Integrated ESIPF Calculation

YOUR COMPANY NAME

Attandance for the month of MAY 2008

THU FRI SAT SUN MON TUE WEN THU FRI SAT SUN MON TUE WEN THU FRI SAT SUN MON TUE WEN THU FRI SAT SUN MON TUE WEN THU FRI SAT

SL. Name 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### Days

1 P.SURESHCHANDRAN P P H P P P P P P H P P P P P P H P P P P P P H P P P P P P 262 V.SENTHILNATHAN P P H P P P P P P H P P P P P P H P P P P P P H P P P P P P 263 V.JAYAKUMAR P P H L L L P L L H P P P P P L H P P P L L L H P P P P P P 174 M.RAJASEAKARAN L L L H P P P P P P H P P P P P P H L L L P L L H L L P P P L 165 K.KANNAN P P H P P P L L L H P P P P L L H P P P P P P H P P L L P L 186 S.AMRUTHEEN A P P H P P P P P P H P P P P P P H P P P P P P H P P P P P P 267 K.JOTHI P P H L L L P P P H P P P L L L H P P P P P P H L L P P P L 168 VELLINGRI B P P H L L L L P L H P P P L P P H P L P P L L H P P P P P P 179 SIVA L L H P P P P P P H P L P L L L H P L P P P P H P L P L L L 15

10 A.VELU O P P H P L L P P L H P P P P P L H P L L P L P H P P L P P L 1711 K.KARTHICK P P H P P P P L L H P P P P P L H P L L L P P H P L P P L L 1712 P.GOVINDARAJ U P L H P P P P P P H P P P P P P H P L P P P P H P P L L L L 2013 JAGANNATH L L H P P P L L L H P P P P L P H P P L P P L H P P P L L L 1514 RAVI R P P H L L L P P P H P P P P L L H P P P P P L H P P P L L L 1715 MANIVEL P P H P L P P P L H L L L L L L H P P P L P P H P P P P P L 1616 RAMESH S P P H P P P P L L H P L L P P P H P L P P P L H P L P P L L 1717 GANESH P L H L L P P P P H P L P P L L H P P P P P P H P P P P L P 1918 STEAPAN D L L H P P P P P P H L L L P P L L P P P P P P H P L L L L L 1519 SELVARAJ P P H P P P P P P H P P P P P L H P L P L L L H P P P O L L 1820 SELVAM A P P H L P L P P P H P P P L L L H P P P P P P H P L L L P L 1721 MURUGESAN P L H P P P P P P H P P L P P P H P L P L L L H P P P P P P 2022 PRAKASH Y P P H L L L P P P H P P P L L L H P L P L L L H P P P P P P 1623 DEBARAJ P L H P P P P L L H P P P P P P H L L L L P P H P P P P P P 1924 SUDAY L P H L P P L L L H P P P L L L H P P P P P P H P L P P P P 1725 RAMACHANDRAN H P P H P P P P P P H P P P P P P H L L L L L L H P P P P L L 1826 GOBU O P P H L L L L L L H P P P P P L H P P P P L P H P P P L P P 1727 MURUGAN L P P H P P P L L L H P L P P L L H P P P P P L H P L L L P P 1628 RAJMOHAN I P P H P P P P P P H P P H P P P H L L P L P L H L P P P P L 1929 PARAMASIVAM D P P H P P P P L L H P P P L P P H P P L P P L H P P H P L L 1830 RAVI A P L H P L P P P P H L L L L L P H P P P P L P H P L P P L P 1631 RAJU Y P P H P P H L L L H P P P L L L H P L P L L L H P P P P P P 1532 SUNDARAJAN P P H P P P P P P H P P P P L L H P P P P P L H L L P P L L 1933 PAVENDARAN P P H P P P L L L H P P P L L L H P L P P P P H P P L P P L 1734 KARTHIKEYAN L L H P L P P L L H P L P P P P H P P P P P P H P L L L L L 1535 SELVAM L L H P P P P P P H P P P P L L H P P L L L L H P P P P P P 18

