Form XVII

Download as xlsx, pdf, or txt
Download as xlsx, pdf, or txt
You are on page 1of 32

FORM XVII

1[See
rule 78 (1) (a) (i)]
Register of Wages

Name and address of


contractor
Name and address of
establishment in/under
which contract is carried
on
Nature and location of
work
Name and address of
principal employer
Wage period monthly

Serial No. in the register of


Sr No.   Name of workman
workmen
FORM XVII
rule 78 (1) (a) (i)]
1[See

Register of Wages

No. of Units of Daily rate of


Designation/ Nature or
days work   wages/piece rate
work done worked  done 
Ms. Nirmala Enterpises
#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR01
PF Account Number PY/BOM/16318/10027
Date of Joining 6-Jun-22
LOP Days 0
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 15,000.00 15,000.00
HRA 40000 4000

Total 19,000.00 19,000.00


In words : Sixteen thousand eight hundred and Fifty seven only

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR04
PF Account Number PY/BOM/16318/10036
Date of Joining 6-Jun-22
LOP Days 0
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 15,000.00 15,000.00
HRA 40000 4000

Total 19,000.00 19,000.00


In words : Sixteen thousand eight hundred and Fifty seven only

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR07
PF Account Number PY/BOM/16318/10025
Date of Joining 6-Jun-22
LOP Days 0
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 12,642.00 12,642.00
HRA 3858 3858

Total 16,500.00 16,500.00


In words : Fourteen thousand six hundred and fifty nine only

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR11
PF Account Number PY/BOM/16318/10037
Date of Joining 1-Jul-22
LOP Days 0
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 12,642.00 12,642.00
HRA 358 358

Total 13,000.00 13,000.00


In words : Eleven thousand three hundred and eighty five only

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR16
PF Account Number PY/BOM/16318/10040
Date of Joining 19-Jul-22
LOP Days 3
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 12,642.00 11,419.00
HRA 358 323

Total 13,000.00 11,742.00


In words : Ten thousand two hundred and eighty three only.

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
Employee Code NIR18
PF Account Number PY/BOM/16318/10042
Date of Joining 1-Aug-22
LOP Days 13
Location Bangalore
Earnings
Particulars Rates/Month Amount
Basic And DA 12,642.00 7,341.00
HRA 858 498

Total 13,500.00 7,839.00


In words : Six thousand eight hundred and ninty nine only
Enterpises Ms. Nirmala
ndra RD, Begur RD Bangalore #30 7th cross 11th Maqin Hongsa
th of Aug-2022 Payslip for the mon
Employee name Prakash R Employee Code NIR02
Esic Account Number 5037443484 PF Account Number PY/BOM/16318/10031
Days Worked 31 Date of Joining 6-Jun-22
Designation Supervisour LOP Days 0
UAN Number 100840868557 Location Bangalore
Deductions Earnings
Particulars Amount Particulars Rates/Month
Profession Tax 200 Basic And DA 15,000.00
Provident Fund 1,800.00 HRA 4000
ESIC 143
Total 2,143.00 Total 19,000.00
Net Pay : 16857.00 In words : Sixteen thousand eight hundred and Fifty sev

Enterpises Ms. Nirmala


ndra RD, Begur RD Bangalore #30 7th cross 11th Maqin Hongsa
th of Aug-2022 Payslip for the mon
Employee name R H Venkatesh Naik Employee Code NIR05
Esic Account Number 502416772 PF Account Number PY/BOM/16318/10035
Days Worked 31 Date of Joining 6-Jun-22
Designation Cook LOP Days 0
UAN Number 101155904195 Location Bangalore
Deductions Earnings
Particulars Amount Particulars Rates/Month
Profession Tax 200 Basic And DA 15,000.00
Provident Fund 1,800.00 HRA 4000
ESIC 143
Total 2,143.00 Total 19,000.00
Net Pay : 16857.00 In words : Sixteen thousand eight hundred and Fifty sev

