Form XVII
Form XVII
Form XVII
1[See
rule 78 (1) (a) (i)]
Register of Wages
Register of Wages
Enterpises
ndra RD, Begur RD Bangalore
th of Aug-2022
Employee name Chandra Talukdra
Esic Account Number
Days Worked 18
Designation HR Assistant
UAN Number 100913467704
Deductions
Particulars Amount
Profession Tax 0
Provident Fund 881.00
Mediclaim 59
Total 940.00
Net Pay : 6899.00
Ms. Nirmala Enterpises
ss 11th Maqin Hongsandra RD, Begur RD Bangalore #30 7th cross
Payslip for the month of Aug-2022
Employee name Ravi O Employee Code
Esic Account Number 502416921 PF Account Number
Days Worked 31 Date of Joining
Designation COOK LOP Days
UAN Number 10130402684 Location
Deductions Earnings
Amount Particulars Amount Particulars
15,000.00 Profession Tax 200 Basic And DA
4000 Provident Fund 1,800.00 HRA
ESIC 143
19,000.00 Total 2,122.00 Total
undred and Fifty seven only Net Pay : 16857.00 In words : Thirteen thousand one hu
Sr.No.
From
To
To
1 2 3
Rate of
wage
(with
particula
Nature of work done
rs of unit Remarks
in case
of piece
work)
4
5 6
FORM XIV
(See rule 76)
Employment Card
1. Name of the
workman
2. Serial number in the
register of workmen
employed
3. Nature of
employment/designati
on
4. Wage' rate with
particulars or unit, in
case of piece work
5 Wage period
6. Tenure of
employment
7. Remarks
Photo
Payment of Bonus A
FORM C
See rule 4(b)
Name of the
establishment
No. of working days in
the year
Whether
he has
completed
15 years
Name of
of age at
Sl. No. the Father's name
the
employee
beginning
of the
accountin
g year
1 2 3 4
ment of Bonus Act
FORM C
See rule 4(b)
Deduction
Deduction
Amount of Puja
on
Total bonus bonus or Net
account of Total sum
salary or payable other Interim amount
No. of Amount of financial deducted
wage in under customary bonus or payable
Designatio days Income- loss, if under
respect of section 10 bonus bonus (Column 8
n worked in tax any, Columns
the or section paid paid in minus
the year deduced caused by 9, 10, 10A
accountin 11, as the during the advance Column
miscondu and 11
g year case may accountin 12)
ct of the
be g year
employee
5 6 7 8 9 10 10A 11 12 13
Signature/
Amount Date on Thumb
actually which impressio
paid paid n of the
employee
14 15 16
FORM XIII
(See rule 75)
Register of workmen employed by Contrac
Male Obalaraju
NIR02 Ravi B O
Male
Male
NIR05 N Nagarajaiah
Male
NIR06 G Parameshwarappa Doddagangappa
e Or Date of
Date of Reasons
Nature of thumb terminati
commencem for
employment/ Permanent home address
Local of
address
workman (village and Tehsil/Taluka
Impressi onand
of District)
ent of terminati
designation on of employ
employment on
No.18, workma ment
No.18, Kanakapura Kanakapura Main
Main Road, Road,
Supervisour Ganigarapalya, Ganigarapalya, - -
Thalaghattapura, Thalaghattapura,
Bangalore 560062 Bangalore
560062 6/6/2022
Dodden Hobli,
Badvanahalli Post,
Boomasandra,
Cook Madhugiri Taluku, 6/6/2022
Bangalore- 560099
Badavanhalli, Tumkur-
572112
- -
No.649,
No.649, Veerasandra, Veerasandra,
Electronics City, Electronics City,
Anekal, Bangalore - Anekal, Bangalore -
Cook 560100 560100 6/6/2022 -- -
#105, 5th Cross,
#105, 5th Cross,
Vinayaka Nagar,
Vinayaka Nagar, Lakshmipur Road,
Lakshmipur Road,
Supervisour Vinayaka Nagar, 6/6/2022
Vinayaka Nagar,
Madavara,
Madavara, Madavara,
Madavara,
Bangalore-562123
Bangalore-562123
- -
Kerekondapura,
Chitradurga, Boomasandra,
Tea Cofee Karntaka- 577540 Bangalore- 560099 6/6/2022 - -
4/77, Henubera
House, Bankeshwara
Road, Kundapura
Thalluk, Byndoor, Boomasandra,
Helper Udupi- 576214 Bangalore- 560099 6/6/2022 - -
#16B, Sembedu
Kollakottai, VTC:
Sembedu, PO:
Sembedu,
Gudiyatham, vellore
distruct, Tamil Nadu, Boomasandra,
Washing 635813 Bangalore- 560099 6/6/2022 - -
Haranagiri,
Kudrihal,Haveri, Boomasandra,
Service Karnataka 581115 Bangalore- 560099 7/1/2022 - -
No.45, Thanigekallu,
Madadhakere Hobli,
Thanigekal, Boomasandra,
Service Chitradurga- 577527 Bangalore- 560099 7/19/2022 - -
Kerekondapura,
Chitradurga, Boomasandra,
Assistant Karntaka- 577540 Bangalore- 560099 8/1/2022 - -
Remarks
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
Still
working
FORM XII
(Sec rule 74)
Register of Contractors
1 2 3
Period of contract Maximum number of workmen employed by contractor
Location of contract work
From To
4 5 6