Page 1
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
SL No. [1] Emp No Father/Husband Name
1 2 3 4 5
1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE
Name of the Employee[2]
Male / Female [3]
Page 2
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
PF No. [7]
Attendance (Please mention the date of suspension of employee, if any [9]
Esic 7(a) 1 2
6 7 9 10 11 12 13
Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P P
De
sig
na
tio
n/
De
pa
rtm
en
t [4
] Date of Joining [5]
Wage fixed
including VDA
[8]
Page 3
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
Attendance (Please mention the date of suspension of employee, if any [9]
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
W/O P P P P P P W/O P P P P P W/O P P P PP W/O P P P P P P W/O P P P P P W/O P P P
Page 4
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]
No
. o
f p
ay
ab
le d
ay
s [
10
]
To
tal
OT
ho
ur
wo
rke
d [
11
] EARNED WAGES AND OTHER ALLOWANCES
21 22 23 24 25 26 27 28 29 30 31
Ba
sic
+D
A [
12
]
HR
A
[14
]
32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
P W/O P P P P P P P P P 31 0 6736 0P P W/O P P P P P P P P 31 0 6736 0
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 5
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Mar 15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS
Co
nv
ey
an
ce
[1
5]
Me
dic
al
All
ow
an
ce
[1
6]
Att
/ B
on
us
[1
7]
Sp
ec
ial
bo
nu
s [
18
]
OT
[1
9]
NF
H [
20
]
Ma
tern
ity
Be
ne
fit
[21
]
Oth
ers
[2
2]
S.
All
ow
an
ce
,if
an
y [
23
]
To
tal
[24
]
ES
I [2
5]
PF
[2
6]
47 48 49 50 51 52 53 54 55 56 57 58
0 0 292 0 0 0 0 0 0 7028 123 8080 0 292 0 0 0 0 0 0 7028 123 808
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 6
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Mar 15DEDUCTIONS
VP
F
PT
[2
7]
TD
S [
28
]
So
cie
ty [
29
]
Ins
ura
nc
e [
30
]/L
WF
Sa
l. A
dv
an
ce
[3
1]
Fin
es
[3
2]
Da
ma
ge
/ L
os
s [
33
]
Oth
ers
[3
4]
To
tal
[35
]
59 60 61 62 63 64 65 66 67 68 69
0 0 0 0 0 0 0 0 0 931 60970 0 0 0 0 0 0 0 0 931 6097
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE
KARNATAKA-560078
Net Payable
[36]
Page 7
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM TSI. No.
1
70 71
ChequeCheque
Mode of Payment Cash / Cheque No. [37]
Employee Signature /
Thumb Impression [38]
Page 8
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
Emp No Father/Husband Name
1 2 3 4 5
1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE
Total
SL No. [1]
Name of the Employee[2]
Male / Female [3]
Page 9
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
PF No. [7]
Attendance (Please mention the date of suspension of employee, if any [9]
Esic 7(a) 1 2
6 7 9 10 11 12 13
Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P W/O
De
sig
na
tio
n/
De
pa
rtm
en
t [4
] Date of Joining [5]
Wage fixed
including VDA
[8]
Page 10
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
Attendance (Please mention the date of suspension of employee, if any [9]
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
W/O P P P P P P W/O P P P P P P W/O PP P P P P P W/O P P P P P P W/O P P
Page 11
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]
No
. o
f p
ay
ab
le d
ay
s [
10
]
To
tal
OT
ho
ur
wo
rke
d [
11
] EARNED WAGES AND OTHER ALLOWANCES
19 20 21 22 23 24 25 26 27 28
Ba
sic
+D
A [
12
]
30 31 32 33 34 35 36 37 38 39 40 41 42
P P P P P W/O P P P P 28 0 6736P P P P W/O P P P P P 28 0 6736
56 0
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 12
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Feb 15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS
HR
A
[14
]
Co
nv
ey
an
ce
[1
5]
Me
dic
al
All
ow
an
ce
[1
6]
Att
/ B
on
us
[1
7]
Sp
ec
ial
bo
nu
s [
18
]
OT
[1
9]
NF
H [
20
]
Ma
tern
ity
Be
ne
fit
[21
]
Oth
ers
[2
2]
S.
