On receipt of a written application from migrant workman or in the event of his death, from next of his kin for providing legal aid in relation to any proceedings before the Authority under section 15 of the Payment of Wages Act, 1936 (Central Act IV of 1936) or Authority under section 20 of the Minimum Wages Act, 1948 (Central Act XI of 1948) or appropriate Labour Court under section 33C (2) of the Industrial Disputes Act, 1947 (Central Act XIV of 1947) or Commissioner for Workmen‘s Compensation under the Workmen‘s Compensation Act, 1923 (Central Act VII of 1923), in which the migrant workman or his legal heir is a party, the specified authority concerned, if he is satisfied, may with the prior approval of the Commissioner of Labour engage an advocate to conduct the relevant proceedings on behalf of the migrant workman or his legal heir as the case may be and meet all legal expenses in this regard.
_________________________________________________________________________
1. Ins. by.G.O.Ms.No.134, Labour and Employment, dated the 3rd October 2018.
28 FORM I [See rule 3(1)] Application for registration of establishments employing Migrant workmen
1. Name and location of the establishment.
2. Postal address of the establishment.
3. Full name and address of the principal employer (furnish father‘s/husband‘s name in the case of individuals).
4. Names and addresses of the directors/particular (sic.) partners (in case of companies and firms).
5. Full name and address of the Manager or person responsible for the supervision and control of the establishment.
6. Nature of the work carried on in the establishment.
7. Particulars of contractors and migrant workmen.
(a) Names and addresses of contractors.
(b) Nature of work for which migrant workmen are to be recruited or are employed.
(c) Maximum number of migrant workmen to be employed on any day through each contractor.
(d) Establishment date and commencement of work under each contractor.
(e) Estimated date of termination of employment of migrant workmen under each contractor.
8. Particulars of Treasury Challan ------ (Name of the Treasury, Amount, Number and Date.
I hereby declare that the particulars given above are true to the best of my knowledge and belief.
Principal Employer Seal and Stamp Office of the Registering Officer Date of receipt of application:
______ 29 FORM II [See rule 4(1)] Certificate of registration Date--------------------- GOVERNMENT OF TAMIL NADU Office of the registering officer A certificate of registration containing the following particulars is hereby granted under clause (a) of sub-section (2) of section 4 of the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Act, 1979 (Central Act 30 of 1979) and the rules made thereunder to---------------------
1. Name and address of the establishment.
(a) Nature of work carried on in the establishment.
2. Names and addresses of contractors.
3. Nature of work for which migrant workers are to be employed or are employed.
4. Maximum number of migrant workmen to be employed on any day through each contractor.
5. Other particulars relevant to the employment of migrant workmen.
(i)
(ii) Signature of Registering Officer with seal ______ 30 FO R M II I [S ee r u le 4 (2 )] R eg is te r o f Es ta b lis h m en ts SI.NO Registration No. and date.
Name and address of the [establishment registered.
Name of the principal Employer and his address.
Type of business, ‘trade, industry, manufacture or occupation, which is carried on in the establishment.
Maximum No.of migrant workmen directly employed on any day.
Name and address of contractor.
Nature of work for which migrant workmen are to be recruited or are employed.
Maximum No.of migrant workmen employed on any day through a contractor.
Probable duration of employment of migrant workmen.
Remarks.
P a rt ic u la rs o f C o n tr a c to r a n d in te r S a te m ig ra n t w o rk m e n (1 ) ( 2 ) ( 3 ) (4 ) ( 5 ) ( 6 ) ( 7 ) ( 8 ) ( 9 ) (1 0 ) ( 1 1 ) 31 FORM IV [See rule 7 (1)] Application for Licence for recruitment
1. Name and address of the contractor (including his/her Father‘s/Husband‘s name in case of individuals).
2. Date of birth and age (in case of individuals).
3. Particulars regarding the location of the establishment.
4. (a) Name and address of the establishment:
(b) Type of business, trade, industry, manufacture or occupation, which is carried on in the establishment;
(c) Number and date of certificate of registration of the establishment under the Act;
(d) Name and address of the principal employer;
5. Particulars of migrant workmen:
(a) Nature of operation of work for which migrant workmen are employed in the establishment.