Enterpises Ms. Nirmala


ndra RD, Begur RD Bangalore #30 7th cross 11th Maqin Hongsa
th of Aug-2022 Payslip for the mon
Employee name Shekar Devadiga Employee Code NIR08
Esic Account Number 5042416926 PF Account Number PY/BOM/16318/10033
Days Worked 31 Date of Joining 6-Jun-22
Designation Helper LOP Days 0
UAN Number 10084787066207 Location Bangalore
Deductions Earnings
Particulars Amount Particulars Rates/Month
Profession Tax 200 Basic And DA 12,642.00
Provident Fund 1,517.00
ESIC 124
Total 1,841.00 Total 24,330.00
Net Pay : 14659 In words : Eleven thousand thirty only

Enterpises Ms. Nirmala


ndra RD, Begur RD Bangalore #30 7th cross 11th Maqin Hongsa
th of Aug-2022 Payslip for the mon
Employee name Santhosh P R Employee Code NIR12
Esic Account Number 5042428491 PF Account Number
Days Worked 31 Date of Joining 20-Jun-22
Designation Service LOP Days 0
UAN Number 101846580399 Location Bangalore
Deductions Earnings
Particulars Amount Particulars Rates/Month
Profession Tax 0 Basic And DA 12,642.00
Provident Fund 1,517.00 HRA 358
Mediclaim 98
Total 1,615.00 Total 13,000.00
Net Pay : 11385 In words : Eleven thousand three hundred and eighty fiv

Enterpises Ms. Nirmala


ndra RD, Begur RD Bangalore #30 7th cross 11th Maqin Hongsa
th of Aug-2022 Payslip for the mon
Employee name Prabhu O Employee Code NIR17
Esic Account Number 5042493071 PF Account Number PY/BOM/16318/10039
Days Worked 28 Date of Joining 20-Jul-22
Designation Service LOP Days 2
UAN Number 100913467704 Location Bangalore
Deductions Earnings
Particulars Amount Particulars Rates/Month
Profession Tax 0 Basic And DA 12,642.00
Provident Fund 1,370.00
Mediclaim 89
Total 1,459.00 Total 12,642.00
Net Pay : 10283 In words : Ten thousand three hundred and eighteen ru

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

Ms. Nirmala Enterpises


ss 11th Maqin Hongsandra RD, Begur RD Bangalore #30 7th cross
Payslip for the month of Aug-2022
Employee name N Nagarajaiah Employee Code
Esic Account Number 5020732388 PF Account Number
Days Worked 31 Date of Joining
Designation Supervisour LOP Days
UAN Number 101155901188 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 : Sixteen thousand eight hu

Ms. Nirmala Enterpises


ss 11th Maqin Hongsandra RD, Begur RD Bangalore #30 7th cross
Payslip for the month of Aug-2022
Employee name Kanchana Employee Code
Esic Account Number 5038355561 PF Account Number
Days Worked 31 Date of Joining
Designation Washing LOP Days
UAN Number 100842872825 Location
Deductions Earnings
Amount Particulars Amount Particulars
12,642.00 Profession Tax 0 Basic And DA
Provident Fund 1,517.00 HRA
Mediclaim 95
24,330.00 Total 1,612.00 Total
nly Net Pay : 11030 In words : Twelve thousand nine hun

Ms. Nirmala Enterpises


ss 11th Maqin Hongsandra RD, Begur RD Bangalore #30 7th cross
Payslip for the month of Aug-2022
Employee name K Vijayashekhar Employee Code
Esic Account Number 5042432451 PF Account Number
Days Worked 31 Date of Joining
Designation Service LOP Days
UAN Number Location
Deductions Earnings
Amount Particulars Amount Particulars
12,642.00 Profession Tax 0 Basic And DA
358 Provident Fund 1,517.00 HRA
Mediclaim 98
13,000.00 Total 1,615.00 Total
undred and eighty five only Net Pay : 11385 In words : Twelve thousand three hu