PAYROLL FOR THE MONTH OF MAY' 2008 STAFF YOUR COMPANY NAME

S.NO NAME

PF ESI RATE OF DAYS EARNED DEDUCTION NET

SIGANTURE

PF P.FA/C NOA/C NO WAGES WORKED WAGES ESI PF WAGES 3.67% 8.33%

SALARY 1.75% 12% SALARY

1 0 0 0 0 0 0 0

2 0 0 0 0 0 0 0

3 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0

TTL TOTAL STAFF 0 0 0 0 0 0OP 13

+ NIL 0

- NIL TOTAL 57969 6954 2122 4832CL 13 G.TOTAL 57969 6954 A/C NO:1 2122 4832

4.75% 2122 A/C NO:1

TOTAL ESI 9076 TAL A/C NO:1

4832 A/C NO:10

638 A/C NO:2

290 A/C NO:21

6 A/C NO:22

TOTAL PF 14842

PAYROLL FOR THE MONTH OF MAY'08 WORKERS YOUR COMPANY NAME

S.NO NAME

PF ESI RATE OF DAYS EARNED DEDUCTION NET

SIGANTURE

PF P.F

A/C NOA/C NO WAGES WORKED WAGES ESI PF WAGES 3.67% 8.33%

SALARY 1.75% 12% SALARY

1 P.SURESHCHANDRAN 2300 26 2300 40 276 1984 84 192

2 V.SENTHILNATHAN 2900 26 2900 51 348 2501 106 242

3 V.JAYAKUMAR 2100 18 1454 25 174 1255 53 121

4 M.RAJASEAKARAN 2500 17 1635 29 196 1410 60 136

5 K.KANNAN 2500 19 1827 32 219 1576 67 152

6 S.AMRUTHEEN 3000 26 3000 53 360 2587 110 250

7 K.JOTHI 2100 17 1373 24 165 1184 51 114

8 VELLINGRI 2300 18 1592 28 191 1373 58 133

9 SIVA 2100 16 1292 23 155 1114 47 108

10 A.VELU 2200 18 1523 27 183 1313 56 127

11 K.KARTHICK 2300 18 1592 28 191 1373 58 133

12 P.GOVINDARAJ 2100 21 1696 30 204 1462 63 141

13 JAGANNATH 2300 16 1415 25 170 1220 52 118

14 RAVI 2300 18 1592 28 191 1373 58 133

15 MANIVEL 2200 17 1438 25 173 1240 53 120

16 RAMESH 2300 18 1592 28 191 1373 58 133

17 GANESH 2300 20 1769 31 212 1526 65 147

18 STEAPAN 2100 16 1292 23 155 1114 47 108

19 SELVARAJ 2300 19 1681 29 202 1450 62 140

20 SELVAM 2300 18 1592 28 191 1373 58 133

21 MURUGESAN 2300 21 1858 33 223 1602 68 155

22 PRAKASH 2300 17 1504 26 180 1298 55 125

23 DEBARAJ 2300 20 1769 31 212 1526 65 147

24 SUDAY 2300 18 1592 28 191 1373 58 133

25 RAMACHANDRAN 2000 19 1462 26 175 1261 53 122

26 GOBU 2100 18 1454 25 174 1255 53 121

27 MURUGAN 2200 17 1438 25 173 1240 53 120

28 RAJMOHAN 2200 20 1692 30 203 1459 62 141

29 PARAMASIVAM 2200 19 1608 28 193 1387 59 134

30 RAVI 2300 17 1504 26 180 1298 55 125

31 RAJU 2200 16 1354 24 162 1168 49 113

32 SUNDARAJAN 2200 20 1692 30 203 1459 62 141

33 PAVENDARAN 2200 18 1523 27 183 1313 56 127

34 KARTHIKEYAN 2200 16 1354 24 162 1168 49 113

35 SELVAM 2200 19 1608 28 193 1387 59 134

TTL TOTAL 57969 1018 6954 49997 2122 4832

OP - - - - - 35

+ - - - - - 0 GRAND TOTAL 57969 1018 6954 49997 2122 4832

0 4.75% 2759 --- - - - - -

CL - - - - - 35 TOTAL ESI 3777

E. S. I. C. l E. S. I. C.Illl

Challan No. l Challan No. EMPLOYEES' STATE INSURANCE FUND ACCOUNT No.1 l EMPLOYEES' STATE INSURANCE FUND ACCOUNT No.1

