FORMS UNDER PW(ATS) Rules, 1968

 

 

Form I

(See Rule 3)

Notice of opening, abandonment, discontinuance, resumption, and change in the ownership, addresses etc.

From

      

2.       -------------------------------

3.       ---------------------------------

4.       ----------------------------------

5.       To,

       The Regional Labour Commissioner (C)

       ---------------------------------

       Sir,

       I have to furnish the following particulars in respect of *_______________ at ______________ establishment of ________________ (Owner)

1. In the case of change of name of establishment-

Old name of establishment

Date of change

2(a) Situation of the establishment: Village

Police Station                  Sub Division (Taluka)

District                             State

(b) In the case of new establishment, particulars of situation of establishment :

Post Office                     Telegraph office

Railway station                Rest House

Post Office Telegraph office Railway station Rest House (Give distance therefrom) Means of traveling

5.       3 (a) Name and postal address of Present/ previous#

(i) Owner

(ii) Managing Agent, if any

(iii) Agent, if any

(iv) Manager

(v) In case of change, date of change

4. Date on which it is intended to open/ resume/ abandon/ discontinue # the establishment

5. Actual date of opening / reopening/ abandonment/ discontinuance #of the establishment

6. No. of persons likely to be affected

      

Yours faithfully

Signature

Designation:

Owner/Agent/Manager

Date:

       INSTRUCTIONS:

* Mention the matter to which the notice refers

# Delete whatever is not applicable.

@ To be filled in only when the notice refers to a change and only against the item in respect of which notice is given.

 

Form II

(See Rule 2)

Register of Fines

Part I

Railway Ė Department/Division/District/Factory

Sl. No.

Nature of employment

Rate of wages

Wages earned during the wage-period

Act or omission for which fine imposed

Date and amount of fine imposed

Date on which fine realized

Remarks

Name of employed person

Fatherís or Husbandís name

1

2

3

4

5

6

7

8

9

10

 

 

 

 

 

 

 

 

 

 

 

Part- II

Particulars of disbursement of Fines

Date of disbursement

Remarks

Amount of disbursement

Purpose for which amount disbursed

1

2

3

4

 

 

 

Form III

(See rule 5)

Register of deductions for damage or loss caused to the employer by the neglect or

default of the employed persons

Name of establishment ______________________

Sl. No.

Nature of employ-ment

Damage or loss caused and its value

Whether workman showed cause against fine or not, if so, enter date

The name of the person in whose presence a workmanís explanation is heard in respect of an employee engaged by a contractor

Date and amount of deduction imposed

No. of installments, if any

Date on which total amount realized

Remarks

Name of employed person

Fatherís or Husbandís name

1

2

3

4

5

6

7

8

9

10

11

 

 

 

 

 

 

 

 

 

 

 

Form IV

(See rule 6)

Muster Roll

Name of Establishment________________Name and address of employer___________ Location_____________________ Wage period from____________to ______ Post office _________________

Sl. No.

Fatherís/ Husbandís name

Daily attendance/ No. of units worked 123456789 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Total attendance / Total no. of units worked

Remarks

Name of employed person

Designation

1

2

3

4

5

6

7

 

 

 

 

 

 

 

Form V

(See rule 6)

Register of Wages

Name of Establishment__________________Name & address of employer___________

Location_____________________

Wage period from____________to ______ Post office _________________

Govt. of India, Ministry of Labour & Employment

Sl. No

Name of employed person

Designation

Fatherís/ Husbandís Name

Total attendance/ no. of units worked

Rates of wages

Wages earned

Total

Basic

DA

Other allowance

Basic

DA

O.T.

Other allowances

1

2

3

4

5

6

7

8

9

8

10

11

12

 

 

 

 

 

 

 

 

 

 

 

 

 

Govt. of India, Ministry of Labour & Employment

Deduction from Wages on account of

Other deductions

Other deductions

Net amount payable

Acquittance with date

Remarks

Fines

Damage or loss

Loss caused to the employer by neglect or default of employed person

Amenities/ services/ House Rent

Provident Fund/ Income Tax/ Postal Insurance/Co.op.Soc.

13

14

15

16

17

18

19

20

21

22

 

 

 

 

 

 

 

 

 

 

Form VI

(See rule 6)

Muster roll cum Register of Wages

Name of Establishment__________________Name & address of employer___________

Location_____________________

Wage period from____________to ______ Post office _________________

Govt. of India, Ministry of Labour & Employment

Sl. No

Name of employed person

Designation

Fatherís/ Husbandís Name

Daily attendance / no. of units worked 1234567

Total attendance/ no. of units worked

Rates of wages

Wages earned

Total

Basic

DA

Other allowance

Basic

DA

O.T.

