Please find the soft copy of various returns under factories act.
FACTORIES ACT, 1948
Form 34 (Revised)
[Prescribed under Rule 12(a)]
ANNUAL RETURN
For the year ending 31st December __________
1. Registration number of Factory :
2. Name of Factory : M/s
3. Name of Occupier : Mr.
4. Name of the Manager : Mr.
5. District :
6. Full Postage Address of Factory :
7. Nature of Industry :
NUMBER OF WORKER AND PARTICULARS OF EMPLOYMENT
8. No. of days worked in the year :
9. No. of Man Days worked during the
a) Men :
b) Women :
c) Children :
(See explanatory note)
a) Adults (i) Men
(ii) Women
b) Adolescent (i) Male
(ii) Female
c) Children (i) Male
(ii) Female
a) Men :
b) Women :
c) Children :
(See explanatory note)
a) Men :
b) Women :
Declared as dangerous under section 87 (see rule 116)
(b) if so, give the following information
Name of the dangerous process of operations Average No. of persons employed daily in each of
Carried on the processes or operations given in col 1
1 2
(i)
(ii)
(iii)
LEAVE WITH WAGES
a) Men
b) Women
c) Children
Leave with wages during the year
a) Men
b) Women
c) Children
a) Men
b) Women
c) Children
Dismissed from the services, or quit employment,
Or were superannuated, or who died while
Service during the year.
b) Number of such workers in respect of whom
wages in lieu of leave were paid.
SAFETY OFFICERS
18. a) Number of Safety Officers required to be
Appointed as per notification under
Section 40-B
b) Number of Safety Officers appointed
AMBYLANCE ROOM
Factory as required under Section 45?
CANTEEN
required under section 46?
b) Is the canteen provided managed?
i) Departmentally, or
ii) Through a Contractor?
SHELTERS OR REST ROOMS AND LUNCH ROOMS
Rooms provided in the factory as required under
Section 47?
b) Are there adequate and suitable much rooms
Provided in the factory as required under
Section 47?
CRECHES
Required under section 48?
WELFARE OFFICER
23. a) Number of Welfare Officers required to be
Appointed under section 49?
b) Number of Welfare Officers appointed
ACCIDENTS
24. a) Total Number of accidents (see explanatory note)
i) Fetal
ii) Non-Fetal
b) Accident in which workers returned to work
During the year to which this returns relate.
i) Accidents (workers injured) occurring during
The previous year in which injured works
Returned to work during the year to which this
Return relates.
aa) Number of Accidents
bb) Man Days lost due to Accidents
c) Accidents (workers injured) occurring during the
Previous year in which injured workers did not
Return to work during the year to which this return relate to
aa) Number of Accidents
bb) Man Days lost due to Accidents
25. a) Is a suggestion scheme in operation in the factory?
b) If so, the number of suggestions
i) Received during the year
ii) Accepted during the year
d) Amount awarded in cash prizes during the year
i) Total amount awarded
ii) Value of maximum cash prizes awarded
iii) Value of minimum cash prizes awarded
Certified that the information furnished above is to the best of my knowledge and belief, correct.
Signature of the Manager
Date……………………….
Explanatory Note: –
FORM NO. III
Annual Return for the year 2010
Prescribed under section 18(I) of the Minimum Wages Act, 1948 abd Rule 21 (4-A) of the H.P. Minimum Wages Rules, 1959
Note: Information may be given only for those categories of workers in respect of whom minimum wages have been fixed under the minimum wages act, 1948.
Adults Children
(Total Attendence)
The year _________ _________
5. Total Wages Paid Rs._____________
6. Cash Value of Wages Paid in Kind
Fine Damage or Loss Breach of Contract
No. of Cases
Amount
No. of Cases
Amount
No. of Cases
Amount
Purpose Amount Spent
a) _____________________________ ______________________________
b) _____________________________ _______________________________
c) _____________________________ _______________________________
d) _____________________________ _______________________________
10. Balance of fine fund at the end of the year: _____________________________
Signature of the Manager
Date ……………………
FORM IV
ANNUAL RETURNS UNDER THE PAYMENT OF WAGES ACT, 1936
WAGES AND DEDUCTION FROM WAGES]
RETURN FOR THE YEAR ENDING 31ST DECEMBER 2010
b) Code No.
c) Industry
b) Average daily No. of persons employed during the year:
Persons receiving Persons receiving Rs. 1000 and
Less than Rs. 1000 more but less than Rs. 10000
Adults
Children
a) Gross amount paid as remuneration to persons getting less than Rs. 1000 including deductions under section 7 (2) …………………….. of which the amount due to profit sharing bonus is ……………………….. and that due to money value of concession is ………………………………..
b) Gross amount paid as remuneration to persons getting Rs. 1000 and more but less than 10000 including deductions under section 7 (2) ……………… of which the amount due to profit sharing bonus is …………………. And that due to money value of concession is ………………………..]
