Muster Roll Cum Wage Register

Factory F. No. 17,29

Factory Rules 122,99 Month
Name of Establishment :- Name of the Employer : Year

Interval for Rest or meal

Nature Of Work & Designation
Date Of Entry In to Service
Work ing Hours
HOURS WORKED ON
ESIC NO.

Age & sex

Sr. No.

Full Name of the PF.No.

Employees

From

From
To 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

To
1 2 3 4 4(a) 5 6 7

4
 5

Note :- The Actual No Of Hours Worked On Each Days shall be marked Mark ' H ' shall be made in coloumn reating any
day on which weekly holiday is given and " A " or on leave " L " if employee is absent or on leave as the case may be.
0
0
0
0
Total

4
3
2
1
Sr. No.

0
0
0
0
Employees
Full Name of the
Name of Establishment :-

0
0
0
Toal Days in Month

8
Total Days Worked

OT HRs

9
10 Gross Wages

Earned Basic
11

Earned HRA
12

Earned Salary
13

Overtime earning
14

other
15

Gross Wages payable

Professional Tax

Advance

Employees State
Insurance
16

Provident Fund
Deductions

MLWF
Muster Roll Cum Wage Register

Other Diduction of
permissible & nature

Total Deduction

Net Wages paid

17

Pre. Bal. Accumulated

18

further enjoied & or

wages

refused
Leave with
M.W. Form 1
0 5 0 0

0 6 0 0

96130 Signature of the employer or the person authorised

by him to authinticate the above entries
Cum Wage Register
M.W. Form 11 Rule - 27(I)
Month

Year

Date of payment of wages

Sign or thumb of employee

19 20
Signature of the employer or the person authorised
by him to authinticate the above entries