All Forms

T. ANJAIAH KARMIKA BHAVAN, RTC 'X' ROADS, HYDERABADApplication No.

Between:The Asst. Labour Officer,Circle No. , Hyderabad.and Inspector under Minimum Wages Act, 1948. ….Applicant

ANDSri/Smt.

The applicant above named begs respectfully to submit as follows:1) The above named opponent is Employer of

which is a scheduled employment specified in the schedule under Part1 underSec.2(g) and 27 of the Act.

2. That the above opponent is person responsible for payment of wages tothe person employed in the said establishment, as per G.O. Ms. No.and VDA as notified by Commissioner of Labour from time to time.

3. The opponent is bound to pay wages at the Minimum rate of Wages fixedby Government but he has paid less wages to the following employees as givenbelow:

The applicant prays that a direction may be issued under Section 20 (3) for:a) Payment of the difference the wages due according to the Minimum rates of Wages fixed by Govt. and actually paid;b) Compensation amounting to Rs.

IN THE COURT OF THE AUTHORITY APPOINTED UNDER THE MINIMUM WAGES ACT, 1948 & THE ASST. COMMISSIONER OF LABOUR

- , HYDERABAD.

Name of Child S/o. and Designation

Wages Payable Basic + VDA

Wages Paid

Difference

Period of Claim

Total Payable

Date: Signature of Applicant

M/W CASE NO.NOTICE

Between:1

…ApplicantAND

2

…Opposite PartyWhereas has made the above said applicationto me under the Minimum Wages Act, 1948 (Central Act 11 of 1948) you are hereby summoned toappear before me in person or by a duly authorized person, able to answer all material questions relating to the applications, or who shall be accompanied by some person able to answer all such questions, on the day of 200 at

the claim and as the day fixed for the appearance is appointed for the final disposal of the applicationyou must be prepared to produce on that day all the witnesses upon whose evidence and all the documents upon which you intend to replay in support of your defence.

Take notice that in default of your appearance on the day before mentioned, the applicationwill be heard and determined in you absence.

Date:Authority under Minimum Wages Act and

The Asst. Commissioner of labour - , HyderabadTo,Shri / Smt

BEFORE THE AUTHORITY UNDER THE MINIMUM WAGES ACT, 1948 AND THE ASST. COMMISSIONER OF LABOUR - , HYDERABAD. T. ANJAIAH KARMIKA BHAVAN, RTC 'X' ROADS, HYDERABAD.

O' Clock at T. ANJAIAH KARMIKA BHAVAN RTC 'X' ROADS, HYDERABAD to answer

CHILD LABOUR INSPECTION REPORT

1 Date and Time of Inspection :

2 Name & Address of the Establishment :

3 Name of the Employer including :Age / Father's Name

4 Hazardous / Non - Hazardous :

5 Registration Certificate No. :

6 Total No. of Employees Working :

7 Details of Child Labour Detected :

a) Name of the Child :b) Father's Name :c) Age / Sex :d) Address :e) Nature of Work :f) Working Since :g) Salary Paid :h) Identification Marks if any :i) Educational Qualification :j) Whether willing to study :k) Signature of Child Labour / : Thumb Impression

8 Details of Parents

9 Occupation of Father 10. Monthly income

11 Occupation of Mother 12. Monthly income

13 Whether the Family is depending on the Child

Signature of the Witness Signature of theEmployer / Manager Inspecting Officer

FORM - XXVI[ Vide rule 30 of A.P. Shops & Establishments Rules, 1990]

L E T T E R O F A P P O I N T M E N T

Name and Address of the Establishment

Name and Address of the Exployer

Registration Number1. Sri/Srimathi/Kumari

Son/Wife/Daughter of AgedDate of Birth is appointed as (Discribe here the nature of appointment) ………………………in this Etablishment with effect from in the scale of pay Rs2. He /Her sclae of pay/rate of increment in wage………………………………………………..(insert the period)shall be …………………………………3. He/She will draw a total perday/weak

STATEMENT OF EMPLOYEES

GOVERNMENT OF ANDHRA PRADESHSL. No.

LABOUR DEPARTMENT

1INSPECTION REPORT!. MOTOR TRANSPORT WORKERS ACT 1961 & RULES 1963:

21 Date & Time of Inspection :2 Name & Address of the Motor Transport :

Undertaking

3

43 Name of the Owner with Father's Name and :

Residential Address

54 Date of Commencement of undertaking :

5 Whether applied for Registration Certificate :6in Form 1 (U/s. RWR 4)

6 Total Number of Vehicles owned by the :undertaking and their Registration number's under the Motor Vehicle Act.

1 Whether Welfare Fund paid or not (U/s RWR 6) :7 Number of Motor Transport workers : 2 Number of Workers covered :

Employed in the undertaking3 Particulars of Amount paid :

