revoked
1 2
21.S3J\:AUGU8T?~1980 (SRAVANA 30~ 1905)
No. and date
No. and date of crossed deof the crossed
mand·draftof
demand draft· of Afu.o~nt 1>1 Amount of the ba,laIicesecurity depo!lit pre;vious secusecurity deposit security deposit
in ~sPeCt of rity deposit , . fo~ tiliefresh '
•depoSited with the~previous the fresh appli
licence
): 'jIid!nCe
: . cation "'; ~" •..:,;<.',
6 J 8
\(-~": ;,' :;;;~ G:·,~:'::~'<~l N&.a·and da.t~
~";J:, :~, .~>r·)·
i /; '.~:~_rJ:·:)'ir r~tratioli. of. Name ;md
of certificate of
the l!stablishmeJ'rt address of the Particulars of 1.
in .relation to principal emfresh appliRemarlts which the fresh ployer Cation
licence is '!-pplied for
9 , 10 12
'i';;'" I.' L0'i':..
!J, I \. ~
PI~: ( Sigp.ature of applicant Date:
F0RM VIII
\. [See \rul~ '11(1)]'
".... G6Vi:RNMENr OF INDIA
:,',
Office of Licensing Officer
(il'
(.L bJ..· :.. '
Licence lIT(). . .. Dated ... Fee paid Rs.
LICENCE
Licence is .hereby granted to .., un4er section 8~(i) of the :rnte-.r"'State ~grant,:Wor1pnan (Regulationiof Employment and Conditions )j~£: ,8ervice) ACt; 1979, 'subject MCTh¢coonmtions specified in the Annexure. ",n ..
Ii':' ,. : :. .• . ',i'
2.,!I'his licence' is for doing the work of (nature of" work to be indicated) in the establishment of (name of principal emP,19Yerto.ge indicated) at(I>~~~e. of work to be indicated).
3. The licence shall remain.info:rce till (date to be indi
ca~e4).
Signat)l~~:#~ Sel;lrof Licensing Officer
: RENEWAL
[Seerul~14j
Date of renewal Fee paid for renewal Date of expiry
0:1' ri.
-
-
3:
Date Signature ,and Seal. of the Licensing Officer
ANNEXURE
The licence is subject to the .following conditions:
1. The licence shall be nori!triuisferabl~;'
:i ."'2:" ·The number of workmen employed as migrant work'meri ifi the establishment shall not, on any day, 'exceed the maximumtl~ber specified in the appli
cation for licence. . . .." .
;;:;);~ave;aspro'V~dedin' fllese'rules the" ~eespaid\ for tIfe'griwt':or aStlie;cas~maybe: if6r"rimewal,,·ofliceila;J'$lifiun~bE!:)ru,ri"'reiftin(bi1!ile~ i',,};,"',i': ..,;' .I,.
4 •. The rate/:! ()fyv. ag.e.s Fayab~~.t.O
by the contractor s~alL nott prescribed under l:he.Minimum such ..erhploymentw::!1eteappH ..' rates have.been fixed. by. agreement,award; :hot less than the~ raites,'sGfixecL .
.. 5.' (a:) incases'where th~ migrant ~W6rRm.enerilplaYed by the contractor perform the same:jjlt;:$imil!U' kind of work l:tsthe ~orkIll~n.9irec.tly:, IOled . 'by the Principa:lEinployer <:ffthee'Sft1: i'lnt, the wage rates, holidays, hours of and other conditions Q,f,..../:!e.rvice o,f . migrant worJ,qnen of. the cQlirta:q~o.t; sha~; th ,;,.~ as applicable to the workmen yed by the Principal Employer o~.the ent on the same !.of or simUar kind
C:,:',: .'
Provided that in the case of any disagreem!Ont with regard to the type of wO:rk, the salne shall be decided by tlie Deputy Chief L~bour Commissioner (Central)
~hose dE1cision ,~~~11 be .. final. J •
y; .(b) ln o~er. cases th,e'~E;e r1i~~~, hol.. i.da.vs. of work and cond~tiol;ls.of ..servrc!:. '1f mitlt!!'ll.nlt workmen of the: contractor shaJl ;'e as
(;' prescribed (in the~e rules.
6. Every migrant workman shall be entitled allo'\i,.ance, benefits, facilities, etc., as prescribed in the Act and these Rules.
by
J. ,No female migrant WOrltman shall be
. ·,ariYcontl'actOI'·,before 6 a:J.11.' or after
Provided that this clause shall not apply to the employment:of female migrant workman in Pit head Baths, Creches and Canteens and as Midwives and Nurses in hospitals and dispensaries.
8. The contractor shall notify any change in the number
of migrant workmen or the conditions of to . the licensillg officel,'.·
t
9. The contr~ctor shall co~plY with all the provIsions ·of the Act and, these Rules.
\'.-;.. ,
10. A copy of the licence shall be displllyed prominently at tll.e premises where the migrant workmen are empioyed.
FORM IX
1\
[See rule 15(2)] "
.',: . Applicatio.p, for R~ewal of .Licrn~
-
Name andacldress of the contractor.
-
Number and date of the licence.
-
Date of expiry of the previous licence.
4. Wh~ther the licence of thecontractQ~ was suspended
or revoked. ' . . '. .
5. Number and date of the crOSsed dem'ant1 draft erielol;ed.
Place ... Signature of the Applicant
Date ..•.
(To be filled in the Office of the Licensing Officer)
Date of receipt of the application with crossed demand draft No. and date.
Signature of the Licensing Officer
FOIU\f X
[See rule .21)
[Form in which to furnish particulars in respect of
recl'1Ji,t;IIl~ntlll1d eIIlployment 0:( migrant workman/workmen".M.' pres<;r~pe~, tlM~r'sub-rule(l) pf Rule 21,' to tll~ autliori, tie8~pecifiedtfuder the. explanation below I:\ub·section' (2)of secti~h ,.l;~; qftnter~'State MigT!tnt w~rknien(Regulatidn of Employment'iandConditi6nscif Services) Act, 1979])':
1. Name and 'address' of tlie Contractor ;" ,."
BERIES 1 No. 21
"::2~."~aJne Sfdaddress of the sub"cQntractor th~ough'whom .. ~ recruitment has been made '" . .
. ·S•. Name~d apdress of the establishment •..
4. Name.8.ndaddress .of the !"rincipalEmployer, ~. Name"of.. :the State in which the, place of· ,work is
located... . .
6. Name .of the State in which recruitment was made
Name of Father'sl
Permanent
.:;11. No. Dligrant Husband's Sex Age
.home address
workirian .name
'2 3 4 5 G
Name and Place and
address of the ~.A.tnount of AIDount of next of kln'.of displacement outward journey
address of ~i,~~Iii'the
themi~t allowance paid allowance paid
/ home State
workiri~>'
-
Name and address of the sub"-contractor thlWU[l;h recruitment has been made ., .
-
Name and address of the establishment, :4. Name ~({ad.dress; (If the prfuCipal Em~ioyer
-
Name of the State in which the place of located ...
-
Name of the state in which recruitment was mad~) ..
Name of Father'sl SI. No. migrant Husban(J.'s Designationworkirien name
1 2 3 5
,-="'=-""''''''''''''''''''
Place and
Perma.:IlIlnt Date on
address of
home address Date of which
residence
Indicating Employment ceased to
In home
the State be employed
State
c'r
8 9 10
./,
/'~'
Amount of
"wages fc:irQu~, Nature of job Date of Date of ward journey recruitment employment
.' required to.be period paid'
performed
U 12 13 14
,,Detalls of rates of wages and Details of
Period of
contract of
other allowances other service 'Remarks
employment
p?,yable, conditions
16 17 18
Signature of Contractqr or his authorised 'representative
Date ... SUbmitted to
(1)
(Specified authority in the State' in which migrant workman/workmen is/are employed).
(2)
(Specified authority in the State from, . which the migrant workman/workmen has/have been recruited)
Copy fOtylarded to (The Principal Employer)
) Signature of the: Contractor or his authorised repx:esentative.
Date ...
Note: In case where migrant workmen concerned havebOOn recrUi'tea' from more than one States, separate returns shall be submitted in respect of each such State.
FORM XI
[See rule 24]
[Return', to be sent by the Contractor to the authorities .speeifjed~der explanation belqw sub-section: (2).9f sec.non 12 of Inter-.~tate MigrantWorlmlen (R;egulation of
Employment anddonditions ·of Servtce).Act, 1~79] .
