FORM G
(See Rule 14)
Register of Employment & Remuneration
Year ………………..... Month ……………….. of …………..
Wage Period
(Where Different) ……………………………………………..
Name of Establishment ………………………………..
Name of Employee …………………………………….
Father’s Name …………………………..
Nature of Work ..………………………………………..
Rate of Wages …………………………..
Wage Period ……………………………………………
Date of Employment …………………….
Hours of Works
Interval for Rest & Meals
Hours Worked with the Employer
Overtime
Casual or sickness Leave Availed during the Month/Wage Period
Privilege Leave
Signature of Owner or Occupier
Remarks
Date
From
To
Hours Worked
Wages Earned
Leave Due
Leave Availed
Balance
Remuneration Due
Deductions
Net Amount Payable
Date of Payment
Signature of Employee
Basic Salary or Wages
Other Allowances if any
Total
Fines & Deductions on account of Damage or loss
other Deduction
Advance Paid
Amount
Signature of Employer
Central Bare Acts State Bare Acts
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