Persons receiving less Persons receiving Rs. 1000 and
Than Rs. 1000 more but less than Rs. 10000
a) Basic wages including over time
Wages and non-profit sharing
Bonus
b) Dearness and other allowance
In cash
c) Arrears of pay in respect of previous
Year paid and during the year.
Persons receiving less Persons receiving Rs. 1000 and
Than Rs. 1000 more but less than Rs. 10000
No. of |
Cases AmountNo. of CasesAmount
a) Fines
b) Deduction for Damages or Loss
c) Deduction for Breach of Contract
6. Disbursement From Fines fund: Purpose Amount
a)
b)
7. Balance of fines fund in hand at the end of the year Rs. ……………………….
Signature ………………….
Designation ……………….
MATERNITY BENEFIT ACT, 1961
FORM ‘N’
(See rule 16)
(MATERNITY BENEFIT RULES, 1973)
Details of payment made during the year ending 31st December 2008
M/S
Name of person to whom paid _____________ Amount paid _____________
1. Date of payment _______________
2. Woman Employee _______________
3. Nominee of woman _______________
4. Legal representative of woman _______________
5. Amount for the period preceding date of expected delivery _______________
6. Amount of the subsequent period _______________
7. Under section 8 of the Act _______________
8. Under section 9 of the Act _______________
9. Under section 10 of the Act _______________
10. Number of the woman workers who absconded after receiving the first installment of maternity benefits _______________
11. Cases where claims were contested in a court of law _______________
12. Result of such cases _______________
13. Remarks _______________
SIGNATURE OF THE EMPLOYER
Date _____________
MATERNITY BENEFIT ACT, 1961
FORM “L”
(See Rule 16)
ANNUAL RETURN FOR THE YEAR ENDING 31ST DECEMBER 2008
1 | Name of the Establishment | M/S |
2 | Address of the establishment, P.O. District |
3Date of opening the establishment 4Date of closing, if closed 5Postal address of the establishment 6Name of the Employer, postal address of the Employer 7Name of Managing Agent, if any, Postal Address of Managing Agent 8Name of Agent or Representative of employer, Postal address of Representative of Employer
9Name of Manager, Postal address of Manager
10(a) Name of Medical Officer, if any attached to the establishment?
(b) Qualification of medical Officer attached to the establishment
(c) Is he resident at the establishment?
(d) If a part time employee, how often does he pay visit to the establishment? 11(a) Is there any hospital attached to the establishment?
(b) If so, how manyu beds are provided for women employees?
(c) Is there a lady Doctor?
(d) If so, what are her qualifications?
(e) Is there a qualified Midwife?
(f) Has any Crech been Provided?
DATE: –
SIGNATURE OF THE EMPLOYER
Form 35
For the Period ending 30th June ___________
Name of Factory : M/s
Name of Occupier : Mr.
Name of the Manager : Mr.
Men :
Women :
Adults
Men __________________
Women _______________
Childern
Men __________________
Women _______________
31st Dec 2008 during the Half Year _______ Days
Signature of Occupier Signature of Manager
Certified that the information furnished above is to the best of my knowledge and belief, correct.
Date ………………………….. Signature of the Manager
WORKMEN’S COMPENSATION
Return relating to period from Jan-2008 to 31st Dec-2008
State :
District :
Town or Village :
Post Office :
Name of Establishment :
Name of Work :
Average Numbers Employed Per day : ____________________________________
Adults (Men) :
Minors (Women) :
Accidents |
Occupational Diseases |
||||||||||
Number of cases of injuries in respect of which final compensation has been paid during the year | Amount of compensation paid | Number of cases of diseases in respect of which final compensation has been paid during the year | Amount of compensation paid | ||||||||
Death | Permanent Disablement | Temporary Disablement | Death | Permanent Disablement | Temporary Disablement | Death | Permanent Disablement | Temporary Disablement | Death | Permanent Disablement | Temporary Disablement |
Adult |
Minors
Date:……………………… Signature………………………………
Designation……………………………
Note4s: –
MATERNITY BENEFIR ACT, 1961
FORM ‘O’
(See rule 16)
(HIMACHAL PRADESH MATERNITY BENEFIT RULES, 1973)
Prosecution during the year ending 31st December 2008
M/S
Place of employment of the women employee | Number of cases instigated |
Number of cases which resulted in convictionRemarks
SIGNATURE OF EMPLOYER
Dated: _______________________
MATERNITY BENEFIT ACT, 1961
FORM “M”
(See Rule 16)
EMPLOYMENT, DISMISSAL, PAYMENT OF BONUS, ETC., OF WOMEN FOR THE YEAR ENDING ON 31ST DECEMBER 2008
1 | Name of [the Mine or Circus] | |
2 | Aggregate number of women permanently or temporarily employed during the year | |
3 | Number of women who worked for a period of not less than [eighty days] in the twelve months immediately preceding the date of delivery | |
4 | Number of women who gave notice under section 6 | |
5 | Number of women who were granted permission to remain absent on receipt of notice of confinement | |
6 | Number of claims for maternity benefit paid | |
7 | Number of claims for maternity benefit rejected | |
8 | Number of cases where pre-natal, confinement and post-natal care was provided by the management free of charge (section 8) | |
9 | Number of claims for medical bonus paid (section 8) | |
10 | Number of medical claims for medical bonus rejected. | |
11 | Number of cases in which leave for miscarriage [MTP] was granted. | |
12 | Number of cases in which leave for miscarriage [MTP] was applied for but was rejected. |
a) Number of cases in which leave for tubectomy operation under section 9A was granted.