Ms. Nirmala Enterpises


ss 11th Maqin Hongsandra RD, Begur RD Bangalore #30 7th cross
Payslip for the month of Aug-2022
Employee name Gundamma Employee Code
Esic Account Number 5042493121 PF Account Number
Days Worked 29 Date of Joining
Designation Washing LOP Days
UAN Number 101362180195 Location
Deductions Earnings
Amount Particulars Amount Particulars
11,826.00 Profession Tax 0 Basic And DA
Provident Fund 1,419.00 HRA
Mediclaim 89
11,826.00 Total 1,508.00 Total
dred and eighteen rupees only Net Pay : 10318 In words : Thirteen thousand one hu
Ms. Nirmala Enterpises
#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
NIR03 Employee name Narayan M Nayak
PY/BOM/16318/10032 Esic Account Number 5041499003
6-Jun-22 Days Worked 31
0 Designation Vegitable cutting
Bangalore UAN Number 101585892441
Deductions
Rates/Month Amount Particulars Amount
12,642.00 12,642.00 Profession Tax 200
2358 2358 Provident Fund 1,517.00
ESIC 113
15,000.00 15,000.00 Total 1,830.00
Thirteen thousand one hundred and seventy only Net Pay : 13170.00

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
NIR06 Employee name Parameshwarappa
PY/BOM/16318/10026 Esic Account Number 5042416931
6-Jun-22 Days Worked 31
0 Designation Tea cofee
Bangalore UAN Number 100699435112
Deductions
Rates/Month Amount Particulars Amount
15,000.00 15,000.00 Profession Tax 200
4000 4000 Provident Fund 1,800.00
ESIC 143
19,000.00 19,000.00 Total 2,122.00
Sixteen thousand eight hundred and Fifty seven only Net Pay : 16857.00

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
NIR09 Employee name Ranganath
PY/BOM/16318/10041 Esic Account Number 5042416803
1-Aug-22 Days Worked 28
3 Designation Assistant
Bangalore UAN Number 101157663601
Deductions
Rates/Month Amount Particulars Amount
12,642.00 11,419.00 Profession Tax 0
3358 3033 Provident Fund 1,370.00
ESIC 109
16,000.00 14,452.00 Total 1,479.00
Twelve thousand nine hundred and seventy two only Net Pay : 12972

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
NIR15 Employee name Harish Obaleshappa
PY/BOM/16318/10030 Esic Account Number 5042451924
26-Jun-22 Days Worked 30
0 Designation Jr Counter
Bangalore HO UAN Number 101413967658
Deductions
Rates/Month Amount Particulars Amount
12,642.00 12,642.00 Profession Tax 0
1358 1358 Provident Fund 1,517.00
Mediclaim 105
14,000.00 14,000.00 Total 1,622.00
Twelve thousand three hundred and seventy eight only Net Pay : 12378

Ms. Nirmala Enterpises


#30 7th cross 11th Maqin Hongsandra RD, Begur RD Bangalore
Payslip for the month of Aug-2022
NIR18 Employee name Chakra Sharma
PY/BOM/16318/10038 Esic Account Number 5042492847
18-Jul-22 Days Worked 31
0 Designation Assistant
Bangalore UAN Number 101047062185
Deductions
Rates/Month Amount Particulars Amount
12,642.00 12,642.00 Profession Tax 200
2358 2358 Provident Fund 1,517.00
Mediclaim 113
15,000.00 15,000.00 Total 1,830.00
Thirteen thousand one hundred and seventy only Net Pay : 13170
FORM XV
(See rule 77)
Service Certificate

Name and address of contractor


Name and address of,
establishment in/under which
contract is carried on
Nature and location of work
Name and address of principal
employer
Name and address of the
workman
Age or date of birth
Identification marks
Father's/Husband's name

