SECOND SCHEDULE
[See Sec. 2 (c)]
FORM A
[See Sec. 4 (1) proviso (a)]
Core Return
Return for the year ending 31st December
(To be furnished on or before the 15th February of the succeeding year by small establishments and very small establishments)
1.
(a) Name and postal address of the establishment.
(b) Name and residential address to the employer.
(c) Name and residential address of the Manager or person responsible for supervision and control of the establishment.
(d) Name of the principal employer In the case of a contractor’s establishment.
(e) Date of commencement of the establishment.
Nature of Operation/Industry/Work carried on
2.
(a) Number of days worked during the year.
(b) Number of man-days worked during the year.
(c) Daily hours of work.
(d) Day of weekly holiday.
3.
(a) Average number of persons employed during the year.
(i) Males.
(ii) Females.
(iii) Adolescents (those who have completed 14 years but have not completed 18 years of age).
(iv) Children (those who have not completed 14 years of age).
(b) Maximum number of workers employed on any day during the year.
(c) Number of workers discharged, dismissed, retrenched or whose services were terminated during the year.
4. Rates of wages – category-wise.
(1) Males
(2) Females
(3) Adolescents
(4) Children.
5. Gross wages paid
(a) In cash.
(b) In kind.
6. Deductions
(a) Fines.
(b) Deductions for damage or loss.
(c) Other deductions.
7. Number of workers who were granted leave with wages during the year.
8. Nature of welfare amenities provided: Statutory (specify the Statute).
9. Does the establishment carry out any hazardous process or dangerous operation coming within the meaning of the Factories Act, 1948, if so, give particulars.
10. Number of accidents
(a) Fatal.
(b) Non-fatal.
11. Nature of safety measures provided as required under the Factories Act, 1948.
Signature of the employer with full name in capitals.
Date……………
Place…………..
FORM B
[See Sec. 4(l) proviso (b) (i)]
Register of wages required to be maintained by small establishments
(To be maintained within seven days of the expiry of the wage period)
Name of establishment…………… Name and address of employee……………
Address (Local)…………………. Name of work…………………………….
(Permanent)……………………… Wage
period………………………………
Wages earned
| Sl Nr | Name of the employee | Sex | Desig nation |
Classification Whether permanent/temporary/ Casual/part-time or worked | Father’s or husband name | Total Days/ no. of unit | Basic allowance |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Wage Statutory Minimum rate | Dearness | Over-time Actual | Bonus Gratuity Or ex-gratia | Maternity benefits | Any other allowance | Total amount | Advance |
| 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 |
| Fine due to damage or loss by neglect or default | Provident fund | Employees state Insurance | Other deductions indicating the nature | Total dedu ctions |
Net amount payable | Sign or thumb impression of employee with date | Sign of Insp ector with date |
||
| Employees contribution | Employees contribution | ||||||||
| 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 |
NOTES:
1. In case of deduction of any advance taken by an employee, the employer shall also indicate therein the number of instalments paid/total instalments paid/total instalments by which advance is to be repaid such as “5/20,6/20”, etc. The purpose of advance shall also be mentioned in the Remarks column.
2. In case of imposition of fines or deduction for damage or loss, the specific act or omission for which the penalty has been imposed has to be indicated in the Remarks column. A certificate shall also be recorded in the said column to the effect that an opportunity to show cause was given to the employee concerned before imposition of fine or deduction.
Signature of the employer with full name in capitals.
Date……………….
Place………………
FORM C
[See Sec. 4(l) proviso (b) (i)]
Muster Roll to be maintained by small establishments
Name of establishment ……………………….. Name and address of the employer
Address (Local)……………………………….…………………………………
(Permanent)…………………………………..Wageperiod……………………
| Serial Number | Name of the employee | Date of employment | Permanent address | Age or date of birth | Father’s husband’s name | For the period ending… Number of units of work done during |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Total attendance | Total overtime worked | Total production in case of piecerated workers | Compensatory rest | Signature of with date | Remarks | |
| Brought Inspector forward from previous wage period | Given during the wage period | |||||
| 8 | 9 | 10 | 11 | 12 | 13 | 14 |
NOTES:
1. In the case of daily-rated workers, the extent of overtime done on each occasion has to be reflected against each concerned date, such as, “P/I” meaning “Present with one hour’s overtime”, “P/1-2” meaning “Present with one and a half hour’s overtime”, and so on.
2. The number of units of work done by a piece-rated worker has to be noted for each day in the Register. In case of employment of any child/adolescent, the employer shall indicate the hours worked each day with intervals of rest.
3. The Compensatory Test availed by the worker has to be marked in the Register in red ink as “CR”.
4. Column 7 to be filled up on each working day and the remaining columns to be completed within seven days of the expiry of the wage period.
Signature of the employer with full name in capitals.
Date……………..
Place………………
FORM D
[See Sec. 4(l) proviso (b) (i)]
Monthly register showing welfare amenities to be maintained by small establishments
Name and address of the Address of the establishment: For the month of … Employer ……………… Local/Permanent
| Serial Number | Name of the employee | Sex | Desig nation |
Weekly day of rest | Dates of holidays for festival or similar other occasions | No. of casual leave availed by the employee | Quantum of annual leave with wages | |
| Due | Availed | |||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
| Whether Welfare Amenities provided for | Whether Scheduled Caste/Scheduled Tribe, Handicapped or any other particular category | Signature of the employer or his agent | Remarks of the Inspecting Officer | Signature of Inspector with date | ||
| Rest room | Drinking water | First aid | ||||
| 10 | 11 | 12 | 13 | 14 | 15 | 16 |
NOTE :
To be completed within seven days of the expiry of each calendar month.
Signature of the employer with full name in capitals.
Date…………………
Place………………..
FORM E
[See Sec. 4(l) proviso (b) (ii)]
Monthly register of muster roll-cum-wages required to be maintained by very small establishments
Year……………
Month or………
Wage period…….
(Where different……
Name of establishment…………………….
Name of employee………………………. Father’ name………..
Nature of work………………………….. Rate of wages……..
Wage period………………………….. Date of employment…..
| Date | Hours of work | Interval for Rest and Meal | Hours worked with the employer | Overtime | Casual or sicknees leave availed during the month/ wage period | |||
| From | To | From | To | Hours worked | Wages earned | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
| Privilege leave | Signature of them employer | Remarks of the employer | Remuneration | |||||
| Leave due | Leave availed | Balance | Basic salary or wage | Overtime allowances, if any | Other | Total | ||
| 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 |
| Deductions | Net Amount of payment | Date of pay ment |
Sign or thumb impression of the employee | Sign of Inspector with remarks, if any, and date. | ||||
| Fines and deductions on account of damage or loss by neglect or default | Other dedu ctions |
Advance paid if any | ||||||
| Date | Amount | Total | ||||||
| 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 |
NOTE :
Columns 1 to 12 be filled up on each working day and the remaining columns to be completed within seven days of the expiry of the wage period.
Date……………………
Place…………………..
Signature of the employer with full name in capitals.