PAY - IN - SLIP FOR CONTRIBUTION l PAY - IN - SLIP FOR CONTRIBUTIONSTATE BANK OF INDIA l STATE BANK OF INDIAStation Tirupur Date : l Station Tirupur Date :Paid into the credit of the Employees' State Insurance l Paid into the credit of the Employees' State InsuranceFund Account No. 1 Rs. 3777 l Fund Account No. 1 Rs. 3777

THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY l THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY

in cash / by Cheque (on realisation) for payment of contribution as per l in cash / by Cheque (on realisation) for payment of contribution as perdetails given below under the Employees' State Insurance Act, 1948, l details given below under the Employees' State Insurance Act, 1948,for the month of MAY'08 l for the month of MAY'08

lDeposited by l Deposited by

l

Employer's Code No. l Employer's Code No. 0l

Name and Address of Factory/Establishment l Name and Address of Factory/Establishment YOUR COMPANY NAME l YOUR COMPANY NAMEADDRESS ADDRESSADDRESS ADDRESS

No. Of Employees' 35 l No. Of Employees' 35

Total Wages Rs. 57969 l Total Wages Rs. 57969Employees' Contribution Rs. 1018 l Employees' Contribution Rs. 1018Employer's Contribution Rs. 2759 l Employer's Contribution Rs. 2759

Total Rs. 3777 l Total Rs. 3777l

(For use in Bank) l (For use in Bank)ACKNOWLEDGEMENT l ACKNOWLEDGEMENT(to be filled by depositor) l (to be filled by depositor)

Received payment with Cash / Cheque / Draft No. l Received payment with Cash / Cheque / Draft No. dated for Rs. 3777 l dated for Rs.

THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY l THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY

drawn on THE FEDERAL BANK LTD (Bank) in favour of l drawn on THE FEDERAL BANK LTD (Bank) in favour ofEmployees' State Insurance Fund Account No. 1 _________________ l Employees' State Insurance Fund Account No. 1 _________________Sl. No. In Bank's Scroll _______________________________________ l Sl. No. In Bank's Scroll _______________________________________

lDated: Authorised Signatory l Dated: Authorised Signatory

of the receiving Bank l of the receiving Bank

Rupees Rupees

Rupees Rupees

E. S. I. C.

EMPLOYEES' STATE INSURANCE FUND ACCOUNT No.1PAY - IN - SLIP FOR CONTRIBUTION

THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY

MAY'08

0

YOUR COMPANY NAMEADDRESSADDRESS

35

ACKNOWLEDGEMENT(to be filled by depositor)

3777

THREE THOUSAND SEVEN HUNDRED & SEVENTY SEVEN ONLY

Authorised Signatoryof the receiving Bank

COMBINED CHALLAN OF A/C. NO. 1,2,10,21 & 22(STATE BANK OF INDIA)

EMPLOYEES' PROVIDENT FUND ORGANISATION(USE SEPARATE CHALLAN FOR EACH MONTH)