8 Whether notice of hours of work of the workers :displayed in Form - V (U/R 28)

9 Whether Register of workers in Form - IX :Produced or not ( U/R 35)

a) Whether Bonus paid to Employees (U/S 10)10 Whether Leave Book in Form - VIII produced : b) % of Bonus and Amount Paid

or not (U/R 34) c) No. of Workers Benefitedd) Whether Registers in form ABC Produced or not :

11 Whether letter of Appointement issued to workers :or not in Form XIV (U/R 35A)

12 Whether Register of Muster Roll in Form - X :produced or not (U/R 36)

13 Whether Register of Compensatory Holidays in :Form - VI produced or not (U/R 30)

Contd…….. Signature of the Employer / Manager

2 A.P. LABOUR WELFARE FUND ACT 1987 AND RULES 1988

3. PAYMENT OF BONUS ACT 1965 & PAYMENT OF RULES ACT 1975

4. GENERAL REMARKS

STATEMENT OF EMPLOYEESSTATEMENT OF EMPLOYEES

1 Whether Welfare Fund paid or not (U/s RWR 6) :

2 Number of Workers covered :

3 Particulars of Amount paid :

a) Whether Bonus paid to Employees (U/S 10) :b) % of Bonus and Amount Paid :c) No. of Workers Benefited :d) Whether Registers in form ABC Produced or not :

Signature of the Signature of theEmployer / Manager officer

Name of the Employee, with Designation

Date of Appointment

Whether L. A Issued

Whether Uniform provided

Present Wages Drawn

Signature of thumb Impression

2 A.P. LABOUR WELFARE FUND ACT 1987 AND RULES 1988

3. PAYMENT OF BONUS ACT 1965 & PAYMENT OF RULES ACT 1975

4. GENERAL REMARKS

IR ON PRINCIPAL EMPLOYER

INSPECTION REPORT UNDER THE CONTRACT LABOUR( R&A) ACT, 1970 AND A.P. CONTRACT LABOUR (R&A) RULES 1971

1 Date of Inspection2

3

b) Name of the Manager, Age and Address

4

5

6

7Name and particulars of contractors engaged

Furnish the information in Annexure - I

8

9

10

11

121314151617181920

Name of the Factory / Establishment with address

a) Name of the Principal Employer, Age and Address

Whether Registration obtained, if so the number and date.

Any changes in the particulars of Registration, if so whether such changes are informed to the Registering Officer.

Whether any Contractors are engaged without Registration

Whether submitted notice in Form - VIB abour commencement / completion of contract work by each contractor

Whether engaged any Contract Labour in the Core Activities.

Yes / No. If yes furnish details in Annexure - II

Whether any contract labour do perform the same and similar kind of work as that of the workmen directly employed by the Prinipal employer.

Name, Designation and wages of lowest paid employee with Principal Employer ( Obtain Separate letter from the Management)

GOVERNMENT OF ANDHRA PRADESHLABOUR DEPARTMENT

INSPECTION REPORT UNDER THE PAYMENT OF BONUS ACT, 1965 AND RULES THERE UNDER.

1:

inspected with address :

2 Date and time of Inspection :

3 Whether the Factory / Establishment :

is covered by the provisions of the Act. :

4 Whether Sec. 16 is applicable to the :

Factory / Establishment. :

5 Accounting year of the Factory / Establishment :

6 No. of employees. :

7 Accounting period for which Bonus was paid :

8Date of expiry of the 8 months period under Sec 19(b) :

9:

10 Date of Payment of Bonus :

11 Rate of Bonus Paid. :

12 No. of employees to whom Bonus was paid :

13 Total amount paid as Bonus :

14:

15:

16 Wheter Annual Return in Form -D submitted :

17 Action taken or proposed to be taken :

18 :

19Rate of Bonus paid for the previous accounting year :

20 No. of employees to whom Bonus was paid :

21:

22 Remarks :

Inspector under Payment of Bonus Act, 1965 & Asst. Commissioner of labour

Name of the Factory / Establishment inspected with address

Whether any extension of time was granted by the Government.

Whether bonus has been paid on the basis of the allocable surplus

Whether necessary registers in Form - A Form-B, and Form - C are maintained

Whether Bonus for the previous accounting year was paid

Total amount of bonus paid for the previous accounting year

Karimnagar.

