Statutory Register 878

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    HR - 055

    ARREAR REGISTER FOR THE MONTH OF . . . . . . . . . . . . . .

    Sl. Emp. Name of the Employee/ Arrear Arrear Days Month in which Salary Slip No. Paid by Voucher Application Signature of Initial of

    No. Code Father's Name Month the Arrear is as per Salary (or) by Salary Number dealing HTK/PPM

    No. given Sheet Sheet Time Keeper

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    HR - 033(Declaration in FORM No. 25 under Rule 53)

    ame o t e or er . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .er a o. as n t e reg ster o wor ers

    under Section 62 of the Act . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Father's Name . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Age and date of birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    ature o wor . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Qualification, if any or

    period of service on similar work . . . . .. . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .7 Date when tight fitting clothings

    was provided . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .emar s . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .

    I certify that the above mentioned worker, whose signature/thumb impression is given below, is aproperly trained male adult worker who is competent to mount or ship belts, lubricate or do othera ust ng operat ons on t e mac nery nsta e n my actory w e t ey are n mot on.

    Date .. Signature/thumb-impression Signature of Manager/Occupier of worker

    MAWANA SUGAR WORKS, MAWANA(A UNIT OF MAWANA SUGARS LIMITED)

    ec arat on n o. un er u e

    1 Name of the Worker . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .2 Serial No. as in the register of workers

    under Section 62 of the Act . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .at er s ame . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    4 Age and date of birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    5 Nature of work . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Qualification, if any or

    period of service on similar work . . . . .. . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .ate w en t g t tt ng c ot ngs

    was provided . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Remarks . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .

    cert y t at t e a ove ment one wor er, w ose s gnature t um mpress on s g ven e ow, s aproperly trained male adult worker who is competent to mount or ship belts, lubricate or do otheradjusting operations on the machinery installed in my factory while they are in motion.

    ate .. gnature t um - mpress on gnature o anager ccup er of worker

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    HR - 032

    FAIR PRICE SHOP COUPON ISSUE REGISTER Month

    Sl. NAME Father's Name Designation/ Coupon No. Amount Employee's Signature R E M A R K S

    No. Code From To

    Rs.

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    ELECTRICITY CHARGES REGISTER

    Block No. A/ B/ C/ D/ E

    Names Shri. ________________________________ Shri. ________________________________ Shri. _______________________________

    & _________________________________ _________________________________ ________________________________

    Qrs. No. _________________________________ _________________________________ ________________________________

    _________________________________ _________________________________ _______________________________

    Date Total Previous Current Charges Total Previous Current Charges Total Previous Current Charges

    Reading Months Months @ 15 P. Reading Months Months @ 15 P. Reading Months Months @ 15 P.

    Total Net Reading per Unit Total Net Reading per Unit Total Net Reading per Unit

    Reading Reading Reading

    Rs. P. Rs. P. Rs. P.

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    HR-031

    Names Shri. ________________________________ Shri. ________________________________ Shri. ________________________________

    & _________________________________ _________________________________ _________________________________

    Qrs. No. _________________________________ _________________________________ _________________________________

    _________________________________ _________________________________ _________________________________

    Date Total Previous Current Charges Total Previous Current Charges Total Previous Current Charges

    Reading Months Months @ 15 P. Reading Months Months @ 15 P. Reading Months Months @ 15 P.

    Total Net Reading per Unit Total Net Reading per Unit Total Net Reading per Unit

    Reading Reading Reading

    Rs. P. Rs. P. Rs. P.

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    PAY SHEET REGISTER

    For the month of 200

    Sl. N A M E Father's Name Designation Attendance R A T E OF PAY Salary Salary for House Employees Employee Employee

    No. Leave Basic D.A. Other Total Earned Linked Rent Provident Family P/F Loan

    (days) Allowance Insurance Fund Pension

    w/o Scheme Scheme

    P. L. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P.

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    HR-029

    Fair Canteen Other Total Salary Net Net Amount Linked Admn. Signature

    Price Dues Deduction Paid Amount Payable Insurance Charges &

    Shop befire after Scheme Remarks

    rouding off

    Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P.

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    HR-028

    Daily Attendance Report for the month of 200

    O F F I C E R S T A F FDate

    On Roll Present Accident Sick L.W .P. L.W .O.P. Absent Holiday Weekly Temp. Substi- On Roll Present Accident Sick L.W .P. L.W.O.P. Absent Holiday Weekly Temp. Substi-

    Leave Holiday tute Leave Holiday tute

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    W E L F A R E CANTEEN, GUEST HOUSE, FAIR PRICE SHOP

    On Roll Present Accident Sick L.W.P. L.W.O.P. Absent Holiday Weekly Temp. Substi- On Roll Present Accident Sick L.W.P. L.W.O.P. Absent Holiday Weekly Temp. Substi-

    Leave Holiday tute Leave Holiday tute

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    SANITATION SECURITY

    On Roll Present Accident Sick L.W.P. L.W.O.P. Absent Holiday Weekly Temp. Substi- On Roll Present Accident Sick L.W .P. L.W.O.P. Absent Holiday Weekly Temp. Substi-

    Leave Holiday tute Leave Holiday tute

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    ENGG. DEPTT.