ESTABLISHMENT CODE NO. ACCOUNT GROUP NO. PAID BY CHEQUE / CASH CHEQUE

D D M M Y Y

DUES FOR THE MONTH OF : { Employees Share MAY'08 DATE OF PAYMENT

Employer Share MAY'08

Total no. of Subscribers { 35 { 35

{ 35

A/c . 1 A/c. 10 A/c.21 Total Wages Due 57969 57969 57969

S. NO. PARTICULARS A/C. NO.1 A/C. NO. 2 A/C.NO. 10 A/C. NO. 21 A/C. NO. 22 TOTAL ………………..Amount (in Rupees) …………………..

PART - 01 1. EMPLOYER'S SHARE OF CONT. 2122 4832 290 7244

2. EMPLOYEES' SHARE OF CONT. 6954 6954

3. ADM. CHARGES 638 6 644

4. INSP. CHARGES

5. PENAL DAMAGES

6. MISC. PAYMENT

Total 9076 638 4832 290 6 14842

FOURTEEN THOUSAND EIGHT HUNDRED & FOURY TWO ONLY (For Banks use only)

NAME OF ESTABLISHMENT Amount Received Rs. For Cheques only: Date of presentation

NAME OF THE DEPOSITER Date of Realisation SIGNATURE OF THE DEPOSITER Branch Name (TO BE FILLED BY EMPLOYER) Branch Code No.

CHQUE NO. DATENOTE : PLEASE ENSURE TOTAL OF EACH COLUMN AGREES WITH GRAND TOTAL

Amount in words

ADDRESS

NAME OF BANK :

FORM 12 - A (Revised)Only for Un-Exempted Establishments (To be filled in by the EPFO)

Name and Address of the Estt. EMPLOYEES, PROVIDENT FUND AND MISC. PROVISIONS ACT, 1952 Establishment Status

YOUR COMPANY NAME EMPLOYEES' PENSION SCHEME (Paragraph 20 (4) )

ADDRESS Currency Period from 1 st April 200 8 To 31 st March 200 9

ADDRESS Statement of Contribution for the Month of A P R - 0 8 Group Code

Statutory rate of Contribution 1 2 %

Code No T N C B

ParticularsWages on which Amount of Amount of Date of Remittance

Contribution Recovered Payable Worker's Employer's administrative administrative ( enclose triplicate copiesare payable from the by the Share Share Charges Due Charges remitted of challan)

1 2 workers Employer 5 6 7

E.P.F.A/c.No. 01 Rs 57969 6954 2122 6954 2122 638 638

Pension Fund A/c.No.10 Rs 57969 NIL 4832 NIL 4832 NIL NIL

E.D.L.I A/c.No. 21 Rs 57969 NIL 290 NIL 290 6 6

Total No.of Employees Name & address of the SBI

( a ) Contract -- --

( b ) Rest 35 Bank in Which the amount

( c ) Total 35 is remitted Rs. 14,842

Details of Subscribers E.P.F E.D.L.I

No.of Subcribers as per last month 35 35 35

No.of New Subcribers (vide Form 5) 0 0 0

No.of Subcribers left service (vide Form 10) 0 0 0 Signature of the Employer

(Nett.) Total Number of Subcribers 35 35 35 with Official (Seal)

Amount of Contribution 3

Amount of Contribution remitted 4

Pension fund

FORM - 5 SRO CBE

THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952

[ Paragraph 36 ( 2 ) ( a ) ]

AND THE EMPLOYEES' PENSION SCHEME, 1995[ Paragraph 20 ( 4 ) ]

Return of the employees qualifying for the Employees' Provident Fund, Emplyoees' Pension Fund & Employees' Deposit Linked Insurance Fund for the first time during the month of MAY'08

(To be sent to the Commissioner with Form 2 ( EPF & EPS )

Name and Address of the Factory / Establishment YOUR COMPANY NAME

ADDRESS

Code No.of Factory / Establishment TN CB

Sl.NoAccount Name of the Employee Father's Name ( or Husband's Name Date of

SexDate of Total period of previous service

RemarksNo ( in block letters ) in case of married woman ) Birth joining the as on the date joining the Fund Fund (Enclose scheme Certificate if applicable)

1 2 3 4 5 6 7 8 9

Signature of the employer or otherDate: authorised officer of the Factory / Establishment

Stamp of the Factory / Establishment

GR…………………………….