(b) Duration of the proposed contract work (give particulars of proposed date of commencing and ending).
(c) Name and address of the agent or manager of the contractor at the work-site.
(d) Maximum number of migrant workmen proposed to be employed in the establishment on any date.
(e) Names and addresses of the directors/partners (in case of companies and firms).
(f) Name(s) and address(es) of the person(s) in charge of and responsible to the company/firm, for the conduct of the business of the company/firm, as the case may be.
6. Whether the contractor was convicted of any offence within the preceding five years. If so, give details.
7. Whether there was. any order against the contractor revoking or suspending licence or forfeiting security deposits in respect of an earlier contract. If so, the date of such order.
32
8. Whether the contractor has worked in any other establishment within the past five years. If so, give details of the principal employer, establishment and nature of work.
9. Whether a certificate by the principal employer in Form VI is enclosed.
10. Amount of licence fee paid—Treasury Challan number and date.
11. Amount of security deposit, if any.
Declaration I hereby declare that the details given above are correct to the best of my knowledge and belief.
Place_________ Date__________ Signature of the Applicant (Contractor) NOTE: The application should be accompanied by a Treasury Challan, showing the payment of the prescribed licence fee and security deposit, if any and a certificate in Form VI from the Principal Employer.
(To be filled in the office of the Licensing Officer) Date of receipt of the application with Treasury Challan for fees.
Signature of the Licensing Officer _____ 33 FORM V [See rule 7 (2)] Application for Licence for Employment
1. Name and address of the contractor (including his/her father‘s/husband‘s name in case of individuals).
2. Date of birth and age (in case of individuals).
3. Particulars regarding the location of establishment where migrant workmen are to be employed.
(a) Name and address of the establishment;
(b) Type of business, trade, industry, manufacture or occupation, which is carried on in the establishment;
(c) Number and date of certificate of registration of the establishment under the Act;
(d) Name and address of the principal employer.
4. Particulars of migrant workmen.
(a) Nature of operation of work for which migrant workmen are employed or are to be employed in the establishment;
(b) Duration of the proposed contract work (give particulars of proposed date of commencing and ending);
(c) Name and address of the agent or manager of the contractor at the work site;
(d) Maximum number of migrant workmen proposed to be employed in the establishment on any date;
(e) Names and addresses of the Directors/Partners (in case of companies and firms);
(f) Name(s) and address(es) of the person(s) in-charge of and responsible to the company/ firm for the conduct of the business of the company/firm, as the case may be.
5. Whether the contractor was convicted of any offence within the preceding five years. If so, give details.
6. Whether there was any order against the contractor revoking or suspending licence or forfeiting security deposits in respect of an earlier contract. If so, the date of such order.
34
7. Whether the contractor has worked in any other establishment within the past five years. If so, give details of the principal employer, establishment and nature of work.
8. Whether a certificate by the principal employer in Form VI is enclosed.
9. Amount of licence fee paid-Treasury Challan No. and date.
10. Amount of security deposit, if any.
DECLARATION I hereby declare that the details given above are correct to the best of my knowledge and belief.
Place: Signature of the Applicant.
Date: (Contractor) NOTE.—The application should be accompanied by a Treasury Challan showing the payment of the prescribed fee and security deposit, if any and a certificate in Form VI from the principal employer.
(To be filled in the Office of the Licensing Officer) Date of receipt of the application with Treasury Challan for fees.
Signature of the Licensing Officer.
____ FORM VI [See rule 7(3)] Form of certificate by principal employer Certified that I have engaged the applicant (Name of the Contractor) as a contractor in my establishment. I undertake to be bound by all the provisions of the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Act, 1979 (Central Act 30 of 1979) and the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Tamil Nadu Rules, 1983 in so far as the provisions are applicable to me in respect of the employment of migrant workmen by the applicant in my establishment.
Place: Signature of Principal Employer.
Date: Name and address of establishment.