    On Roll Present Accident Sick L.W.P. L.W.O.P. Absent Holiday Weekly Temp. Substi-

    Leave Holiday tute

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    PRODUCTION SUMMARY

    On Roll Present Accident Sick L.W.P. L.W .O.P. Absent Holiday Weekly Temp. Substi- Actual Present Accident Sick L.W.P. L.W.O.P. Absent Holiday Weekly Temp. Substi-

    Leave Holiday tute on Roll Leave Holiday tute

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    Grand Total Signature R E M A R K S

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    Form No. 23

    (Section 112, Rule 122)

    REGISTER OF ACCIDENTS AND DANGEROUS OCCURRENCES

    S. Date of Time Name & Address of Sex Age Insurance Shift, Deptt., Injure of dangerous occurrences

    No. report in of injured person No. & Occupation Date Time Place Cause of injury or Nature of What exactly was

    Form 18 to report of dangerous injury or the injured person

    inspector & notice employee occurrences dangerous doing at the time

    (and notice occurrences of injury

    to insurance

    authoritaies

    1 2 3 4 5 6 7 8 9 10 11 12 13 14

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    HR-026

    Name, occupation Signature & Name, address Date of return Name of Remarks

    address and sig. Or Designation and occupation of injured person the State if any

    or thumb imp. of the person of two witnesses to work Insurance

    of the person who makes the Local Office

    giving notice entry to which the

    injured person

    is attached

    15 16 17 18 19 20

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    Name of the Factory : HR-025

    Adult/Child

    Serial No. Emp. Code No.

    Form 14(69) (Rule 102)

    Department LEAVE WITH WAGES REGISTER Name .Approved : Vide CIF Letteer 10580 F/RGN/Misc/MRT-47 Dated 11.10.63

    Serial No. in the Register Adult/Child Year 200 Father's Name .

    Workers . Date and amount of Payment made in

    lieu of leave due

    Date of entry into service ..

    Calender Wages paid Wages No. of days worked during the calendar year Total of Leave to Credi t Total of Whether Leave enjoyed Balance of Normal Cash equivalent of Rate of Remarks

    year of From To earned No. of No. of No. of No. of column Balance Leave columns Leave in From To Leave to rate of advantage accruing wages for

    service during days of days of days of days of 4 to 7 of Leave earned 9 &10 accordance credit wages through concessio- the leave

    the wage work lay off maternity leave from during the with Scheme nal sale of food grains period

    period performed leave enjoyed preceding year under Sec.79 and other particulars (Total of

    year mentioned (8) was columnsin column refused 15 & 16)

    No. 1

    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

    January

    February

    March

    April

    May

    June

    July

    August

    September

    October

    November

    December

    Total

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    REGISTER OF LEAVE/ HOLIDAY

    Name . Father's Name ...

    Unavailed Date on which leave Nature of leave Absent Balance carried over leave(balance)Remarks

    Applied for Availed Sick Casual Previ- Without Date Period Sick Casual Previ- during the

    From To lege Pay From To lege season

    1 2 3 4 5 6 7 8 9 10 11 12 12 14 15

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    HR-023

    Designation Date of Joining .

    Unavailed Date on which leave Nature of leave Absent Balance carried over leave(balance) Remarks

    Applied for Availed Sick Casual Previ- Without Date Period Sick Casual Previ- during the

    From To lege Pay From To lege season

    1 2 3 4 5 6 7 8 9 10 11 12 12 14 15

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    TIME OF REST PERIOD TIME OF

    COMMENCEMENT FROM TO FROM TO COMPLETION

    OF WORK

    MONDAY TO FRIDAY

    SATURDAY

    SUNDAY

    23 24 25 26 27 28 29 30 31 TOTAL NO. LEAVE LEAVE TOTAL

    OF DAYS WITH WITHOUT DAYS R E M A R K S

    WORKED PAY PAY TO PAY

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    HR 019

    26 27 28 29 30 31 Total Leave Leave without Total

    Attendance with without Days R E M A R K Spay pay to pay

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    ATTENDANCE REGISTER for the month of 200

    Sl. Name of Father's Designation Joining 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

    No. S/Shri Name Date

    S/Shri

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    HR 018

    27 28 29 30 31 Total Rate Rate Rate Amount House P.F. Loan Free E.P.F.S. Income Fair Canteen D.C.M. L.I.C. Salary Payable Signature

    Days of of of of Rent A/C. against Loan Tax Price Ins. of & Amount &Basic Allow- consoli- wages P.F. India Wages Remarks

    Wages ance dated earned Meerut Paid

    wages before

    Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P. Rs. P.

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    Form No. 12 (Rule 78)

    Register of Adult Workers under Section 62 of the Act

    Time of commence- R E S T P E R I O D Time of

    ment of work From To From To Completion

    Monday to FridaySaturday

    System of Rotation of Relays Sunday

    W

    eeklyHoliday

    Nat

    ureofwork

    Cat

    egory

    Departmen

    t

    Sl. Emp. Name of Father's Corresponding 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd

    No. Code Adult Name to that in Form-II

    Worker Group Shift

    of

    Relay

    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

    W

    eeklyHoliday

    Nat

    ureofwork

    Cat

    egory

    Departmen

    t

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    HR - 017

    Department . For the month of 2000

    Page No.

    Fine

    23rd 24th 25th 26th 27th 28th 29th 30th 31st Total Rate Rate Total Total Deductions Compul- Actual Total No. Date on Remarks or

    No. of of of Hrs. Under On A/c. Instal- sory Wages of Weekly which indication

    Days Basic Allow. of P.F. of ment Saving Paya- Holidays compen- showing that

    Worked Wages if any Over- Scheme Advance of LIC Scheme ble lost by the satory the payment

    time worker holiday's have beenwill be made together

    given with the dates

    33 34 35 36 37 38 39 40 41 42 43 44 45 45(a) 45(b) 46 47 48 49 50 51 52 53

    Fine