Every notice or order under the Act or the rules made thereunder, addressed to any employer or Beedi or cigar worker shall be presumed to have been duly served if such notice has been sent by registered post.
FORM NO. 1 (See Rules 3 and 4) Application for grant or renewal of license for the financial year
1. Full name of the industrial premises.
2. (i) Full postal address and situation of the industrial premises.
(ii) Full address to which communications relating to the industrial premises should be sent.
(iii) Full address of the applicant.
3. Maximum number of employees proposed to be employed on any one day during the financial year.
4. Full name and residential address of the person who shall be the employer for the purposes of the Act.
5. If the employer is a partnership, company, etc., full name and residential address of other partners or directors, etc. (See note 1 at the end).
सबहार गजट (अिाधारण), २६ जिवरी १९६९ ५१
6. Financial resources of the employer (e.g., particulars and value of movable and immovable properties, bank reference, income-tax, assessment, etc.)
7. Whether the employer us trade mark holder registered under the Trade and Merchandise Marks Act, 1958.
8. Values of Beedis or Cigars or both manufactured at the industrial premises during the preceding financial year.
9. Previous experience of the applicant* in the industry.
10. Whether the proposed site of the industrial premises amounts to the alteration of the site of any existing industrial premises and, if so, the reasons for such alteration.
11. Whether any industrial premises was closed by the applicant during the period of twelve months immediately preceding the date of the application and, if so, the reasons therefor.
12. Sources for obtaining tobacco…………….
13. Whether the Beedis or Cigars or both manufactured by the applicant* will be sold and marketed by himself or through a proprietor or a registered user of a trade mark registered under the Trade and the Merchandise Act, 1958 or any other person*.
14. Whether the plans of the premises are enclosed.
15. Amount of fee Rs. (Rupees ) paid in Treasury vide Chalan No. on enclosed.
५२ सबहार गजट (अिाधारण), २६ जिवरी १९६९ I hereby declare that the particulars furnished by me in the form are to be the best of my knowledge and belief accurate.
Date Signature of applicant* NOTE 1. – Where any industrial premises is run or proposed to be run by a contractor for or on behalf of another person or persons or company, etc., the said other person or persons or company, etc. , is under the Act the employer and particulars to be entered for “employer” in the Form should be in regard to such person, persons or company, etc.
*The applicant for the license may however be made either the contractor or the employer.
NOTE 2. – (1) This form shall be completed in ink in block letters or typed.
(2) If any person named against item 5 is a minor, the fact shall be stated clearly.
FORM NO. II (See RULE 5) License License no. Fee Rs.
Registration no.
License is hereby granted to………………………………………………….valid only for the premises describe below for use as an industrial premises employing not more than…………………………….employees on any one day during the year………………….subject to the conditions specified in Annexure.
The license shall remain in force till the 31st day of March Name of the industrial premises Situation of the industrial premises Permission is also granted for the installation of power-driven machinery Signature and seal of the competent authority (See RULE 4) Date of renewal Fees paid for renewal Date of expiry
1.
2.
3.
4.
Date Signature and seal of the competent authority सबहार गजट (अिाधारण), २६ जिवरी १९६९ ५३.
ANNEXURE This license is subject to the following conditions: -
(1) The manufacturing process shall be carried on only in that part of the industrial premises specified for the purpose in the license.
(2) The maximum number of employees employed in the industrial premises shall not on any day exceed the number specified in the license.
(3) Power-driven machinery not specified in the license shall not be used in the manufacturing process in the premises.
(4) Except with the prior permission in writing of the competent authority, the industrial premises shall not be extended and except with the like permission, no structural alterations shall be made in any building on such premises.
(5) The license shall not be transferable.
FORM NO. III [See RULES 10(2), 14 (3), 21 (6) (b)] Record of white-washing, colour-washing, varnishing and painting and cleaning Part of the industrial premises (e.g.
name of room) Parts whitewashed, colourwashed, painted or varnished (e.g. walls, ceilings, wood work, etc.
Treatment whether whitewashed, colour washed, painted or varnished or cleaned.
