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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