Total period for which employed

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

Name and address of


contractor 

Name and address of


establishment in/under which
contract is carried on
Nature of work and location of
work
Name and address of principal
employer

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)

BONUS PAID TO EMPLOYEES FOR THE ACCOUNTING YE

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)

ES FOR THE ACCOUNTING YEAR ENDING ON THE

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

Name and address of contractor


Nature and location of work
Name and address of
establishment in/under which
contract is carried on
Name and address of principal
employer

Name and surname Father's/


EMP NO Ag. and sex
of workman Husband's name

NIR01 Praksh R Male Ramachandrappa

Male Obalaraju

NIR02 Ravi B O

Male

NIR03 Narayan M Naik Mukund Naik

Male

NIR04 R H Venkatesh Naik Badde Naik


Male Narasimhaih

NIR05 N Nagarajaiah

Male
NIR06 G Parameshwarappa Doddagangappa

NIR07 Shekar Devadiga Male Annappa Devadiga

NIR08 Kanchana Female Seenivasalu

NIR09 Ranganath Male KENCHAIAH

NIR11 Santhosh P R Male Parameshappa

NIR12 K Vijayashekhar Male ramappa


NIR15 Harish Obaleshappa Male OBALESAPPA

NIR16 Prabhu O Male Onkarappa

NIR17 Gundamma Female THIPPESWAMI

NIR18 Chakra Sharma Male SOMANATH SHARMA

NIR19 Chandra Talukdra Male ISWSHAR TALUKDRA


M XIII
rule 75)
employed by Contractor

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
- -

N R Road, Kamat N R Road, Kamat


Hotel Townhall, Hotel Townhall,
Bangalore North Bangalore North
Vegitable cutting 560002 560002 6/6/2022 - -

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 - -

No.30, 7th cross,


"Ukundha
Basaweshwara
Nilaya" 11th
main,,near
Chowdeshwari
Temple, Srinivasa
Layout,
Hongasandra,,Bangalo
re South, Bangalore
560
068.,Dist:BangaloreKa Boomasandra,
Assistant rnataka560068 Bangalore- 560099 8/1/2022 - -

Haranagiri,
Kudrihal,Haveri, Boomasandra,
Service Karnataka 581115 Bangalore- 560099 7/1/2022 - -

No.69, Veerasandra, No.69, Veerasandra,


Electronics City, Electronics City,
Anekal, Bangalore - Anekal, Bangalore -
Service 560100 560100 7/1/2022 - -
#16B, Sembedu
Kollakottai, VTC:
Sembedu, PO:
Sembedu, No.70, Veerasandra,
Gudiyatham, vellore Electronics City,
distruct, Tamil Nadu, Anekal, Bangalore -
Jr Counter 635813 560100 6/20/2022 - -

No.45, Thanigekallu,
Madadhakere Hobli,
Thanigekal, Boomasandra,
Service Chitradurga- 577527 Bangalore- 560099 7/19/2022 - -

No.30, 7th cross, No.30, 7th cross,


"Ukundha "Ukundha
Basaweshwara Basaweshwara
Nilaya" 11th Nilaya" 11th
main,,near main,,near
Chowdeshwari Chowdeshwari
Temple, Srinivasa Temple, Srinivasa
Layout, Layout,
Hongasandra,,Bangalo Hongasandra,,Banga
re South, Bangalore lore South,
560 Bangalore 560
068.,Dist:BangaloreKa 068.,Dist:Bangalore
Washing rnataka560068 Karnataka560068 7/20/2022 - -
No.18, Kanakapura
Main Road,
Ganigarapalya,
Thalaghattapura,
Bangalore 560062
Boomasandra,
Assistant Bangalore- 560099 7/18/2022 - -

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

Name and address of the


principal employer
Name and address of the
establishment    

Sr. No. Name and address of contractor


Nature of work on contract

1 2 3
                  Period  of contract Maximum number of workmen employed by contractor
Location of contract work
From To
4 5 6

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy