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 Establishmen

Postal Address:by a Body Corporate or Association :

S.NO Remarks

1 2 3 4 5 6 7 8 9 10 11 12

Name and Address of the Employee kept under

suspension

Monthly Emoluments

[wages] paid to the employee

Department in which the

employee was working last and his Designation

Nature of Offence

committed and date of offence

Date of Suspensio

n

Date of Revocation of Suspension

Rate at which subsistence allowance

calculated and period for which calculation made

Amount of subsistence

allowance paid and the date of

payment

Whether the Employee has

been exonerated or awarded any

pubishment

Signature of employee with

date for receiving money

or postal ackowledgement of money order

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)

SL.NO Remarks

1 2 3 4 5 6 7 8 9

Name and Address of the

Workman

Designation of the

Workman

Whether Temporary,

Casual, Badli, or Apprentice (other than those cover under the

Apprentices Act 1961)

Date of First Entry into

Service

Date on which he completed 480 Days of

Service

Date on which made permanent

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]

Name of Certifying Surgeon

a.) Mr.

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 Surgeo

12. Result of Medical Examination

13. If Suspended from work, state period of suspensio

with detailed reasons

14. Recertified fit to resume duty on

(With Signature of Certifying Surgeon)

15. If Certificate of unfitness or suspension issued to

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 Father's NameNature of Work Remarks

1 2 3 4 5 6 7 8 9

Name and Residential

Address of the Worker

Letter of Groups as in Form No.11

No. Of Relay, if working in Shifts

No. and Date of Certificate if an Adolescent

No. Of Certificate and

Date

Token No. giving reference to the

Certificates

To be marked as follows: FORM NO. VI'H' for holidays allowedW/D' for work on double wages

[See Sub-rule (1) of Rule 7]W/H' for work with substituted ho

N/E' if not eligible for the wages

Register of National & Festival Holidays for the year 2008

S.N

O

Nam

e o

f th

e E

mp

loyee

Rem

ark

s

1 2 3 4 5 6 7 8 9 10 11 12Tic

ket

No.

or

Fath

er'

s

Nam

eDays, 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)

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 :

[1] [2] [3] [4] [5]

1. Total Realisations under Fi

(i) Basic Wages

(ii) Overtime

(iv) Bonus

(v) Gratuity

Details of Fines and Unpaid Accumulations

Quarter Ending 31st March

Quarter Ending 30th June

Quarter Ending 30th

September

Quarter Ending 31st

December

2. Total amount being unpaid accumulations of--

(iii) Dearness allowances and other Allowance

(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)

S.No Designation

Rate of Wages

Earn

ed

Wag

es

Pro

vid

en

t Fu

nd

E.S

.I.C

Ad

van

ce L

oan

Tota

l D

ed

ucti

on

s

Net

Wag

es P

aid

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17]

Name of the Employee

No o

f D

ays

work

ed

In

clu

din

g

paid

holid

ays

No o

f d

ays o

f Leave g

ran

ted

w

ith

Wag

es

Earn

ed

Wag

es o

f O

vert

ime W

ork

ed

Tota

l W

ag

es

Earn

ed

Date

& S

ign

atu

re

of

Em

plo

yee

Rate of Normal Wages

Dearness Allowance

Total Wages

INSPECTING OFFICER'S REMARKS

Name and address of the Factory:

Name of Proprietor / Occupier :

Inspection Remarks

Date Time

Date and Time of Inspection Designation and Signature of

Inspecting Officer

FORM NO. 26[Prescribed under Rule 104 of the Tamil Nadu Factories Rules, 1950]

Register of Accidents for the Year __________

Factory Name and Address: Regn. No of Factory Rule :

Date

& H

ou

r of

Accid

en

t

No o

f M

an

-days L

ost

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14]

Ru

nn

ing

Sl.

no o

f th

e

Accid

en

t fo

r th

e

Cale

nd

ar

Year

Nam

e a

nd

Desig

nati

on

of

Pers

on

In

jure

d

Exact

Pla

ce in

th

e

Facto

ry

(B

ran

ch

, D

ep

art

men

t, M

ach

ine

Etc

.) W

here

th

e a

ccid

en

t O

ccu

rred

A f

ull c

lear

Descri

pti

on

of

how

th

e a

ccid

en

t occu

rred

Natu

re,

exte

nt,

locati

on

, etc

., o

f in

jury

receiv

ed

Date

of

desp

atc

h o

f re

port

in

Form

No.1

8

Date

of

retu

rn t

o w

ork

of

pers

on

in

jure

d

Date

of

Desp

atc

h o

f re

port

to t

he I

nsp

ecto

r of

the d

ate

of

retu

rn t

o

work

of

the p

ers

on

in

jure

d

Date

of

desp

atc

h o

f su

bseq

uen

t re

port

s in

Form

No.1

8 B

No o

f D

ays t

he p

ers

on

in

jure

d w

as a

way f

rom

w

ork

Deta

ils o

f d

isab

lem

en

t an

d loss o

f earn

ing

cap

acit

y if

an

y

Rem

ark

s a

nd

in

itia

ls o

f M

an

ag

er

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

Cale

nd

ar

Year

[1] [2] [3] [4] [5] [6] [7] [8]

Running Serial Number of the

Dangerous Occurences in the factory for the Calendar

Year

Date and hour of

Dangerous Occurrence

Date of despatch of Report in Form 18-A

Exact Place in the Factory

(branch,department,plant,equipment,etc.) where the

dangerous occurences took

place

A full clear description of the

dangerous occurrence, the damage caused

and steps taken to arrest further

damage or danger, etc.

Details of ultimate damage or loss with value thereof and of repair, replacement,

reconstrction etc., with cost thereof

Remarks and initials of the

Manager