Govt. of India, Ministry of Labour & Employment

FORMS UNDER ER ACT, 1976

 

FORM – A

(To be submitted in triplicate)

[See Rule 3(1)]

 

Complaint under clause (a) of sub-section (1) of section 7 of the Equal Remuneration Act, 1976 (25 to 1976)

 

To,

 

The Authority appointed under sub-section (1) of section7.

………………………………………………………………………………. (Address)

 

A ………………………………………………………………………Complainant(s)

………………………………………………………………………… Full address

 

Versus

 

B………………………………………………………………………Opposite Party

…………………………………………………………………………..Full address

 

 

The complainant(s) begs/beg to complain that the opposite party has been guilty of contravention(s) of the provisions of the Equal Remuneration Act, 1976 (25 of 1976) as shown below:

 

[Here set out briefly the particulars showing the manner in which the alleged contravention(s) has / have taken place and the grounds supporting the complaint.]

 

The complainant(s) accordingly prays / pray that the Authority …………………. May be pleased to decide the complaint set out above and pass such order or orders thereon as it may deem fit and proper.

 

The number of copies of the complaint (along with its annexures) as required under sub-rule (1) of rule 3 of the Equal Remuneration Act, 1976 are submitted here with.

 

The complainant(s) does / do solemnly declare that the facts stated in this complaint are true to the best of his / her / their knowledge, belief and information.

 

 

Signature(s) / thumb impression(s) of

the complainant(s)

 

* I have been duly authorized in writing by …………………………………. [here insert the name of worker(s)], to appear and act on his/her/their behalf.

 

 

Signature of the legal practitioner/official

of a registered trade union

duly authorized

 

Station:

Date:

 

*Strike out this portion if inapplicable.

 

 

 

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FORM – B

(To be submitted in triplicate)

[See Rule 4(1)]

 

Claim under clause (b) of sub-section (1) of section 7 of the Equal Remuneration Act, 1976 (25 to 1976)

 

To,

 

The Authority appointed under sub-section (1) of section7.

………………………………………………………………………………. (Address)

 

A ………………………………………………………………………Petitioner(s)

………………………………………………………………………… Full address

 

Versus

 

B………………………………………………………………………Opposite Party

…………………………………………………………………………..Full address

 

The petitioner(s) above named states/state as follow:

 

(1)       The petitioner(s) was/were/is/are employed from ……………. to …………….. as ………………………. (category) in ………………………………. (name of the establishment) of Shri/Messrs……………………………… (name of the employer and address).

 

(2)       The opposite party is the employer within the meaning of clause (c) of section 2 of the Equal Remuneration Act, 1976 (25 of 1976)

 

(3)       The petitioner(s) was/were/has/have not been paid wages at rates equal to those of workers of the opposite sex for the same work or work of a similar nature for the period from ………………….. to …………………

 

(4)       The petitioner(s) was/were/has/have been paid wages at the rate of ………… whereas workers of the opposite sex for the same work or work of a similar nature were paid / have been paid at the rate of …………………… during the said period.

 

(5)       The petitioner(s) estimates/estimate the value of relief sought by him/them at Rs……………………. (Rupees ………………………. (in words)]

 

(6) The petitioner(s), therefore, prays/pray that the Authority may be pleased to decide the claim set out above and pass such order or orders thereon as it may deem fit and proper.

 

(7)       The petitioner(s) begs/beg leave to amend or add or make alterations in the petition, if and when necessary, with the permission of the Authority.

 

The petitioner(s) does/do solemnly declare that the facts stated in this petition are true to the best of his/her/their knowledge, belief and information.

 

Signature(s) / thumb impression(s) of

the petitioner(s)

 

* I have been duly authorized in writing by …………………………………. [here insert the name of worker(s)], to appear and act on his/her/their behalf.

 

Signature of the legal practitioner/official of a

registered trade union duly authorized.

Station:

Date :

 

*Strike out  this portion if inapplicable.

 

 

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FORM  – C

[ See Rule 5 ]

 

 

Form of authority in favour  of legal practitioner or any official of a registered trade union.

 

I/We hereby authorize Shri/Shrimati/Kumari*…………………………………. a legal practitioner / an official of …………………………….. which is a registered trade union to appear and act on my/our behalf, under *sub-rule (3) of rule 3/sub-rule (3) of rule 4 in respect of the  *complainant/claim against ……………………………. (mention name of employer) on account of …………………………… (mention violation of the Act)

 

 

Signature(s) / thumb impression(s) of

worker(s)

 

Station:

Date :

 

Witness:

 

(1)

 

(2)

 

(3)

 

 

 

I accept the Authorization.

*Legal practitioner

official of a registered trade union

Station:

Date:

 

*Strike out  this portion if inapplicable.

 

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FORM  – D

[ See Rule 6 ]

 

Register to be maintained by the employer under Rule 6 of the Equal Remuneration Rules, 1976

 

            Name of the Establishment with full address……………………………………………

 

            Total number of workers employed……………………………………………………..

 

            Total number of men workers employed ……………………………………………….

 

            Total number of women workers employed ……………………………………………

 

Category of workers

Brief Description of  work

No. of men employed

No. of women employed

Rate of remuneration paid

1

2

3

4

5

 

 

 

 

 

 

 

 

 

 

 

 

 

Components of remuneration

Basic wage or salary

Dearness allowance

House Rent allowance

Other allowances

Cash value of concessional / supply of essential commodities.

6

7

8

9

10