Sl. No.
Name and address of contractor
Nature of work on contract
Location of contract work
Period of contract
Maximum No. of workmen employed by contractor
From
To
1
2
3
4
5
6
7
Place...................
Date....................
Signature of the Licensing Officer
The Contract Labour (Regulation and Abolition) Central Rules, 1971
FORM XIII
[See rule 75]
Register Of Workmen Employed By Contractor
Name and address of Contractor.......................
Name and address of Establishment in/under which contract is carried on .......................
Name and location of work...............................
Name and address of principal employer ................................
Sl. No.
Name and surname of workman
Age and Sex
Father's
/ Husband's name
Designation
/ Nature of employment
Permanent home address of workman (Village and Tehsil / Taluk and Distt.)
Local address
Date of commencement of employment
Signature
/ Thumb-impression of workman
Date of termination of employment
Reasons for termination
Remarks
1
2
3
4
5
6
7
8
9
10
11
12
FORM XIV
(See rule 77)
Employment Card
Name and address of Contractor..........................
Name and address of Establishment in/under which contract is carried on...........................................
Nature of work and location of work...............
Name and address of Principal Employer ........................................
1. Name of the workman
...............................................
2. S.No. in the register of workmen employed
...............................................
3. Nature of employment/Designation
...............................................
4. Wage rate (with particulars of unit in case of piece work)
...............................................
5. Wage period
...............................................
6. Tenure of employment
...............................................
7. Remarks
...............................................
Signature of Contractor
FORM XV
(See rule 77)
Service Certificate
Name and address of Contractor............
Name and address of establishment in/under which contract is carried on................
Nature and location of work...................
Name and address of the workman
Name and address of Principal Employer .................................
Age or Date of Birth ...........................
Identification Marks ............................
Father's/Husband's name ....................
Sl. No.
Total period for which employed
Nature of work done
Rate of wages (with particulars of unit in case of piece work)
Remarks
From
To
1
2
3
4
5
6
Signature..............
FORM XVI
[See rule 78(l)(a)(i)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978).]
Muster Roll
Name and address of Contractor............
Name and address of establishment in/under which contract is carried on................
Nature and location of work...................
Name and address of Principal Employer .................................
For the month of................................................................
Sl. No.
Name of workman
Father's/Husband's name
Sex
Dates
Remarks
12345
1
2
3
4
5
6
FORM XVII
[See rule 78(1)(a)(i)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978.]
Register Ofwages
Name and address of Contractor ....................
Name and address of Establishment in/under which contract is carried on.............
Nature and location of work ............................
Name and address of Principal Employer.............................................................
Wage-period: Monthly..................................................................
Sl.
No.
Name of work-man
Sl.
No. in the register of work-menn
Designation
/ Nature of work done
No.
of days worked
Units of work done
Daily rate of wages / piece rate
Amount of wages earned
Deductions, if any, (indicate nature
Net amount paid
Signature
/ Thumb-impression of work-man
Initials of contractor or his representative
Basic wages
Dear-ness Allow-ance
Over-time
Other cash payments (Nature of payment to be in-dicated)
Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
FORM XVIII
[See rule 78(1)(a)(i)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978.]
Form Ofregister Ofwages-Cum-Muster Roll
Name and address of Contractor ....................
Name and address of Establishment in/under which contract is carried on..............
Nature and location of work ............................
Name and address of Principal Employer.............................................................
Wage-period: Weekly/Fortnightly..................................................................
From....................................... To...........................................................
Sl.
No.
Sl.
No. in Re-gister of workmen
Name of employee
Designation
/ Nature of work
Daily atten-dance/ units worked
Total atten-dances/ units of work odne
Daily rate of wages / piece rate
Amount of wages earned
Deductions, if any, (indicate nature)
Net amount paid
Signature
/ Thumb-impression of work-man
Initials of contractor or his representative
Basic wages
Dear-ness Allow-ance
Over-time
Other cash payments (Nature of payment to be in-dicated)
Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
FORM XIX
[See rule 78(1)(b)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978).]
Wage Slip
Name and address of Contractor................
Name and Father's/Husband's name of the workman.............
Name and location of work .......................
For the Week/Fortnight/Month ending..........................
1. No. of days worked
............................................
2. No. of units worked in case of piece rate workers
...........................................
3. Rate of daily wages/piece rate
............................................
4. Amount of overtime wages
............................................
5. Gross wages payable
............................................
6. Deductions, if any
............................................
7. Net amount of wages paid
............................................
Initials of the Contractor or his representative
FORM XX
[See rule 78(1)(a)(ii)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978).]
Register Of Deductions For Damage Or Loss
Name and address of Contractor...................
Name and address of Establishment in/under which contract is carriedon
...............
Nature and location of work..........................
Name and address of Principal Employer.................................
Sl.
No.
Name of workman
Father's
/ Husband's name
Designation
/ Nature of employment
Particulars of damage or loss
Date of damage or loss
Whether workman showed cause against deduction
Name of person in whose presence employee's explanation was heard
Amount of deduction imposed
No.
of instalments
Date of recovery
Remarks
First instal-ment
Last instal-ment
1
2
3
4
5
6
7
8
9
10
11
12
13
FORM XXI
[See rule 78(1)(a)(ii)] [Substituted by G.S.R. 948, dated 12th July, 1978 (w.e.f. 22-7-1978).]
Register Of Fines
Name and address of Contractor.......................
Name and address of Establishment in / under which contract is carried on .......................
Name and location of work...............................
Name and address of principal employer ................................
Sl. No.
Name of workman
Father's
/ Husband's name
Designation
/ Nature of employment
Act/Omission for which fine imposed
Date of offence
Whether work-man showed cause against fine
Name of person in whose presence employee's explanation was heard
Wage periods and wages payable
Amount of fine imposed
Date on which fine realized
Remarks
1
2
3
4
5
6
7
8
9
10
11
12
FORM XXII
[See rule 78(1)(a)(ii)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978).]
Register Of Advances
Sl. No.
Name
Father's/Husband's name
Designation/Nature of employment
Wage period and wages payable
Date and amount of advance given
Purpose(s) for which advance made
No. of instalments by which advance to be re-paid
Date and amount of each instalment re-paid
Date on which last instalment was re-paid
Remarks
1
2
3
4
5
6
7
8
9
10
11
FORM XXIII
[See rule 78(1)(a)(iii)] [Substituted by G.S.R. 948, dated 12-7-1978 (w.e.f. 22-7-1978).]
Register Of Overtime
Name and address of Contractor.......................
Name and address of Establishment in/under which contract is carried on .......................
Name and location of work...............................
Name and address of principal employer ................................
Sl. No.
Name of workman
Father's
/ Husband's name
Sex
Designation
/ Nature of employment
Dates on which over-time worked
Total overtime worked or pro-duction in case of piece-rated
Normal rates of wages
Overtime rate of wages
Overtime earnings
Date on which overtime wages paid
Remarks
1
2
3
4
5
6
7
8
9
10
11
12
FORM XXIV
[See rule 82(1)]
Return To Be Sent By The Contractor To The Licensing Officer
Half year ending ...........................