All
ow
an
ce
,if
an
y [
23
]
To
tal
[24
]
ES
I [2
5]
43 44 45 46 47 48 49 50 51 52 53 54
0 0 0 292 0 0 0 0 811 0 7839 1380 0 0 292 0 0 0 0 811 0 7839 1380 0 0 584 0 0 0 0 1622 0 15678 276
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 13
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Feb 15DEDUCTIONS
PF
[2
6]
VP
F
PT
[2
7]
TD
S [
28
]
So
cie
ty [
29
]
Ins
ura
nc
e [
30
]/L
WF
Sa
l. A
dv
an
ce
[3
1]
Fin
es
[3
2]
Da
ma
ge
/ L
os
s [
33
]
Oth
ers
[3
4]
To
tal
[35
]
55 56 57 58 59 60 61 62 63 64 65 66
808 0 0 0 0 0 0 0 0 0 946 6893808 0 0 0 0 0 0 0 0 0 946 6893
1616 0 0 0 0 0 0 0 0 0 1892 13786
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE
KARNATAKA-560078
Net Payable
[36]
Page 14
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM TSI. No.
1
67 68
ChequeCheque
Mode of Payment Cash / Cheque No. [37]
Employee Signature /
Thumb Impression [38]
Page 15
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
Emp No Father/Husband Name
1 2 3 4 5
1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE
SL No. [1]
Name of the Employee[2]
Male / Female [3]
Page 16
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
PF No. [7]
Attendance (Please mention the date of suspension of employee, if any [9]
Esic 7(a) 1 2
6 7 9 10 11 12 13
Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P P
De
sig
na
tio
n/
De
pa
rtm
en
t [4
] Date of Joining [5]
Wage fixed
including VDA
[8]
Page 17
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981
Attendance (Please mention the date of suspension of employee, if any [9]
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
P P P P W/O P P P P P P W/O P P P P PP P P W/O P P P P P P W/O P P P P P P
Page 18
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]
Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]
No
. o
f p
ay
ab
le d
ay
s [
10
]
To
tal
OT
ho
ur
wo
rke
d [
11
] EARNED WAGES AND OTHER ALLOWANCES
20 21 22 23 24 25 26 27 28 29 30 31
Ba
sic
+D
A [
12
]
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
P W/O P P P P P P W/O P P P 31 0 6736W/O P P P P P P W/O P P P P 31 0 6736
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 19
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Jan-15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS
HR
A
[14
]
Co
nv
ey
an
ce
[1
5]
Me
dic
al
All
ow
an
ce
[1
6]
Att
/ B
on
us
[1
7]
Sp
ec
ial
bo
nu
s [
18
]
OT
[1
9]
NF
H [
20
]
Ma
tern
ity
Be
ne
fit
[21
]
Oth
ers
[2
2]
S.
All
ow
an
ce
,if
an
y [
23
]
To
tal
[24
]
ES
I [2
5]
46 47 48 49 50 51 52 53 54 55 56 57
0 0 0 292 0 0 0 0 0 0 7028 1230 0 0 292 0 0 0 0 0 0 7028 123
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095
Page 20
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM T
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
MONTH / YEAR: Jan-15DEDUCTIONS
PF
[2
6]
VP
F
PT
[2
7]
TD
S [
28
]
So
cie
ty [
29
]
Ins
ura
nc
e [
30
]/L
WF
Sa
l. A
dv
an
ce
[3
1]
Fin
es
[3
2]
Da
ma
ge
/ L
os
s [
33
]
Oth
ers
[3
4]
To
tal
[35
]
58 59 60 61 62 63 64 65 66 67 68 69
808 0 0 0 0 0 0 0 0 0 931 6097808 0 0 0 0 0 0 0 0 0 931 6097
NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE
KARNATAKA-560078
Net Payable
[36]
Page 21
COMBINED MUSTER ROLL CUM REGISTER OF WAGES
FORM TSI. No.
1
70 71
ChequeCheque
Mode of Payment Cash / Cheque No. [37]
Employee Signature /
Thumb Impression [38]