn in each 6f the Forms 'L', 'M', 'N' and 'O' giving information as to thc particulars specifed in respect of the preceding year, Form L j Bihar Maternity Benefit Rules, 1964 t:s rORM L (See Rule 16) Annual returu under the Maternity Benefit Act, l96l for the yeiir cndiog 6n the 3lst December, 19... ,..
General Instructiow l. Name of the establishment.
2. Situation ald address ofrhe establishment.
3. Nearest Railway Station.
4, Date of opening of the establishnent.
5. Date of closing, if closed.
6. Name of employer* Postal address of employer.
I Forms F-G Rs...
Rs...
Rs...
Rs...
being the first instalment of maternity benefit paid on,..
being the second instalment of maternjty benefit after delivery paid on...
being the medical bonus under section 8 of the Act paid on...
beine the wages for the leave period from,..
to... - mentioned under section 9 or 10.
*Mv/hcr confinement/rniscarriage took place on.,, tlshe fefiiif Uecauie of prdgnancy, delivery,- pr'rmature birth of a child or ;il;;iil;;.-_- .' - ...In consequenie 1... ...her nomincc/legal reoresentitiVe haVe receiVed the aforesaid aDrouDts prescribed in scction 5' 8,'9 and l0 of the Maternity Benefit Act, 1961.
Datc...
Sisnature of an attestor in case the Signatute or thumb imprcssloo of w6.uo ir not able to sign and affixes *woman employee or her nominee tlunU irp..rrion. or legal represeotativc.
lgtrlkc oltt EuDaGclL8ty lrotllo!.
rORM G ( See Rule 9 ) fo.
The ComPetent Authorit!
"ppoint.O under the Maiernity Benefit Act, 1961.
.. ' (address;
Sir, I.... ,.,the undersilned, Woman employec of... ...(name of establishderlt 4dd full address), having been wrongly i"fiiv.a by the employer o[ laternity benefit or mcdical bbnus or both rstiike oui unnecessary portion) for the reas)ns attached hereto, prefer this iooeal under sub-section (2) ofl Section 12 and request that the said employcr bi'ordered to pay the above'mentioned amount to m''. A copy of thc ordbr of the employer in this behalf is enclosed' Date.'.
Sisnature of an Attestor in case the woman SiSnatufe or thumb imp' isioi atte to sign and affixes thumb impression. ression of the womao.
:)J I .) I i I i t I 40] Date... ...
Bihar Maternity ilenefit Ruies, 1964 Name qf Manager, Postal address of Manager.
rORM M (See Rule 16) I Form M
7.
8.
9..
r0.
(a) Name of Medical Oftcer attached to the establishment'
(b) Qualification of Medical Oftcer attached to the establishmeot.
(c) Is he resident at the establishment.
If a part-time Medical Officer, how often does he pay visits to the establishment ?
(a) Is there any hospital at the establishment ?
(b) Ifso, how many beds are provided for woman enployees ?
(c) Is there a IadY doctor ?
(d) If so, what are her qualifications ?
(e) Is there a qualified midwife ?
(0 IIas any creche been Provided ?
Signature ofEmPloYer' 1:
i s o d, (i ai b, ol D si is Annual return under the Maternity Benefit Act,, 196l for the yeat endi::g on' the 3lst Dccember, 19- - Employment, dismissal, paymcnt of bonus, etc; of wonren fcr the year ending on 3lst December, 19- - .
- l. Name of establishmcnt.' 2. Aggegate number of women permanently or temporarily employed during the Year.
X, Number of women who worlted fora period nf not lessthanonol-' hu-narea atrd sixty days iu the twelve months immediately preceding the date of delivcry, lrfrrmber of women who gave notice under section 6.
Number of women who were granted permission to absent otr receipt of notice of confinement.
Number of claims for maternitv benefft paid.
Number of clalms for maternity benefit rejected.
Numberof csses where-,pre-natal eonfinement and post'rtatal crre was provided by the management free of charge (section 8.;.
Nunber of elaims for oedical bonus paid (section I l).
Number of claims for medical bonus rejected.
Number of cases in which leave for miscairiage was gtanted.
Number of cases in which leaVe fof miscarriage was applied for but was reJected.
- Nj=Frll *"bi.rlr"r of each caa€ 6nd foreons for tho actiou t{tkon undcr seri8ll 7r rO, I2, 14, l?.na lt should be given' fEoPloyer ol tlonBod i! Btotion 3 (b)''
4.
(
6.
1.
8.
9.
10.
ll.
12.
-t Date,..
Form N l BlharMaternity Benefit Rules, 1954 I3. Number of cases in which additional leave for illness l0 was granted Number of cases in which additional leave for illness l0 was applied for but was rejected' Number of women who died-
(a) before deliverY.
(b) after delivery.
16, Numbcr ofcases in which payment was niade to persons other than thc woman concerned. I 17, Numbor of women discharged or dismissed while working.
18. Numberolwoman deprived ofmaternity beneft and/or medical bonus under proviso to sub-section (2) ofsection 12.
19. Number of cases in which payment was . rnade on the order of tbo Competent Authority or Inspector.
20, Remarks.
Signature af Enployer, Date...
FORM N (See Rule 1o) Annual return under the MaternityBenefitAct, 196l for the yearendiig on the 3lst December, 19......
Details of payment made during the year ending on the 3lst' December 19',.
Name of person to whom paid.'. ,.. ", Aroount paid.
l. Date of PaYment.
2. Woman emPloYee.
3. Nominee of the woman.
4. Legal representative of the woman.
5. Amount for the pcriod prcceding'date of expected delivery'
6. Amount for the subsequent period... ...
7. Under section 8 of the Act". ...
8. Undcr section 9 of the Act..' '..
9. Undcr section 19 of the Act"' "'
10. Number of woman workers who absconded after receiving thc first instalment of maternitY benefit' l l . Cases where claims were contested in a court of law"' "'
12. Results of such cases"' "'
13. Rcmarks Signature of EmPloYer, l4t under section un(gr section14.