______ 35 FORM VII [See rule 10(2)] Application for adjustment of Security Deposit
(1) (2) (3) (4) (5) (6)
(7) (8) (9) (10) (11) (12) Place: Signature of the applicant.
Date:
______ N am e an d a d d re ss o f t h e co n tr ac to r N u m b er a n d d at e o f ap p lic at io n f o r fr es h lic en ce .
D at e o f e xp ir y o f p re vi o u s lic en ce .
W h et h er t h e p re vi o u s lic en ce o f th e co n tr ac to r w as s u sp en d ed o r re vo ke d .
N u m b er a n d d at e o f th e Tr ea su ry C h al la n o f se cu ri ty d ep o si t in re sp ec t o f th e p re vi o u s lic en ce .
A m o u n t o f p re vi o u s se cu ri ty d ep o si t.
A m o u n t o f se cu ri ty d ep o si t fo r th e fr e sh li ce n ce .
N u m b er a n d d at e o f Tr ea su ry C h al la n o f th e b al an ce s e cu ri ty d ep o si t d ep o si te d w it h t h e fr es h a p p lic at io n .
N u m b er a n d d at e o f ce rt if ic at e o f re gi st ra ti o n o f th e es ta b lis h m en t in r el at io n t o w h ic h t h e fr es h li ce n ce is ap p lie d f o r.
N am e an d a d d re ss o f th e p ri n ci p al e m p lo ye r.
P ar ti cu la rs o f fr es h ap p lic at io n .
R em ar ks .
36 FORM VIII [See rule 11(1)] GOVERNMENT OF TAMIL NADU Office of the Licensing Officer Licence No. Dated Fee paid Rs.
LICENCE Licence is hereby granted to ……….. under sub-section (1) of section 8 of the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Act, 1979 (Central Act 30 of 1979), subject to the conditions specified in the annexure.
2. This licence is for doing the work of (nature of work to be indicated) in the establishment of (name of principal employer to be indicated) at (place of work to be indicated).
3. The licence shall remain in force till (date to be indicated).
Signature and Seal of Licensing Officer.
RENEWAL (See rule 14) Date of renewal Fee paid for renewal Date of expiry.
(1) (2) (3)
1.
2.
3.
Date: Signature and Seal of Licensing Officer.
ANNEXURE The licence is subject to the following conditions:-
1. The licence shall be non-transferable.
2. The number of workmen employed as migrant workmen in the establishment shall not, on any day, exceed the maximum number specified in the application for licence.
3. Save as provided in these rules the fees paid for the grant or as the case may be, for renewal of licence shall be non-refundable.
37
4. The rates of wages payable to the migrant workmen by the contractor shall not be less than the rates prescribed under the Minimum Wages Act, 1948 (Central Act XI of 1948) for such employment where applicable, and where the rates have been fixed by agreement, settlement or award, not less than the rates so fixed.
5. (a) In case where the migrant workmen employed by the contractor perform the same or similar kind of work as the workmen directly employed by the principal employer of the establishment, the wage rates, holidays, hours of work and other conditions of service of the migrant workmen of the contractor shall be the same as applicable to the workmen directly employed by the principal employer of the establishment on the same or similar kind of work:
Provided that in the case of any disagreement with regard to the type of work, the same shall be decided by Commissioner of Labour whose decision shall be final;
(b) in other cases the wage rates, holidays, hours of work, and conditions of service of the migrant workmen of the contractor shall be such as prescribed in these rules.
6. Every migrant workmen shall be entitled to allowances benefits, facilities, etc., as prescribed in the Act and these rules.
7. No female migrant workman shall be employed by any contractor before 6 a.m. or after 7 p.m.:
Provided that this clause shall not apply to the employment of female migrant workmen in pit head baths, creches and canteens and as midwives and nurses in hospitals and dispensaries.
8. The contractor shall notify any change in the number of migrant workmen or the conditions of work to the Licensing Officer.