1. Name and address of the contractor
--~"-"~'"'.-,,~
7 8 9 10
__'_'"''''''''''_'''''ffi'''''-'''
Amount of Amount of Details of outward return rate of journey journey
Amount of displacement
wages and allowances allowance
allowance
other allow-and wages and wages
paid
ances paid for outward for return journey paid journey paid
12 13 14 15 li
. Details 01; Amount ofcompensa-Amount of Amount of advance, if
tion and deductions, adv~ce, if Remarks
any
reco~
other allow-if ~y any paid ances
vered 17 18 19 20 211
----.--
DECLARATION
I/we hereby declare that all wages, other dues including displacement allowance, outward return journeys allowances and wages for journeys periods payable to migrant workman/ /workmen names above and employed by me/us have been paid by me/us/to him/them.
Place
|
.. .
|
Signature of the Contractor or his
|
Date
|
.. .
|
authorised representative
|
.Submitted f.o
|
|
(1)
(SpeCified authority in the State in which migrant workman/workmen is/are employed)
(Specified authority in the State from which the migrant workman/workmen has/have been recruited).
Copy forwarded to
(The PrinCipal Employer)
Signature of the Contractor or his authorised representative
Date ...
Note: In 'cas(l where migrant workmen concerned have . been recruited froin more than one Stat(l, seJ;larate returns shall be submitted lprespect of eachsuchSt~te:; .
21ST AUGUST, 1980 (SRAVANA 30, 1902)
...-~-.-.----~
Name and address of Month andFORM XiI the Principal
[See rule 48] Employer ... Register of Oontractors
Permanent home
Name of the miFather's/Husaddress indicating
(1) Name and address of the Principal Employer S1. No,
grant workman band's name the State
(2) N:ame and address of the establishment .,.
Period of con-Maximum No. Name and Nature of Location of tract of migrant
address of· work on
contract workmen·work employed by
contractor contract from to contractor
-----------......,---------~~.--.-
5 6 7
FORM XIII Railway sta~
Place of work tion/bus standPlace of re. with address
[See Rule 49] nearest to the
cruitment indicating the place of
Register of Workmen Employed by Contractor State residence
Name and address of Name and address of 9 10 11 Contractor ... establishment in/under which migrant work
Name and address of
·men are employed .. ,
the establishment Name and address of
Details of Principal Employer ... modes of jour
Date and time Expected date neys from the of commence. and time of place of resi. Permanent ment of journey arrival at the dence in the HOffie from the place place of worlr home State to Name and Address of residence the place
Father's/ Nature of
SUl'Hame of Age and of migrant of work
Sl. No. Husband's employment/
rr' \~ant sex workmen
I name designation
-workman (village and -----------_._----_._
.--.~.-.
Tehsil/Taluk 13 14 15 and District)
1 2 3 4 5 6
------------,-------~-,~--
Total of Amount of dis
amounts indica-placement allo-Amount of.
ted in column wance outward jo'urneyDate of Signature
or thumb-Date or no. 16 Rs. Ps. allowance
commence
Local ment of -impression termination Reasons for Remarks -----------------------------_.----.
Address eItJ.ploy_ of migrant of employ-termination 17 18 19 20 ment workman ment ----------..-
7 8 9 10 11 12
Signature or Actual date Total Amount Date .on which thumb impres-and time of paid paid sion of the mi_ arrival at the grant workman place of work
Signature of Contractor or his authorised representative 21 22 23 24
FORM XIV Balance wages Date of payment Signature or for outward of the balance thumb impres
[See Rule 50]
journey if any, wages indicated sion of the mig-Remarks payable in Col. No. 25 rant workman
Service Certificate
------~------.
25 26 27 28
Name and address of Name and address of Contractor ... establishment in/under Nature ahd location of which migrant work
work : .. men are emplQyed ...
Note: Indicate separately different mode of journeys.
Name and address of
Name and address of the Entries are to be made against each individual migrant
migrant workman .. . Principal Employer ..,
workman. Age 9r Date of Birth....
Signature of the Contractor or his authorisedIdentification Marks ...
Representative
Father's/Husband's name ." Date ... Rate of
Total period for wages (with
which employed_ particulars)
S1. No. _______ Nature of
Remarkswork done of unit in
FORM XVI
From To case of piece-work
[See rule 51(1)] 1 2 3 4 5
Return Journey Allowance Register
Signature of Contraotor or his Name and Address of the Name and Address of the authorised representative Contractor Establishment ...