BUILDING AND OTHER CONSTRUCTION WORKERS ( R.E & C.S.) ACT, 1996INSPECTION REPORT

Name and Designation of the InspectorDate and time of Inspection

1 Registration No. :

2 Name of Establishment :

3

:

4 Name and Address of the Employer :

5 Name and Address of the Contractor :

6 :

7 Nature of work :

8 Total estimated cost of the works :

9 Total area proposed for construction :

10 Date of commencement of work :

11 Duration of Work :

12 Date of Completion :

13 :

14 Violations detected remarks :

Address of the Registered / Administrative Officer

Authority who has approved the Plan of the Construction

No. of workers employed/ Proposed to be employed

Signatures of the employer / Signature of the Inspector

his representative present

IR ON PRINCIPAL EMPLOYER

INSPECTION REPORT UNDER THE CONTRACT LABOUR (R&A) ACT, 1970 AND

A.P. CONTRACT LABOUR (R&A) RULES 1971

1 Date of Inspection

2 Name of the Factory / Establishment with address

3 a) name of the Prinicipal Employer, Age and Address

b) name of the Manager, Age and Address

4

5

6

7 Name and Particulars of Contractos engaged Furnish the information in Annexure- I

8

9

10

11

Whether Registration obtained, if so the number and date

Any changes in the particulars of Registration, if so wheter such changes are informed to the Registering Officer.

Whether any Contractors are engaged without Registration.

Whether submitted notic in Form - VIB about commencement / completion of contract work by each contractor.

Whether engaged any Contrat Labour in the Core Activities

Yes / No. If yes furnish details in Annexure-II

Whether any contract labour do perform the same and similar kind of work as that of the workmen directly employed by the Prinicipal Employer Yes / No.

If yes furnish details in Annexure-III

Name, Designation and wages of lowest paid employee with principal Employer ( Obtain separate letter from the management)

12

a) Dirnking waterb) First - Aid facilitiesC) Washing facilitiesd) latrines & Urinals

13 ( If provided record the details)

14

15

If not paid give the details

16

17

18

19

20 Remarks

Whether provided within seven days from the expiry of period under Rule 40 (1) read with Section 20 as per the specifications under the Rules

( if Provided record the details such as number and condition of such amenity)

Whether provided as per the specifications under the Rules

a) Rest rooms (within 15 days from the expiry of period as per Rule 41(1)

b) Canteen within 60 days from expiry of the time allowed to the Contractor

Name and Designation of authorised representative of principal Employer to be present at the time of disbursement of wages ( Rules 72)

Wheter the authorised representative certified the amounts paid to the contract workers ( Rule 73)

15 A

Whether the Principal employer paid unpaid / short payments to contract labour, if contractor fails to pay wages within the prescribed time

Whether maintained and produced Register of contractors in form - XIII ( Rule 74)

Whether displayed the Name and Address of the Inspector, date of payment of wages and rates of wages ( Rule 81 (1) (i))

Wheter the notices under Rule 81 (1) (i), are submitted to the Inspector Rule 42 ( rule 81 (2))

Whether annual return in Form XXV is sent to the Registering Officer. ( Rule 82 (2)

INSPECTION REPORT UNDER CONTRACT LABOUR ( R&A) ACT, 1970

1 Date & Time of Inspection :

2 Name & address of the Principal Employer :

3 Particulars of Registration :a) Registration No.b) No. of contractorsc) Total No. of workers

4 Name & address of the Contractor :

5 Particulars of Licence :

a) Licence No. & Date :

b) Total No. of workers :

c) Nature of Contract :d) Period of Contract :

6 Facilities provided to the Workers :

a) Whether uniforms & shoes issued :to the workers or not….? :

b) Whether canteen provided to the :workers or not….? :

c) Whether holidays allowed to the :workers or not….? :

d) Whether O.T paid to the workers or not..? :e) Whether Bonus paid to the workers :

or not…?

7 Whether the following registers & records :are maintained U/R 78 of Contract Labour ( R & A) Act & Rules

1 Whether a Muster Roll & Register of :

wages in Form No. XVI and Form No. XVIImaintained & produced or not…?

2 Whether a Register of Deductions :

for Damage of Loss, Register of Fines & Register of Advances in Form No. XX Form No. XXI & Form XXII maintained& produced or not…?

3 Whether maintained a Register of :

Overtime in Form No. XXIII recordingTheir names no. of hours & wages paidfor overtime work…?

4 Whether issued wage Slips in form :

No. XIX to all the wlrkmen atleast a

day prior to the disbursement of thewages or not…?

8. Particulars of employement of Contract Workers:

Sl. No Name & Designation Wages paid Period of Service Signature

Remakrs

Signature of the Employer Signature of Inspecting Officer.Manager/Representative with Date

CHILD LABOUR INSPECTION REPORT

Child Details Date: Time:

Child ID District:

Mandal: Village:

Child Name: Child Identified on:

Gender: Mother Tongue: Identification Marks:

Address:

Studied Upto: Age:

Father or Mother Name:

Parent Occupation: Wages or Salary of child:

No. of children in the family:

If not studying what are they doing:

No. of children studying:

Family Status

Health status

Enforcement

Name of the Establishment:

Nature of work:

Hazardous / Non - Hazardous

Earlier Found working in:

Signature of Inspector Signature of Employer Signature of Witness Signature of child labour

Religion: Caste

Total income of the family : per month Rs…………………………..