9. The contractor shall comply with all the provisions of the Act and these Rules.
10. A copy of licence shall be displayed prominently at the premises where the migrant workmen are employed.
______ 38 FORM IX [See rule 15(2)] Application for Renewal of Licence
1. Name and address of the contractor.
2. Number and date of the Licence.
3. Date of expiry of the previous licence.
4. Whether the licence of the Contractor was suspended or revoked.
5. Number and date of Treasury Challan enclosed.
Place: Signature of the Applicant Date:
_____________________________________________________________________________ (To be filled in the Office of the Licensing Officer) Date of receipt of the application with treasury challan No. and date.
Signature of the Licensing Officer ______ FORM X [See rule 21(1)] Particulars regarding the migrant workmen.
1. Name and address of the contractor.
2. Name and address of the sub-contractor through whom recruitment has been made.
3. Name and address of the establishment.
4. Name and address of the Principal Employer.
5. Name of the State in which the place of work is located.
6. Name of the State in which recruitment was made.
39
(1) (2) (3) (4) (5) (6) (7) (8) (9)
(10) (11) (12) (13) (14) (15) (16) (17) (18) Signature of Contractor or his Date: authorised representative Submitted to
(1) …………………… …………………… (Specified authority in the State in which migrant workman/workmen is/are employed.)
Se ri al n u m b er N am e o f m ig ra n t w o rk m an .
Fa th er ’s /H u sb an d ’s n am e.
Se x.
A ge .
P er m an en t h o m e ad d re ss .
N am e an d a d d re ss o f th e n ex t o f th e ki n o f th e m ig ra n t w o rk m an .
P la ce a n d a d d re ss o f re si d en ce in t h e h o m e St at e.
A m o u n t o f d is p la ce m en t al lo w an ce p ai d .
A m o u n t o f o u tw ar d jo u rn ey al lo w an ce p ai d .
A m o u n t o f w ag es f o r o u tw ar d jo u rn ey p er io d p ai d .
N at u re o f jo b r e q u ir ed t o b e p er fo rm ed .
D at e o f re cr u it m en t.
D at e o f em p lo ym en t.
D et ai ls o f ra te s o f w ag es /a n d o th er a llo w an ce s p ay ab le .
P er io d o f co n tr ac t o f em p lo ym en t.
D et ai ls o f o th er s er vi ce co n d it io n s.
R em ar ks .
40 (Specified authority in the State in which migrant workman/workmen has/have been recruited.)
Copy forwarded to …………………………… (The Principal Employer) Signature of the Contractor or his authorised representative.
Date:
_________________________________________________________________________________ ___ NOTE: In case where migrant workmen concerned have been recruited from more than one State, separate returns shall be submitted in respect of each such State.
_____ FORM XI (See rule 24) Return to be sent by the contractor to the specified authorities
1. Name and address of the Contractor.
2. Name and address of sub-contractor through whom recruitment has been made.
3. Name and address of the establishment.
4. Name and address of the Principal Employer.
5. Name of the State in which the place of work is located.
6. Name of the State in which recruitment was made.
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Se ri al N u m b er N am e o f m ig ra n t w o rk m an .
Fa th er ’s /H u sb an d ’s N am e.
Se x.
D es ig n at io n .
A ge .
P er m an en t h o m e ad d re ss in d ic at in g th e St at e.
P la ce a n d a d d re ss o f re si d en ce in h o m e St at e .
D at e o f em p lo ym en t.
D at e o n w h ic h c ea se d t o b e em p lo ye d 41
(11) (12) (13) (14) (15) (16) (17) (18) (19) (20) Declaration I/We hereby declare that all the wages, other dues including displacement allowance, outward return journeys allowance and wages for journeys periods payable to the migrant workman/workmen named above and employed by me/us have been paid by me/us to him/them.
Place……………….
Date………………..
Signature of the Contractor or his authorised representative.
Submitted to
(1) ………………… ………………… (Specified authority in the State in which migrant workman/workmen is/are employed.)
(2) ……………..
……………..
(Specified authority in the State from which the migrant workman/workmen has/have been recruited.)
To ta l d ay s w o rk e d .
D e ta ils o f ra te s o f w ag e s an d o th e r al lo w an ce s p ai d .