FORM - 10

Return of the members leaving service during the month of

Name and Address of the Factory / Establishment YOUR COMPANY NAME Code No

ADDRESS

Sl.NoAccount Name of the member Father's Name ( or Husband's Name Date of leaving Reasons for Leaving

RemarksNo ( in block letters ) in case of married woman ) Service Service

1 2 3 4 5 6 7

Signature of the employer or other authorised officer

Date Stamp of the Factory / Establishment

* Please state whether the member is (a) retiring according to para 69 (1) or (b)of the scheme: (b) leaving india for permanentsettement abroad: ( c ) retrenchment

(d) permanent & total disablement due to employment insury ; (e) discharged ; (f) resigning from or leaving service ; (g) taking up employment elsewhere ( The Name &

address of the Employers should be stated) (h) death (i) attained the age of 58 years.

"Certified that the member mentioned at serial No Shri / Smt / Kum was paid / not paid retrechment compenstion

of Rs: under the Industrial Dispute Act.1947

Signature of the Employer

THE EMPLOYEES' PROVIDENT FUNDS SCHEME, 1952 [ Paragraph 36 ( 2 ) ( A ) & ( B ) ]

AND THE EMPLOYEES' PENSION SCHEME, 1995 [ Paragraph 20 ( 2 ) ]

(For Unexempted Establishments only) (Form 3-A Revised)

THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952

( Para 35 & 42 ) and

Emplyee's Pension Scheme, 1995

(Paras 19)

Contribution Card for the Currency Period From To

1. Account No. : 4. Name & Address

of the Establisment:

2. Name/Surname: #REF! 5. Statutory rate of contribution : 12%

3. Father's/husband Name: 6. Voluntary higher rate of employees contribution if any:

MONTH

CONTRIBUTIONS * Refund Break in

RemarksAmount of Worker Share Employer's Share of membership

Wages EPF Total EPF EPS Total Advances reckonable

a b a b c servive

1 2 3 4 5 6 7

Apr-03 #REF! #REF! #REF! #REF! #REF! #REF!Date of leaving serivce

May-03

Jun-03Reason for leaving service

Jul-03

Aug-03

Sep-03 this card i.e Rs.

Oct-03

Nov-03

Dec-03

Jan-04

Feb-04

Mar-04

TOTAL #REF!

Certified that the difference between the total of the contributions shown under the columns (3) & (4) of the above table and that

arrived at on the total wages shown in column (2) at the prescribed rate is solely due to the rounding off the contributions to be

nearest rupee under the rules.

* Contributions for the month of March paid in April

Date:

Signature of Employer(Office Seal)

In respect of the Form ( 3A ) sent to the Regional Office during the course of the currency period for the purpose of final settlement

of the accounts of the members who had left service details of date and reasons for leaving service and also a certificate as shown

in the Remarks Column should be added

Certified that the total amount of

contribution indicated in

Col.3( b ) +col.4( c ) has already

been remitted in

full in E.P.F. A/c No.1

(Provindent Fund.

Contributions A/c) and in Account

No.10(Employee's

Pension Fund Contributions

account vide notebelow)

THE EMPLOYEES' PROVIDENT FUND SCHEME, 1952

NIL

Remarks

7Date of leaving serivce

Reason for leaving service

#REF!

Certified that the difference between the total of the contributions shown under the columns (3) & (4) of the above table and that

arrived at on the total wages shown in column (2) at the prescribed rate is solely due to the rounding off the contributions to be

Signature of Employer(Office Seal)

In respect of the Form ( 3A ) sent to the Regional Office during the course of the currency period for the purpose of final settlement

of the accounts of the members who had left service details of date and reasons for leaving service and also a certificate as shown

Certified that the total amount of

contribution indicated in

Col.3( b ) +col.4( c ) has already

been remitted in

full in E.P.F. A/c No.1

(Provindent Fund.