Major property : Approximate worth:

Any family members with physical or mental disability : Disability nature: Mental / Physical Disability cause:

Name of the Employer, Age And Establishment Address:

GOVERNMENT OF ANDHRA PRADESHLABOUR DEPARTMENT

INSPECTION REPORT

1 Name of the Establishment

&

Postal Address

2 Name and Residential Address of the

Occupier of the Factory & Registration Number

3 Name and Residential Address of the Managing Agent/Director Partner in charge of the day -to -day affairs of theFactory

4 Date & Time of Inspection

5 Nature of Manufacturing Activity

6 Name of the Scheduled Employement

7 No. of workers for which factory license obtained

MINIMUM WAGES ACT 1948 & A.P. MINIMUM WAGES RULES 1960

8 Whether the following records Produced at the time ofinspection (U/R 30)

a Muster Roll in Form V (U/R 30(5))b Register of wages (U/R 30(1))c Whether wage slips issued in form XI (U/R 30(2))d Whether a notice in form No. XII in Telegu / english

containing Minimum rate of wages fixed for workers in theShops/Estt/Factory together with abstract of the Act & RulesExhibited ( Rule 23)

e Register of over time in form IV (U/R 20)f Whether the signature of thumb impression of the

employees in the register of wages & in wage slip obtained from the employees (U/R 30 (3))

9 Existing manpower Particulars Male Female Total

a) Staff

b) Regular Workers

C) Casual Workers

d) trainees

e) Contract Labours

Total:

10 Principal Employer & Registration No

a) Total No. of Contract Workers

b) Details of ContractorsValid Up to

i)

ii)

iii)

iv)

11 No. of days worked during the year

PAYMENT OF BONUS ACT 1965 &PAYMENT OF RULES ACT 1975

12 Whether Bonus paid to Employees (U/S 10)

a) Bonus Amount paid with date

b) % of Bonus paid

c) No of Beneficiaries

d) Whether Registers in form ABC Producd or not

A.P. LABOUR WELFARE FUND ACT 1987 AND RULES 1988

13 a) Whether Welfare Fund paid or no (U/S 10 RWR 6)

b) Particulars of amount paid with date

14 Wages particulars

Skilled

Semi-Skilled

Un-Skilled

GENERAL REMARKS:

Signature of the Signature of the

Occupier/Manager/Incharge Officer

Llicence No

No. of Worker Engaged

No. of Workers

Minimum Wages

Maximum Wages

GOVERNMENT OF ANDHRA PRADESHLABOUR DEPARTMENT

INSPECTION REPORT UNDER ANDHRA PRADESH SHOPS AND ESTABLISHMENT ACT, 1988AND RULES 1990

Previous Inspection

Date…………………………………. Date…………………………………………………………

Time………………………………… Time………………………………………………………..

name………………………………………………………(Inspecting Officer)

Name of the Officer:

Inspected.

1 Name and Addres of the Shop/Establishment:

2 Name , Age and Residential addressof the Employer:

3 Registration No. of Shop/Establishment:

4 No. of Employees as per the Registration Certificate/ found on physical verification:

5 Whether maintained and produced thefollowing Registers for inspection:

(a) Register of Employment inForm -XXII under Rule 29 (1):

(b) Register of Wages in Form - XXII under Rule 29(6)

(c) Register of Leave in Form-XXV Under Rule 18 (4):

(d) Register of Advance in Form-XIIunder Rule 18(4):

(e) Appointment Letter (s) in form-XXVIunder Rule 30:

(f) Notice of weekly holiday in Form-XXIVunder Rule 29(3):

GENERAL REMARKS:

Signature the Employer of the Signature and DesignationShop/ Establishment. of the Inspecting Officer

STATEMENT SHOWING THE PARTICULARS OF THE EMPLOYEES EMPLOYED IN SHOP /ESTABLISHMENT………………………………………………………..…………………..

Sl. No. Age Designation

WAGES PAID

Basic V.D.A Total

Signature of the Employer / Manager Signature of the inspecting Officerof the Shop / Establishment and Designation

Name of the Employee with Father's Name

Residential Address

Date of Appointment

Minimum wages to be paid

Signature of the Employee

STATEMENT SHOWING THE PARTICULARS OF THE EMPLOYEES EMPLOYED IN SHOP /ESTABLISHMENT………………………………………………………..…………………..

Remarks

STATEMENT SHOWING THE PARTICULARS OF THE WORKERS WORKING IN M/S. ………………………………………………………..…………………..

Designation Service

working Hours

Signature of EmployeeEnding

Sl. No.

Name of the Employee and father's Name

Residential Adresses

Age ( Yrs)

Wages per month/day

Bonus paid in Rupees

Weekly Off allowed /

not allowedBeginning