FORM 1 [See Rule 3 of the Tamil Nadu Payment of Subsistence Allowance Rules, 1981] Register of Employees Placed under

Suspension
Name of The Establishment :

Name and residential Address of the Employer including Managing Agent / Managing Director in-charge of day to day affairs of the Establishment owned by a Body Corporate or Association :

Postal Address:

S.NO

Name and Address of the Employee kept under suspension 2

Monthly Emoluments [wages] paid to the employee 3

Department in which the employee was working last and his Designation 4

Nature of Offence Date of Revocation Date of committed and of Suspension Suspension date of offence 5 6 7

Rate at which subsistence allowance calculated and period for which calculation made 8

Amount of Whether the subsistence Employee has been allowance paid and exonerated or the date of awarded any payment pubishment 9 10

Remarks

Signature of employee with date for receiving money or postal ackowledgement of money order 12

11

FORM NO. 1
[ See Rule (1) under rule of the Tamil Nadu Establishments (Conferment of Permanent Status to Workmen) Rules, 1981]

REGISTER OF WORKMEN (To be Maintained by the Employer of Industrial Establishment)

Whether Temporary, Casual, Badli, or Apprentice (other than those cover under the Apprentices Act 1961) 4

SL.NO

Name and Address of the Workman

Designation of the Workman

Date of First Entry into Service

Date on which he completed 480 Days of Service

Date on which made permanent

Remarks

Signature of the workman with date (to attest the entries)

FORM NO. 17 [See Rule 14 of the Tamil Nadu Factories Rules, 1950]

[IN RESPECT OF PERSONS EMPLOYED IN OCCUPATIONS DECLARED TO BE DANGEROUS OPERATIONS UNDER SECTION 87]
a.) Mr. Name of Certifying Surgeon b.) Mr. c.) Mr. From To 1. Serial No 2. Works Number 3. Name of Worker 4. Sex : Male / Female 5. (Last) Birthday Age 6. Date of Employment on Present Work 7. Date of Leaving or Transfer to other work 8. Reason for Leaving Transfer or Discharge 9. Nature of Job or Occupation 10. Raw Material or by-product Handled 11. Date of Medical Examination by Certifying Surgeon 12. Result of Medical Examination 13. If Suspended from work, state period of suspension with detailed reasons 14. Recertified fit to resume duty on (With Signature of Certifying Surgeon) 15. If Certificate of unfitness or suspension issued to worker 16. Signature with Date of Certifying Surgeon NOTES: 1. Column ( 8 ) - Detailed summary of reasons for transfer or discharge should be stated. 2. Column ( 11 ) - Should be expressed as fit / unfit / suspended

FORM NO. 12 REGISTER OF ADULT WORKERS

SL.NO Name and Residential Address of the Worker 2 Father's Name Nature of Work Letter of Groups as No. Of Relay, if in Form No.11 working in Shifts No. and Date of Certificate if an Adolescent No. Of Certificate and Date 7 Token No. giving reference to the Certificates 8 Remarks

To be marked as follows: 'H' for holidays allowed W/D' for work on double wages W/H' for work with substituted holiday N/E' if not eligible for the wages

FORM NO. VI
[See Sub-rule (1) of Rule 7]

Register of National & Festival Holidays for the year 2008

Name of the Employee Ticket No. or Father's Name
Days, dates and months of the year on which National Festival Holidays are allowed under section 3 of the Tamil Nadu Industrial Establishments (National and Festival Holidays) Act, 1958 (Tamil Nadu Act XXXIII of 1958)

S.NO

10

11

12

Remarks

FORM C
[See Rule 29 of the Tamil Nadu Labour Welfare Fund Rules, 1973] Register of Fines and Unpaid Accumulations for the Year 2008

Name of the Establishment :

Details of Fines and Unpaid Accumulations [1] 1. Total Realisations under Fines Quarter Ending 31st March [2] Quarter Ending 30th June [3] Quarter Ending 30th September [4] Quarter Ending 31st December [5]

2. Total amount being unpaid accumulations of--

(i) Basic Wages

(ii) Overtime

(iii) Dearness allowances and other Allowance

(iv) Bonus

(v) Gratuity

(vi) Any other item of unpaid accumulation 3. Deductions under Standing Orders 4. Deductions under payment of Wages Act

PAYMENT OF WAGES ACT, 1936 WAGES REGISTER FOR THE MONTH OF .. (Prescribed under The Tamil Nadu Payment of Wages Rules, 1937)
No of days of Leave granted with Wages No of Days worked Including paid holidays Earned Wages of Overtime Worked Advance Loan Total Wages Earned Rate of Wages S.No Name of the Employee Designation Date & Signature of Employee [17] Total Deductions Net Wages Paid [16] Provident Fund Earned Wages

Rate of Normal Wages [4]

Dearness Total Wages Allowance [5] [6]

[1]

[2]

[3]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

E.S.I.C

[14]

[15]

INSPECTING OFFICER'S REMARKS

Name and address of the Factory: Name of Proprietor / Occupier :
Date and Time of Inspection Date Time Inspection Remarks Designation and Signature of Inspecting Officer

nd Signature of ng Officer

Factory Name and Address:

[1] [2] Date & Hour of Accident [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] Exact Place in the Factory (Branch, Department, Machine Etc.) Where the accident Occurred A full clear Description of how the accident occurred Nature, extent, location, etc., of injury received Date of despatch of report in Form No.18 Date of return to work of person injured Date of Despatch of report to the Inspector of the date of return to work of the person injured Date of despatch of subsequent reports in Form No.18 B No of Days the person injured was away from work No of Man-days Lost Details of disablement and loss of earning capacity if any Remarks and initials of Manager Name and Designation of Person Injured

Running Sl.no of the Accident for the Calendar Year

FORM NO. 26

[Prescribed under Rule 104 of the Tamil Nadu Factories Rules, 1950] Register of Accidents for the Year __________ Regn. No of Factory Rule :

FORM NO. 26-A

[Prescribed under Rule 104 of the Tamil Nadu Factories Rules, 1950]
Name and Address of the Factory : Registration No. of the Factory :

REGISTER OF DANGEROUS OCCURENCES

Running Serial Number of the Dangerous Occurences in the factory for the Calendar Year [2] Exact Place in the A full clear Factory description of the Details of ultimate damage (branch,department dangerous Date of despatch or loss with value thereof ,plant,equipment,et occurrence, the of Report in Form and of repair, replacement, c.) where the damage caused and 18-A reconstrction etc., with cost dangerous steps taken to arrest thereof occurences took further damage or place danger, etc. [4] [5] [6] [7] Calendar Year

Date and hour of Dangerous Occurrence

Remarks and initials of the Manager

[1]

[3]

[8]