Date on which white-washing, colour-washing, painting or varnishing or cleaning was carried out according to the English Calendar Date Month Year Remarks Signature of Employer 1 2 3 4 5 6 ५४ सबहार गजट (अिाधारण), २६ जिवरी १९६९ .
FORM NO. IV [See RULE 22 (1)] Figures 1, 2, 3 relate to 1st, 2nd and 3rd shifts or relays.
Name of the industrial premises Place................... District.........
Period of work Men Women and young person Description of groups.
Remarks Total number of employee.
Total number of women and young persons employed.
Group Nature of letter work.
1 2 3 A B C D E F Working days 1 2 3 1 2 3 1 2 3 1 2 1 2 1 2 A From B To C From D To E Partial working day F From To From To Weekly Holiday Date on which this notice comes into force……………………..
Employer सबहार गजट (अिाधारण), २६ जिवरी १९६९ ५५.
FORM NO. V [See RULE 22(2)] Register showing hours of work including overtime Week ending……………………………….
Name of the employee Whether young person or not Total hours worked during the week Date on which overtime work is done and extent of such overtime on such occasion Extent of overtime worked during the week ५६. सबहार गजट (अिाधारण), २६ जिवरी १९६९ FORM NO. VI [See RULES 24 (1) and 25 (1)] REGISTER OF LEAVE WITH WAGES (REGULAR EMPLOYEES LEAVE BOOK) Separate page shall be allotted to each employee – Name of the establishment Serial no. Adult/young person Date of entry Name into service Father’s name Date of joining the establishment Date of discharge Date of amount of payment made in lieu of leave due.
1. Calendar year of service ……………….
2. Wage period from to………………
3. Number of days of work performed during the calendar year.
4. Balance of leave from the preceding year.
5. Leave earned during the year mentioned in column
(1) …………………
6. Total of columns (4) and (5) …………………
7. Leave enjoyed from to
8. Balance of leave to credit …………………
9. Normal rate of wages, i.e. daily average of full time earnings in cash.
10. Cash equivalent of advantage accruing through concessional sale of food grains etc.
11. Rate of wages for the leave period [total of columns (9) and (10)].
12. Date and amount paid …………………
13. Remarks ………………… सबहार गजट (अिाधारण), २६ जिवरी १९६९ ५७.
FORM NO. VII [See RULES 24(2) and 25(1)] REGISTER OF LEAVE WITH WAGES (HOME WORKERS) LEAVE BOOK
1. Name of establishment ….
2. Serial no. ….
3. Name of employee and age ….
4. Father’s/husband’s name ….
5. Date of entry into service ….
6. Date of discharge ….
7. Amount paid in lieu of leave ….
8. Calendar year of service ….
9. No. of days worked during the year ….
10. Balance of leave from preceding year...
11. Leave earned during the year mentioned in column 8. ….
12. Total of columns 10 and 11 ….
13. Leave enjoyed from to
14. Balance of leave to credit ….
15. Normal rate of wages, i.e. daily average of full-time earning in cash ….
16. Cash equivalent of advantage accruing through concessional sale of food grains etc. if any,
17. Rate of wages for the leave period total of columns 15 and 16.
18. Date and amount paid ….
19. Remarks ….
५८. सबहार गजट (अिाधारण), २६ जिवरी १९६९ FORM NO. VIII [See RULE 26(3) (a)] NOTICE TO THE EMPLOYER UNDER CLAUSE (b) OF SUB-SECTION (2) OF SECTION 31 Shri…………………………………………………………………………………..has appealed to the Appellate Authority under clause
(a) of sub-section (2) of section 31 of the beedi and Cigar workers (Conditions of employment) Act, 1960, against the orders of his discharge/dismissal/retrenchment. A copy of his appeal petition is enclosed.
The appeal has been posted for hearing on the…………..day of………..196…………..at………………….A.M/P.M at……………………….You should appear before the Appellate authority on that day and answer the claims. You must be prepared to produce on that day all the witnesses upon whose evidence and all the documents upon which you intend to rely in support of your defence. In default on your appearance on that day the matter will be heard and determined in your absence.