A m o u n t o f d is p la ce m e n t al lo w an ce p ai d .
A m o u n t o f o u tw ar d jo u rn ey al lo w an ce s an d w ag es f o r o u tw ar d jo u rn ey p ai d .
A m o u n t o f re tu rn jo u rn ey al lo w an ce s an d w ag e s fo r re tu rn jo u rn e y p ai d .
To ta l w ag es p ai d .
D e ta ils o f co m p e n sa ti o n a n d o th e r al lo w an ce s.
A m o u n t o f d e d u ct io n s if a n y.
A m o u n t o f ad va n ce if a n y p ai d .
A m o u n t o f ad va n ce , i f a n y re co ve re d .
42 Copy forwarded to ……………………… (The Principal Employer) Signature of the Contractor or his authorised representative.
Date:
NOTE: In case where migrant workmen concerned have been recruited from more than one State, separate returns shall be submitted in respect of each State.
_____ FORM XII (See rule 48) Register of Contractors
1. Name and address of the Principal Employer.
2. Name and address of the establishment.
(1) (2) (3) (4) (5) (6) (7) _______ Se ri al n u m b er .
N am e an d a d d re ss o f co n tr ac to r.
N at u re o f w o rk o n c o n tr ac t.
Lo ca ti o n o f co n tr ac t w o rk .
Fr o m To M ax im u m n u m b er o f m ig ra n t w o rk m en e m p lo ye d b y co n tr ac to r.
Period of contract 43 FORM XIII (See rule 49) Register of workmen employed by Contractor Name and address of Contractor.
Name and address of the establishment.
Name and address of establishment in/under which migrant workmen are employed.
Name and address of Principal Employer.
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) Signature of Contractor or his authorised representative ______ Se ri al n u m b er .
N am e an d s u rn am e o f m ig ra n t w o rk m an .
A ge a n d S ex .
Fa th er ’s /H u sb an d ’s n am e.
N at u re o f em p lo ym en t.
P er m an en t h o m e ad d re ss o f m ig ra n t w o rk m en ( V ill ag e an d Ta h si l, Ta lu k an d D is tr ic t) .
Lo ca l A d d re ss .
D at e o f co m m en ce m en t o f em p lo ym en t.
Si gn at u re o r th u m b - im p re ss io n o f M ig ra n t w o rk m an .
D at e o f te rm in at io n o f em p lo ym en t.
R ea so n s fo r te rm in at io n .
R em ar ks .
44 FORM XIV (See rule 50) Service Certificate Name and address of Contractor.
Name and address of establishment in/under which migrant workmen are employed.
Name and address of Principal Employer.
Nature and location of work.
Name and address of the migrant workman.
Age or date of birth.
Identification Marks.
Father‘s/Husband‘s name.
(1) (2) (3) (4) (5) (6) Signature of Contractor or his authorised representative.
_____ Se ri al n u m b er .
Fr o m To N at u re o f w o rk d o n e.
R at e o f w ag es ( w it h p ar ti cu la rs o f u n it in c as e o f p ie ce -w o rk ).
R em ar ks .
Total period for which employed.
45 FORM XV [See Rule 51(1)] Displacement and outward journey allowances sheet Name and address of the Contractor.
Name and address of the Principal Employer.
Name and address of the establishment.
Month and Year.
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
(12) (13) (14) (15) (16) (17) (18) Se ri al n u m b er .
N am e o f th e m ig ra n t w o rk m an .
Fa th er ’s /H u sb an d ’s n am e.
P er m an en t h o m e ad d re ss in d ic at in g th e St at e.
P la ce a n d a d d re ss o f re si d en ce in t h e h o m e St at e.
D es ig n at io n .
R at e o f w ag es .
W ag es P ay ab le .
P la ce o f re cr u it m en t.
P la ce o f w o rk w it h a d d re ss in d ic at in g th e St at e.
R ai lw ay S ta ti o n /B u s st an d n ea re st t o t h e p la ce o f re si d en ce .
R ai lw ay S ta ti o n /B u s st an d n ea re st t o t h e p la ce o f w o rk .