Name & address of the Month and Year ... Principal Employer ... FORM XV
[See Rule 51(1)] Place & address
Name of Father's/ Permanent home of residence DiSPlacement and outward Journe/'"allowa:nces sheet SI. No. the migrant Husband's address indica-in the home
workman name Hng the State State Narrieand address of ./!,~e and address of the
1 2 3 4 5
the Contractor ." establishment ... .
200.
Railway St&tion/bus standDesignation Rate of wages Place of work
nearest to the place of wo'rk
6 7 8 9
:,'
Railway staHon/bus sta.nd ne,arestc to the place of residence in the ,home State
|
Date and time of'commencement of journeyfrom the placeof work
|
Expected date and time of arrival at the residence in home State
|
Expected modes of journeys·from the place of work to place of,residence in the home State
|
w.___________ __
|
|
|
10
11 12 13·
Amounts of bus
fare and/or
-.-seeond·-class.,'-,
train fare andl
or other jour~
"
Total amounts Amount of Wages for re'separate(yas
ney .expenses,
indicated in return journey turn journey per expected
column No, 14 allowance period modes of jour'n'eyS indicated'
in column
No. 13
l' 15 16 17
|
|
Signature or
|
|
|
|
thumb lmpres
|
|
Total amount
|
Date on which
|
sion of the
|
Remarks
|
. paid .
|
. paid
|
migrant
|
|
|
|
workman
|
|
18. 19 ~o 21
I,.
,$ Indicate separately differtmt modes of journey.
". Note: Entries are to be made against each individual inter~Statemigrant workman.
Signature of the Controller or his authorised Representative
Date ...
FORM XVII
[See rule 52(2) (a)] Muster Roll
Name and Address of ConName and Address of Estatractor ... blishment in/under which migrant workmen are em
N:!liture',' a,nd Location of
ployed... '
work Name and Address of Principal Employer ...
For the month of
Name'of Dates
Father's/Hus-Sex
S1. No. migrant -----'---Remarks
band's name
wor~~n 1 2 345
FORM XVIII {See rule 52 (2) (a)] R~gister of 'Wages
N.ame and Address of ConName and Add'ress of Estatractor .., blishment in/under which
.... _.._-----.--~----
Nature and Location of work inter·State: men are Name and A.ddress cipal Employer Wage period .,'
Serial No. in the
Sl Name of inter-State
register of
. No. migrant wOJ;kman
workmen
1 2 3
Amount
Daily.rate of
No. of days Units of work
wages/piece
worked done Basic
ra.te
5
wages earned
-----------------.-...
Other cash pa.yments (Nature Dearness allo-Overtime of payment to
wance be :indicated)
9 10 11
Deductions, if any (indicate nature)
|
Net amount paid
|
workman
|
13
|
14
|
15
|
16
|
FORM XIX [See rule 52(2) (c)] Register of Deductions for Damage or Los!!; Name and Address of ConName and Address of Esta..
tractor ... blishment in/under which inter-State migr&"lt work
Nature and Location of work men are employed. .,_
Name and Adress of Prin.. cipal Employer ._,
--".-....,.,.....,.,.....,,-=,..
|
81. No.
|
Name of inter-State migrantworkman
|
Father's/Husband's name
|
Designation/ /Nature of employment
|
Particulars of damage or loss
|
|
|
|
|
-------.
|
1
|
2
|
3
|
4
|
5
|
Whether inter-Name of person-State migrant in whose pre-Amount of deDate of damage workman showed sence employee's duction im
or loss causes against explanation posed deduction V;'aB heard
6 7 8
Date of recovery
Remarks
No. of instal
ments First instalment Last instalment
12 13
10 11
FORM XX [See rule 52(2) (c) Register of Fines
Name and Address of Name and Address of EstaContractOl' ... blishment in/under which inter-State migrant work
Nature and location of work _.,
men are employed .. _
Name and Address of Principal Employer .. _
Sl N Na:ne of inter-Stare' Father's/Hus-Designation/Nature
• O. mIgrant workman 're_"".-b_a_n_d_'s_n_a_m_e____o_f_e_m_p_l_O_y_m'-en_t__
1 2 ...., B
218P AUGU8T~ 1980 (SRAVANA 30, 1902)
------------._----------_•._-----
Whether interName of person Act/Omission _State mig-rant in whose prefo-rwhich .fine Date of ofl'ence wodonan sence employee's
. ~Inposed showed cause e",planation against fme was heard
7 6 7 8
Wage periods
Amount of fine· Date of which
andw!iges Remarks
imposed fine Irealised
Payable
9 10 11 12
FORM XXI [See rule 52.(2) (c)] Register of Advances
Name and' Address'of .' Name and Address of EstaContractor ... blishment in/under which inter-State migrant work
Nature and locatioo of work ...
men are employed ... Name and Address of Principal Employer ...