Contributions A/c) and in Account

No.10(Employee's

Pension Fund Contributions

account vide notebelow)

1 P.SURESHCHANDRAN2 V.SENTHILNATHAN3 V.JAYAKUMAR4 M.RAJASEAKARAN5 K.KANNAN6 S.AMRUTHEEN7 K.JOTHI8 VELLINGRI9 SIVA

10 A.VELU11 K.KARTHICK12 P.GOVINDARAJ13 JAGANNATH14 RAVI15 MANIVEL16 RAMESH17 GANESH18 STEAPAN19 SELVARAJ20 SELVAM21 MURUGAN22 PRAKASH23 DEBARAJ24 SUDAY25 RAMACHANDRAN26 GOBU27 MURUGAN28 RAJMOHAN29 PARAMASIVAM30 RAVI31 RAJU32 SUNDARAJAN33 PAVENDARAN34 KARTHIKEYAN3536

Date of Payment 04.06.2008

SELVAM (REJOINED 1.4.2008)SARTAR VALLABHAI PATTEL-LEFT 1.4.08

Deepthy Fenishers

Wages Period From : MAY'08

Workers Name : P.SURESHCHANDRAN

a. Min . Rate Wages of Payable : 2300

b. No of Days Working : 26

c. No of days working overtime : NIL

d. Allowance : NIL

e. The Gross Wages for the Wage period : 2,300

f. Deductions : 1.Advance : Nil

2.P.F : 276

3.ESIC : 40

Total 1,984

f. Actual wages paid for the period: : 1,984

Date Of Payment. : 04.06.2008Signature of Worker Manager

Deepthy Fenishers


Workers Name : V.SENTHILNATHAN




d. Allowance : NIL



2.P.F : 348

3.ESIC : 51

Total 2,501


Date Of Payment. : 04.06.2008

Signature of Worker Manager

Deepthy Fenishers


Workers Name : V.JAYAKUMAR




d. Allowance : NIL



2.P.F : 174

3.ESIC : 25

Total 1,255


Date Of Payment. : 04.06.2008Signature of Worker Manager

Deepthy Fenishers


Workers Name : M.RAJASEAKARAN




d. Allowance : NIL



2.P.F : 196

3.ESIC : 29

Total 1,410




YOUR COMPANY NAME


Workers Name : K.KANNAN




d. Allowance : NIL



2.P.F : 219

3.ESIC : 32

Total 1,576




YOUR COMPANY

Wages Period From : APR'08

Workers Name : S.AMRUTHEEN




d. Allowance : NIL



2.P.F : 360

3.ESIC : 53

Total 2,587


Date Of Payment. : 03/05/2008


YOUR COMPANY NAME


Workers Name : K.JOTHI




d. Allowance : NIL



2.P.F : 145

3.ESIC : 21

Total 1,046




YOUR COMPANY NAME


Workers Name : VELLINGRI




d. Allowance : NIL



2.P.F : 170

3.ESIC : 25

Total 1,220




YOUR COMPANY NAME


Workers Name : SIVA




d. Allowance : NIL



2.P.F : 155

3.ESIC : 23

Total 1,114




FORM 6 - A

The Employees' Provident Fund Scheme, 1952( Paragraph 43 ) and

The Employees' Pension Scheme, 1995[ Paragraph 15 ( 4 ) ]

Annual statement of contribution for the Currency Period From 1st To

Name and address of the Estabilshment Statutory rate of contribution 12%

Code No. of the Establishment No.of member voluntary contributing at a higher rate Nos.

Wages retaining Employer's

allowance Amount of Workers Contribution Rate of

(if any) & Contributions

EPF Total

Refund higher EDLI Remarks

S.No Account Name of member DA including deducted from of voluntary Contri-

Number ( in block letters ) Cash value of the wages PC Advance contribution bution

food concession

EPF Total

8.33% (if any)

paid during the

currency period

1 2 3 4 5 6 7 8 9 10

TOTAL 0 0 0 0 0 0

P.T.O

Documents

Integrated ESIPF Calculation