{"id":7508,"date":"2012-09-28T05:39:42","date_gmt":"2012-09-28T05:39:42","guid":{"rendered":"http:\/\/www.yourhrworld.com\/formats\/?p=7508"},"modified":"2019-08-22T10:15:13","modified_gmt":"2019-08-22T10:15:13","slug":"forms-for-maternity-benefit-act-1961","status":"publish","type":"post","link":"https:\/\/www.yourhrworld.com\/formats\/hr\/forms-for-maternity-benefit-act-1961\/","title":{"rendered":"Forms Required to be Maintained Under Maternity Benefit Act 1961"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong>Please find attached the Form A &amp; annual return Form KLMN as per Haryana government rules.<\/strong><\/p><div class=\"69eb924294c115e6505da44099e8df92\" data-index=\"1\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<script type=\"text\/javascript\"><!--\r\ngoogle_ad_client = \"pub-0867779017855679\";\r\n\/* 300x250, created 4\/20\/11 *\/\r\ngoogle_ad_slot = \"1035864135\";\r\ngoogle_ad_width = 300;\r\ngoogle_ad_height = 250;\r\n\/\/-->\r\n<\/script>\r\n<script type=\"text\/javascript\"\r\nsrc=\"http:\/\/pagead2.googlesyndication.com\/pagead\/show_ads.js\">\r\n<\/script>\n<\/div>\n\n<p><strong><br \/>\n<\/strong><strong><\/strong><\/p>\n<p style=\"text-align: justify;\"><strong><br \/>\n<\/strong><\/p>\n<p align=\"center\"><strong>FORM \u201cA\u201d<\/strong><\/p>\n<p align=\"center\">(See rule 3)<\/p>\n<p align=\"center\"><strong>Muster Roll<\/strong><\/p>\n<p align=\"center\"><strong>&nbsp;<\/strong><\/p>\n<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Name of the Establishment&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <strong>M\/S &nbsp;<\/strong><\/p>\n<p><strong>&nbsp;<\/strong><\/p>\n<ol start=\"1\">\n<li>Serial Number<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<ol start=\"2\">\n<li>Name of the women and her father\u2019s&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Mrs. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;W\/o Mr. Arun Bajaj<\/li>\n<\/ol>\n<p>(or if married husband\u2019s name)<\/p>\n<p>&nbsp;<\/p>\n<ol start=\"3\">\n<li>Date of appointment&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 03\/04\/20<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<ol start=\"4\">\n<li>Nature of work&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ??\/<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<ol start=\"5\">\n<li>Date with month and year in which<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<table width=\"720\" cellspacing=\"0\" cellpadding=\"0\" border=\"1\">\n<tbody>\n<tr>\n<td width=\"73\" valign=\"top\"><strong>Month<\/strong><\/td>\n<td width=\"165\" valign=\"top\">No. of days employed<\/td>\n<td width=\"141\" valign=\"top\">No. of days laid off<\/td>\n<td width=\"179\" valign=\"top\">No. of days not employed<\/td>\n<td width=\"162\" valign=\"top\">remarks<\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">JAN<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">FEB<\/td>\n<td width=\"165\" valign=\"top\">28<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">MAR<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">APR<\/td>\n<td width=\"165\" valign=\"top\">30<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">MAY<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">JUN<\/td>\n<td width=\"165\" valign=\"top\">30<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">JUL<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td rowspan=\"4\" width=\"162\" valign=\"top\">20&nbsp;&nbsp; (on MaternityLeave w.e.f31&nbsp;&nbsp;&nbsp;&nbsp; 12nd July 07<\/p>\n<p>30&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; to 9<sup>th<\/sup> Oct07)<\/p>\n<p>09<\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">AUG<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">SEP<\/td>\n<td width=\"165\" valign=\"top\">30<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">OCT<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">NOV<\/td>\n<td width=\"165\" valign=\"top\">30<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<tr>\n<td width=\"73\" valign=\"top\">DEC<\/td>\n<td width=\"165\" valign=\"top\">31<\/td>\n<td width=\"141\" valign=\"top\"><\/td>\n<td width=\"179\" valign=\"top\"><\/td>\n<td width=\"162\" valign=\"top\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>6.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date on which women gives notice under section 6<\/p>\n<p>&nbsp;<\/p>\n<p>7.