Nature of Wage pe_ Date and
Name of iinter-Father's/Hus-employ-riod and amount of
81. No. -State migrant band's name ment/De-wages pa-advance workman signation yable given
,
1 2 3 4 5
No. of ins
Purpose(s) Date and Date on
talments by
fOT which amount of which last
which ad-Remark!!
advance each instal-instwlment
v3.l1ce to be
made ment repaid was repaid
repaid 7 8 9 10 11
FORM XXII [See rule 52(2)(d) j Register of Overtime
Name_ and Address of Name and Address of EstaContractor ... blishment in/under which Nature and locatioo of work .. , migrant .workmen are
employed ...
Name and Address of Principal Jl!mployer ...
Name-of inter-Designa-
Father's/HU8-tion/Nature workman
81. No. -State mig-rant Sex,
band's name of employment
1 2 3 4 5
Date on whiCh Total overtime worked. or pro-Normwl rates overtime worked duction in case of piece-rated of wages
7 8
6 J
~-------------------------------------------
Overtime rate of wages
|
Overtime earnings
|
,{;
|
Date on which overtime wagespaid
|
Remark.
|
-----------------------~
|
|
|
9
|
10
|
11
|
12
|
FORM XXIII [See rule 56(1)] Return to be sent by the Contractor to Licemri.ng OlficeI
Half-Year Ending ........... L Name and address of the Contractor:
2. Name and address of the establishment. 3, Name and address of the Principal Employer' 4, Duration of contract: From .,. to
5. No. of days during the half year on which
(a) the establishment of the principal had worked ...
(b) the contractors' establishment had
-
Maximum number of i-!Jlter-State migrant employed on any daycluring the half-year: Men . Women Children Total
-
(i) Daily hours of work and spread over.
(ti) (a) whether weekly holiday observed day:
(b) if so, whether it was paid for:
(iii) No. of man-hours of overtime worked:
-
Number of mandays worked by: Men Women Children Total
-
Amount of wages paid: Men Women Children Total
Note: -Wages shall not include wages for outwards and return journeys.
10. Amount of deductions from wages, if any: Men Women Children Total
11. Amount of displacement allowance paid: Men Women Children Total
12. Amount of Outward journey allowance paid: Men Women Children Total
13, Amount of wages for outward journeys period paid; Men Women Children Total
14. Amount of return journeys allowance paid: Men Women Children Total
15. Amount of wages for return journeys period paid: Men Women Children Total
16. Whether the following have been provided:
(i) Residential accommodation;
(ii) Protective clothing;
(iii) Canteen;
(iv) Rest-room;
(v) Latrine and Urinals;
(vi) Drinking water;
(vii) Creche;
(viii) Medical facilities; (!x) First Aid.
(If the answer is "yes' state briefly nature/standards provided). Place .. . Signature of Contractor
Date .. .
FORM XXIV [See Rule 56(2)] AnmJal Return of Principal Employer to be lient to the Registering Officer
Year ending 31st December 1, Full name and address of the Principal Employer: 2, Name of the establishment:
(a.) District:
I
202
(b) Postal Address:
(c) Nature of operation/industry/work carried on:
-
Full name of the .Manager or person responsible for supervision and control of the establishment.
-
Number, of contractors who worked in the establishment duririg'the year (Give details in AIIDexure) ,
-
Nature of work/operations on which Migrant workman was employed.
-
Total'iullnber' of days during the year on which migrant workman was employed.
7~ Total number of mandays worked for by migrant work· man duriD.g the'year.
-
'MaximUm number of workmen employed directly on any day duringthe year.
-
Total num~r of days during the year on which direct labour was eIllploye4.
-
Total number of mandays worked by directly employed workmen.. '
-
Change, if any, in the management of the establishment, its location, or any other particulars furnished to the
Registering Officer in the appHcation for Registration cating also the dates.
Pilice ... Date ",
ANNEXPRE TO FORM
Period of contract
Name and Address
Natureof the contractor To
From
-----:-1--------2-------'---·,--'-'---'
4 .5
[No, S. 16027/10;
R. KUNJITHAPADAM,
_'.r:·'''·
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