D at e an d t im e o f co m m en ce m en t o f jo u rn ey fr o m t h e p la ce o f re si d en ce .
Ex p ec te d d at e an d t im e o f ar ri va l a t th e p la ce o f w o rk .
D et ai ls o f m o d es o f jo u rn ey fr o m t h e p la ce o f re si d en ce in th e h o m e St at e to t h e p la ce o f w o rk .
A m o u n ts o f b u s fa re a n d /o r se co n d c la ss t ra in f ar e an d /o r o th er jo u rn ey e xp en se s se p ar at e ly a s p er t h e m o d es o f jo u rn ey s in d ic at ed in c o lu m n (1 5 ).
To ta l o f am o u n ts in d ic at e d in co lu m n N o .( 1 6 ).
A m o u n t o f d is p la ce m en t al lo w an ce .
46
(19) (20) (21) (22) (23) (24) (25) (26) (27) (28) NOTE:- Indicate separately different mode of journeys. Entries are to be made against each individual migrant workman.
Signature of the Contractor or his Date: authorised representative.
_____ FORM XVI [See rule 51(1)] Return journey allowance Register Name and address of the Contractor.
Name and address of the Principal Employer.
Name and address of the establishment.
Month and year.
(1) (2) (3) (4) (5) (6) (7) (8) (9) A m o u n t o f o u tw ar d jo u rn ey al lo w an ce .
W ag es f o r o u tw ar d jo u rn ey p er io d .
To ta l a m o u n t p ai d .
D at e o n w h ic h p ai d .
Si gn at u re o r th u m b - im p re ss io n o f th e m ig ra n t w o rk m an .
A ct u al d at e an d t im e o f ar ri va l at t h e p la ce o f w o rk .
B al an ce w ag es f o r o u tw ar d jo u rn ey if a n y p ay ab le .
D at e o f p ay m en t o f th e b al an ce w ag es in d ic at ed in co lu m n ( 2 5 ).
Si gn at u re o r th u m b - im p re ss io n o f th e m ig ra n t w o rk m an .
R em ar ks .
Se ri al n u m b er .
N am e o f th e m ig ra n t w o rk m an .
Fa th er ’s /H u sb an d ’s n am e.
P er m an en t h o m e ad d re ss in d ic at in g th e St at e.
P la ce a n d a d d re ss o f re si d en ce in t h e h o m e St at e.
D es ig n at io n .
R at e o f w ag es .
P la ce o f w o rk .
R ai lw ay S ta ti o n /B u s st an d n ea re st t o t h e p la ce o f w o rk .
47
(10) (11) (12) (13) (14)
(15) (16) (17) (18) (19) (20) (21) *Indicate separately different modes of journey.
NOTE.-- Entries are to be made against each individual inter State migrant workman.
Signature of the Contractor or his authorised representative.
Date:
_______ R ai lw ay S ta ti o n /B u s st an d n ea re st t o t h e p la ce o f re si d en ce in t h e h o m e St at e.
D at e an d t im e o f co m m en ce m en t o f jo u rn ey fr o m t h e p la ce o f th e w o rk .
Ex p ec te d d at e an d t im e o f ar ri va l a t th e re si d en ce in h o m e St at e.
Ex p ec te d m o d es o f jo u rn ey s fr o m t h e p la ce o f w o rk t o p la ce o f re si d en ce in t h e h o m e St at e.
A m o u n ts o f b u s fa re a n d /o r se co n d c la ss t ra in f ar e an d /o r o th er jo u rn ey e xp en se s, se p ar at e ly a s p er e xp ec te d m o d es o f jo u rn ey s in d ic at ed in co lu m n N o . ( 1 3 ) To ta l a m o u n ts in d ic at e d in co lu m n N o . ( 1 4 ).
A m o u n t o f re tu rn jo u rn ey al lo w an ce .
W ag es f o r re tu rn jo u rn e y p er io d .
To ta l a m o u n t p ai d .
D at e o n w h ic h p ai d .