Other allowances

1

2

3

4

5

6

7

8

9

8

10

11

12

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Govt. of India, Ministry of Labour & Employment

Deduction from Wages on account of

Deductions from wages on account of other deductions

Total deductions

Net amount payable

Acquittance with date

Remarks

Fines

Damage or loss

Loss caused to the employer by neglect or default of employed person

Amenities/ services/ House Rent

Provident Fund/ Income Tax/ Postal Insurance/Co.op.Soc.

13

14

15

16

17

18

19

20

21

22

 

 

 

 

 

 

 

 

 

 

Form VII

(See Rule 11(1)(ii))

Notice of rates of wages and scales of allowances payable to employed persons

Name of establishment_________________

Date from which wage rates will be or are enforced _________

Sl. No.

Rate of Wages Rs. P.

Rate of allowances, if any

Remarks

Class of employees or description of work

Particulars of Wage period

1

2

3

4

5

6

 

 

 

 

 

 

 

 

Form VIII

(See Rule 16)

Annual Return

Return for the year ending 31st December ____

1.(a) Name of the Establishment, location and postal address:

** (b) Name and address of the Manager / Contractor:

**(c) Name of the Company/ Firm owning the establishment and full address of its registered office:

** (d) Name and residential address of the Managing Agent/Director/ Partner in charge of the day to day affairs of the establishment:

**(e) Name and address of the person, if any, other than the Manager/Contractor, who is responsible for payment of wages in terms of the proviso to section 3 of the Payment of Wages Act, 1936 :

2. Number of days worked during the year:

*3. (a) Number of mandays worked during the year: _________________________________________________________ Persons receiving less than Ď[Rs.10,000/-] pm

Adults

Children

___________________________________________________________

# (b) Average daily no. of persons receiving less than Ď[Rs.10,000/-] pm Employed during the year

Adults

Children

____________________________________________________________

(c) Gross amount paid as remuneration to persons getting less than Ď[Rs.10,000/-] pm including deductions under sec.7(2) is ____________ of which the amount due to profit sharing bonus is __________ and that due to ## money value of concession is ___________

4. Total wages paid including deductions under sec. 7(2) on the following accounts:-

(for Persons receiving less than Ď[Rs.10,000/-] pm)

(a) Basic wages including overtime wages and non profit sharing bonus.

(b) Dearness and other allowances in cash

(c) Arrears of pay in respect of previous year paid during the year

_______________________________________________________________

5.Number of cases and amount realized:-

( for Persons receiving less than [Rs.10,000/-] pm)

No. of cases

Amount

(a) Fines

(b) Deductions for damage or loss

(c) Deductions for breach of contract

6.Disbursement from the fines fund:-

(Purpose and amount)

(a)

(b)

7. Balances of fines fund in hand at the end of the year _________

Signature

Designation

* This is the aggregate number of attendances during the year.

# The average daily number of persons employed during the year is obtained by dividing

aggregate number of attendances during the year by the number of working days.

##Money value of concessions should be obtained by taking the difference of the cost

price paid by the employer and the actual price paid by the employees for supplies of

essential given free or at concessional rates.

** Strike of whichever is not applicable.

Form IX

[See Rule 17(3)]

Register of advances made to employed persons

Name of Establishment

Govt. of India, Ministry of Labour & Employment

Sl. No

Name of employed person

Fatherís or husbandís name

Nature of employment

Earning during a wage period

Date and amount of advance

Purpose for which advance made

Installments for repayment of advances

Date of installments repaid

Date of which total amount repaid

Signature or thumb impression of the worker or remarks

No. of installments

Amount of each installment

1

2

3

4

5

6

7

8

9

10

11

12

 

 

 

 

 

 

 

 

 

 

 

Form X

[See rule 18(3)]

Register of loans granted to the employed persons for house building or other approved purposes

Govt. of India, Ministry of Labour & Employment

Sl. No

Name of employed person

Fatherís or husbandís name

Nature of employment

Amount of loan

Date and amount of granted

Purpose for which granted

Installments for repayment of loan

Date of installments repaid

Date of which total amount repaid

Signature or thumb impression of the worker or remarks

No. of installments

Amount of each installment

1

2

3

4

5

6

7

8

9

10

11

12