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date of discharge or dismissal, if any<\/p>\n<p>&nbsp;<\/p>\n<p>8.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date of production of proof of pregnancy under section 6<\/p>\n<p>&nbsp;<\/p>\n<p>9.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date of Birth of child :&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;18\/07\/2007<\/p>\n<p>&nbsp;<\/p>\n<p>10.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date of production of proof of delivery of miscarriage<\/p>\n<p>of death<\/p>\n<p>&nbsp;<\/p>\n<p>11.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date of production of proof of illness referred to in<\/p>\n<p>section 10<\/p>\n<p>&nbsp;<\/p>\n<p>12.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date with the amount of maternity benefit paid in<\/p>\n<p>advance of expected delivery<\/p>\n<p>&nbsp;<\/p>\n<p>13.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date with the amount of subsequent payment of<\/p>\n<p>maternity benefit .<\/p>\n<p>&nbsp;<\/p>\n<p>14.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date with the amount of medical bonus, if paid under<\/p>\n<p>section 8.<\/p>\n<p>&nbsp;<\/p>\n<p>15.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date with the amount of wages paid on account of<\/p>\n<p>leave under section 9.<\/p>\n<p>&nbsp;<\/p>\n<p>16.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date with the amount of wages paid on account of<\/p>\n<p>leave under section 10 and period of leave granted.<\/p>\n<p>&nbsp;<\/p>\n<p>17.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Name of the person nominated&nbsp; by the women under<\/p>\n<p>section 6.<\/p>\n<p>&nbsp;<\/p>\n<p>18.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If the women dies, the date of her death, the name of the<\/p>\n<p>person to whom maternity benefit and or other&nbsp; amount<\/p>\n<p>was paid , the amount thereof and the date of payment.<\/p>\n<p>&nbsp;<\/p>\n<p>19.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If the women dies and the child survive the name of the<\/p>\n<p>person to whom the amount of maternity benefit was<\/p>\n<p>paid on behalf of the child and the period for which<\/p>\n<p>if was paid<\/p>\n<p>&nbsp;<\/p>\n<p>20.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Signature of the employer of the establishment<\/p>\n<p>authenticating the entries in the must Roll.<\/p>\n<p>&nbsp;<\/p>\n<p>21.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Remarks Column for the use of inspector;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>&nbsp;<a href=\"https:\/\/www.yourhrworld.com\/formats\/wp-content\/uploads\/2012\/09\/Forms-for-Maternity-Benefit-Act-19611.doc\">Click Here To download annual return form KLMN<\/a><\/strong><\/p>\n<p><strong><a href=\"https:\/\/www.yourhrworld.com\/formats\/wp-content\/uploads\/2012\/09\/Forms-for-Maternity-Benefit-Act-1961.doc\">Click Here To download Form for maternity benefit act 1961<\/a><\/strong><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Please find attached the Form A &amp; annual return Form KLMN as per Haryana government rules. FORM \u201cA\u201d (See rule 3) Muster Roll &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Name of the Establishment&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; M\/S &nbsp; &nbsp; Serial Number &nbsp; Name of the women and her father\u2019s&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Mrs. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;W\/o Mr. Arun Bajaj (or if married husband\u2019s name) &nbsp; Date of appointment&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 03\/04\/20 &nbsp; Nature of work&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ??\/ &nbsp; Date with month and year in which &nbsp; &nbsp; Month No. of days employed No. of days laid off No. of days not employed remarks JAN 31 FEB 28 MAR 31 APR 30 MAY 31 JUN<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[45],"tags":[1596,541,982,174,1595],"class_list":["post-7508","post","type-post","status-publish","format-standard","hentry","category-hr","tag-act-1961","tag-benefit","tag-for","tag-forms","tag-maternity"],"yoast_head":"<!-- This site is optimized with the Yoast SEO 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