Si gn at u re o r th u m b - im p re ss io n o f th e m ig ra n t w o rk m an .
R em ar ks .
48 FORM XVII [See rule 52(2) (a)] Muster Roll Register Name and address of Contractor.
Nature and location of work.
Name and address of the establishment in/under which migrant workmen are employed.
Name and address of Principal Employer.
For the month of……………….
Serial number.
Name of migrant workman.
Father‘s/Husband‘s name.
Sex. Dates 1 2 3 4 5 Remarks _____ FORM XVIII [See rule 52(2) (a)] Register of Wages Name and address of Contractor.
Nature and location of work.
Name and address of the establishment in/under which inter-State migrant workmen are employed.
Name and address of Principal Employer.
Wage period.
49
(1) (2) (3) (4) (5) (6) (7)
(8) (9) (10) (11) (12) (13) (14) (15) (16) _______ Se ri al n u m b er .
N am e o f In te r- St at e m ig ra n t w o rk m an .
Se ri al n u m b er in t h e re gi st er o f w o rk m en .
D es ig n at io n /n at u re o f w o rk .
N u m b er o f d ay s w o rk ed .
u n it s o f w o rk d o n e.
D ai ly r at e o f w ag es /p ie ce -r at e .
B as ic w ag es .
D ea rn es s al lo w an ce .
O ve rt im e.
O th er c as h p ay m en ts ( n at u re o f p ay m en t to b e in d ic at e d ).
To ta l.
D ed u ct io n s, if a n y (i n d ic at e n at u re ).
N et a m o u n t p ai d .
Si gn at u re /T h u m b -i m p re ss io n o f In te r- St at e m ig ra n t w o rk m an .
In it ia ls o f C o n tr ac to r o r h is au th o ri se d r ep re se n ta ti ve .
Amount of wages earned 50 FORM XIX [See rule 52 (2) (c)] Register of deductions for damage or loss Name and address of Contractor.
Name and address of establishment in/under which migrant workmen are employed.
Name and address of Principal Employer.
(1) (2) (3) (4) (5) (6) (7)
(8) (9) (10) (11) (12) (13) ______ S e ri a l n u m b e r.
N a m e o f In te r- S ta te m ig ra n t w o rk m a n .
F a th e r‘ s /H u s b a n d ‘s n a m e .
D e s ig n a ti o n /n a tu re o f e m p lo y m e n t.
P a rt ic u la rs o f d a m a g e o r lo s s .
D a te o f d a m a g e o r lo s s .
W h e th e r In te r- S ta te m ig ra n t w o rk m a n s h o w e d c a u s e a g a in s t d e d u c ti o n .
N am e o f p er so n in w h o se p re se n ce e m p ly ee ’s e xp la n at io n w as h ea rd .
A m o u n t o f d ed u ct io n im p o se d .
N u m b er o f in st al lm en ts .
Fi rs t in st al lm en t.
La st in st al lm en t.
R em ar ks .
Date of recovery 51 FORM XX [See rule 52 (2) (c)] Register of Fines Name and address of Contractor.
Name and address of establishment in/under which Inter-State migrant workmen are employed.
Nature and location of work.
Name and address of Principal employer.
(1) (2) (3) (4) (5) (6)
(7) (8) (9) (10) (11) (12) _________ S e ri a l n u m b e r.
N a m e o f In te r- S ta te m ig ra n t w o rk m a n .
F a th e r‘ s /H u s b a n d ‘s n a m e .
D e s ig n a ti o n /n a tu re o f e m p lo y m e n t.
A c t/ O m is s io n f o r w h ic h f in e im p o s e d .
D a te o f o ff e n c e .
W h e th e r In te r- S ta te m ig ra n t w o rk m a n h a s s h o w n c a u s e a g a in s t fi n e .
N a m e o f p e rs o n i n w h o s e p re s e n c e e m p lo y e e ‘s e x p la n a ti o n w a s h e a rd .
W a g e p e ri o d s a n d w a g e p a y a b le .
A m o u n t o f fi n e i m p o s e d .
D a te o n w h ic h f in e r e a li z e d .