Appellate Authority FORM NO. IX [See RULE 26(3) (b)] NOTICE TO THE EMPLOYER UNDER CLAUSE (b) OF SUB-SECTION (2) OF SECTION 31 Your appeal has been posted for hearing on the………………..day of………………..196…………….at…………. A.M/ P.M….
You should appear before the Appellate Authority on that day to prove the claim. You must be prepared to produce on that day all the witnesses on whose evidence and all documents upon which you intend to rely in support of your case. In default of your appearance on that day, the matter will be heard and determined in your absence.
Applicant Authority सबहार गजट (अिाधारण), २६ जिवरी १९६९ ५९.
FORM NO. X [See RULE 27(1)] RECORD OF DECISION OR ORDER
1. Serial No. ….
2. Date of application ….
3. Name or names, percentage, address or addresses of applicants or some or all of the applicants. ….
4. Name and address of the employer ….
5. Substance of the dispute ….
6. Plea of parties and their examination, if any. ….
7. Documents seen ….
8. Substance of the evidence taken ….
9. Finding and brief statement of the reasons therefor ….
10. Decision ….
Date Signed FORM NO. XI (See RULE 32) MONTHLY RETURN
1. Name of the industrial premises and full postal address…
2. No. and date of license ……
3. Month to which the return relates ……
4. Name of the employer …… ६०. सबहार गजट (अिाधारण), २६ जिवरी १९६९
5. Name of the Principal Employer if the Employer is working as contractor for Principal Employer.
6. Quantity of Beedi and/or cigar tobacco released by the Central Excise Department.
7. Quantity of Beedi and/or cigar tobacco supplied by the Principal Employer.
8. Number of Beedi and/or cigar manufactured by the employer in industrial establishment.
9. No. of Beedi and/or cigar manufactured by the employer in places other than industrial establishment.
10. Number of Beedi and/or cigar sold and to whom.
Date Signature of the employer FORM NO. XII (See RULE 32)
1. Name and address of the industrial premises.
2. No. and date of license .....
3. Name of the employer. .....
4. Name of the Principal Employer if the employer is working as contractor for a Principal Employer.
सबहार गजट (अिाधारण), २६ जिवरी १९६९ ६१.
5. *Average number of employees employed daily in the industrial premises: - Men Women Young persons Male Female
6. Average monthly no. of home workers employed (i.e., who work in their homes).
7. Normal hours worked per week in the industrial premises.
8. Number of days worked in the year in the industrial premises.
9. Number of employees who were granted leave during the calendar year.
Young persons–
(a) employed in the industrial premises.
(b) employed in homes.
Other than young persons –
(a) employed in the industrial premises.
(b) employed in homes.
10. No. of female employees who were given maturity benefit during the year –
(a) employed in the industrial premises.
(b) employed in homes.
Certified that the information furnished above is to the best of my knowledge and belief correct.
Signature of the employer Date ६२. सबहार गजट (अिाधारण), २६ जिवरी १९६९ NOTE. – Partial attendance for less than half a shift of working day shall be neglected and attendance for half a shift or more shall be treated as full attendance.
*The average daily number shall be calculated by dividing the aggregate number of attendance of working days by the number of the working days in the year. Attendance on separate shift, e.g., night and day shifts shall be counted separately.
The average shall be calculated by dividing the aggregate number of workers on the Home-Workers Employment Register during each of the preceding 12 months by twelve.
FORM NO. XIII [See RULE 33 (1)] MUSTER ROLL OF EMPLOYEES Name and address of the industrial premises Date..........................................
Serial no. Name. Designation. Group. Relay. Shift number.
Period of work.
Remarks.
1 2 3 4 5 6 7 8 सबहार गजट (अिाधारण), २६ जिवरी १९६९ ६३.
FORM NO. XIV [See RULE 33 (2)] HOME WORKERS LOG BOOK
1. Name of the home worker .....
2. Address of the home where manufacturing process is carried on.
3. Month .....
Account of work done at home Date. Whether work was done. No. of Beedi/cigars manufactured.
Wages received.
4. Total number of days worked in the month. Date and signature or thumb impression of the home-worker.