b) Number of cases in which leave for tubectomy operation was applied for but was rejected. 13Number of cases in which additional leave for illness under section 10 was granted 14Number of cases in which additional leave for illness under section 10 was applied for but was rejected. 15Number of women who died
a) Before delivery.
b) After delivery. 16Number of cases in which payment was made to persons other than the woman concerned 17Number of women discharged or dismissed while working 18Number of women deprived of maternity benefit and / or medical bonus under provision to sub section (2) of section 12 19Number of cases in which payment was made on the order of the Competent Authority or Inspector 20Remarks
N.B. – Full particulars of each case and reasons for the action taken under serials 7, 10, 12, 14, 17 and 18 should be given in Appendix below:-
DATE: –
SIGNATURE OF THE EMPLOYER
FORM “XXV”
[See Rule 82(2)]
ANNUAL RETURNS OF PRINCIPAL EMPLOYER TO BE SENT TO THE REGISTERING OFFICER ENDING YEAR ON 31ST DECEMBER 2008
1 | Full name and address of the Principal Employer |
2Name of Establishment
(a) District
(b) Postal Address
(‘c) Nature of operations / industry / work carried on 3Full name of the Manager or person responsible for supervision and control of the establishment 4No. of contractors who worked in the establishment during the year (Give details in Annexure) 5Nature of work / operation on which contract labour was employed 6Total number of days during the year on which contract labour was employed 7Total number of days maydays worked by contract labour during the year 8Maximum No. of workmen employed directly on any day during the year 9Total no. of days during the year on which direct labour was employed 10Total No. of maydays worked by directly employed workmen 11Change, if any, in the management of the establishment, its location or any other particulars furnished to the Registering Officer in the application for Registration indicating also the date
Place: Kumarhatti
DATE: –
PRINCIPAL EMPLOYER
ANNEXURE TO FORM
Name and address Period of Contract Nature of Maximum No. of No. of
Of the Contractor From — to o– Work No. of workers days Mondays
Employed by each worked worked
Contractor
1 2 3 4 5 6
FORM “XXIV”
[See Rule 82(1)]
RETURN TO BE SENT BY THE CONTRACTOR TO THE LICENSING OFFICER
HALF YEAR ENDING ON_______________________
1 | Name and address of Contractor | |
2 | Name and address of Establishment | |
3 | Name and Address of Principal Employer |
4Duration of ContractFrom to
5No. of days during the half year on which –
a) the establishment of the principal employer had worked
b) the contractors establishment had worked 6Maximum number of contract labour employed on any day during the half year:
Men
Women
Childern 7i) Daily hours of work and spread over—
ii) (a) Whether weekly holidays observed and on what day
(b) If so, whether it was paid for—
iii) Number of man hours of overtime worked—
8Number of mandays worked by-
Men
Women
Childern 9Amount of wages paid
Men
Women
Childern 10Amount of deductions from wages, if any-
Men
Women
Childern 11Whether the following have been provided
i) Canteen
ii) Rest Rooms
iii) Drinking water
iv) Creches
v) First Aid
(if the answer is ‘yes’ state briefly standards provided)
Place: Kumarhatti
DATE: –
Signature of Contractor
[FORM D]
[See Rule 5]
Annual return – bonus paid to employees for the accounting year ending on 31.03.2008
1. Name of Establishment and its complete postal M/s
2. Name of Industry M/s
3. Name of Employer
4. Total Number of Employee
5. Number of employees benefited by bonus payments
1 |
2 |
3 |
4 |
5 |
6 |
7 |
Total amount payable as bonus under section 10 or 1 of the Payment of Bonus Act, 1965 as the cas may be | Settlement if any, reached under section 18(1) or 12(3) of the Industrial Dispute Act, 1947 with date | Percentage of Bonus declared to be paid | Total amount of bonus actually paid | Date on which payment made | Whether bonus has been paid to all the employees if not, reason for non payment | Remaarks |
Rs.
|
NIL |
8.33% |
Rs. |
|
Paid to all eligible employee |
NIL |
For
Authorised Signatory
Ref. Date:
To
The Labour Commissioner – Cum-
Chief Inspector of Factories,
Shimla – Himachal Pradesh
Sub. Submission of Annual Return 2008
R/Sir,
Please find enclosed herewith the following documents:
Kindly do the needful and oblige.
Thanking you.
Yours Truly,
For
Authorised Signatory
Click Here To Download Annual return under factory act 1948
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