Attaching Form T (Muster roll & Wage register format ) under Karnataka S & E Act.
|1[Form – T|
|COMBINED MUSTER ROLL CUM REGISTER OF WAGES|
|[See Rule 24 (9-B) of Karnataka Shops & Commercial Establishment Rules, 1963]|
|in lieu of|
|1. Forms I & II of Rule 22(4); Form IV of Rule 28(2);Forms V and VII of Rule 29(1) and (5) of the Karnataka Minimum Wages rules 1958.|
|2.Form I of Rule 3(1) of the Karmataka Payment Wages Rules,1963.|
|3. Form XIII of Rule 75;Forms XV,XVII,XX,XXI,XXII and XXIII of rule 78(1)(a)(i),(ii) and (iii) of the Contract labour ( Regulation and Abolition) (Karnataka ) Rules,1974|
|4. Form XIII of Rule 43;Forms XVII,XVIII,XIX,XX,XXI and XXII of Rule 46(2)(a),( c) and (d) of inter State Migrant Workmen( Regulation of Employment and Conditions of Service)Karnataka Rules, 1981|
|Month / Year||Name & address of the employer:|
|Name & address of the establishment:|
|S.No||Building Name||Location||Emp ID||Name of the employee||Father / Husband Name||Male/Female||Designation / department||Date of joining||Date of Birth||Date of Leaving||ESI No.||PF No||Wages fixed including VDA||Leave date From||Leave date to||No. of days leave taken||Type of leave||No. of payable Days||Total OT hours worked||Month / Year||Net Payable||Mode of payment Cash / Cheque No.||Employee signature / Thumb impression|
|Earned wage and other allowances||Deductions|
|Basic||DA/VDA||HRA||Conveyance||Med. Allowance||Attendance bonus||Special Allow.||OT||NFH||Maternity Benefit||Others||Subsistance allowance if any||Leave Encashment||Total||ESI||PF||PT||TDS||Society||Insurance||Sal. Adv.||Fines||Damages / Loss||Others||Total|
|HS||Half Sick Leave|
|HC||Half Casual Leave|
|HP||Half Previlage Leave|
|LOP||Loss of pay|
|NFH||National Festival Holiday|
|WFH||Work From Home|
|OD||On Duty (On site job / On duty job)|
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I have attached format of Form 11 (See Rule 27) (1) Muster Roll Cum Wages Register.
(FOR UNEXEMPTED ESTABLISHMENTS ONLY)
THE EMPLOYEES’ PROVIDENT FUND SCHEME, 1952
THE EMPLOYEES’ FAMILY PENSION SCHEME 1971
Declaration by a person taking up employment in an establishment in which the Employees Provident Fund and Family Pension Fund Scheme are in Force.
I, ____________________________________son/wife/daughter of Shri / Smt. _________________________ do hereby solemnly declare that
(a) I was last employed in M/s _________________________________________________________
(Name & full address of the establishment)
and left services on _______________________________________(Prior to that I was employed with
M/s____________________________________ from _______________to ______________
(b) I was a member of _____________________________________________Provident Fund and also of the family pension fund from ________________________to ___________________and my account number(s) was / were ___________________________________________________
(c) I have / have not withdrawn the amount of my Provident Family Pension Scheme.
(d) I have / have not drawn superannuation benefits in respect of my past services from an employer.
(e) I have never been a member of any Provident fund and / or Family Pension Scheme.
Date ___________________________ Signature or right / left hand thumb impression of the employee.
(To be filled in by the employer only when the person employed had not already been a member of the Employees’ Provident Fund)
Shri_______________________________________ is appointed as _______________________________
(Name of the employee) (Designation)
(Name of the Factory / establishment)
with effect from ______________________________.
(Date of Appointment)
Date_________________________ Signature of the employer or Manager or other authorized Officer
N.B.: The Principal employer should have filled it up also n respect of employees to be employed by through a contractor.
Search Sample Formats:
I have Attached Register Of Wages Cum Muster Roll
|Name and address||FORM XVIII [See Rule 78 (2) (a)]||Name and address of establishment|
|of Contractor :||FORM OF REGISTER OF WAGES – CUM – MUSTER ROLL||in/under which contract is carried on|
|Wages Period : MONTHLY|
|From : 01/03/2012 To 31/03/2012||Name and address of Principal employer|
|Nature and Location of Work: :|
|SERIAL NO||SL No.in register of workmen||NAME OF WORKMAN /
|Designation /Nature of Kork||Daily attendance units worked||Total ayttendaceunits of worked done||Dailyrate/wagespiecerate||Amount of wages Earned||Deduction of ESI 1.75%||Deducton if any (indicate nature) PF 12 %||Net Amount paid||Sig / Thumb impressin of workmen||intial of contractor on his Representative|
|Amount of wages Earned||D A||Over time||others cash payments||Total|
|1||1||RAKESH SINGH (ESI NO:5900033272)||SSK||P||P||P||P||P||P||PH||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||P||27.0||171.50||4631.00||270.00||4901.00||86.00||588.00||4227.00|