FormsFollowing Forms & Registers Required to be filed and
maintained under The A.P Building & Other Construction Workers
(Regulation of Employment and Conditions of Service) Rules,1998Form
No.Prescribed Under RuleName of the Register/FormIssued/
Submitted/Maintained By whomWhom to submitRemarksForm ISee rule
23(1)Application for Registration of Establishments Employing
Building Workersby Principal EmployerGovt.of A.P,Registering
OfficerIn Triplicate along with DD showing Payment of Fees for
RegestrationIf the number of workers to be employed as b.workers
for B&O C work on one day is uoto 100 no. Rs.100/- exceeds 100
but not exceed 500 no. Rs.500/- exceeds 500 no. Rs.1000/-Form IISee
rule 24(1)Certificate of RegistrationGovt.of A.P,Registering
Officerby Principal EmployerFor any changes occurs in ownership or
management or other employer shall intimate to registering officer
within 30 daysForm IIISee rule 24(2) and 25(2)Register of
EstablishmentGovt.of A.P,Registering OfficerForm - IVSee rule 26(3)
and 239(1)Notice of Commencement/Completion of Building or Other
Construction Workby Principal EmployerGovt.of A.P,Registering
Officerthe employer shall before 30 days of commencement and
completion of any building or other construction work,submit a
written notice to inspector of area in form IVForm - VSee rule 56
and 74(b),Schedule ICertificate of Initial and Periodical Test and
Examination of Winches, Derricks and Their Accessory GearCompetent
PersonForm - VISee rule 56 and 74(b)Certificate of Initial and
Periodical Test and Examination of Cranes or Hoists and their
Accessory GearCompetent PersonForm - VIISee rule 70 and
74(b)Certificate of Initial and Periodical Test and Examination of
Loos GearCompetent PersonForm - VIIISee rule 62 and
74(b)Certificate of Test and Examination of Wirerope before being
taken into UseCompetent PersonForm - IXSee rule 72 and
74(b)Certificate of Annealing of Loose GearsCompetent PersonForm -
XSee rule 69 and 73Certificate of Annual thorough Examination of
Loose Gear exemted from AnnealingCompetent PersonForm - XISee rule
223 ('c)Cerificate of Medical Examinationissued by Medical
Inspector/CMOAll the building workers employed as driver,Operators
of lifting appliance and transport equipment before employing,afetr
illness or injuryOnce in every Two years up to age of 40 and Once
in a year, thereafterForm - XIISee rule 223(d)Health
RegisterInrespect of persons employed in Building and other
construction work involving hazardous processesForm - XIIISee rule
230(a)Notice of Poisoning or Occupational Notified Diseasesissued
by Employer/CMOForm - XIVSee rule 210(7)Report of Accidents and
Dangerous Occurrencesby Principal EmployerForm - XVSee rule
240Register of Building Workers Employed by the Employerby
Principal EmployerForm - XVISee rule 241(1)(a)Muster Rollby
Principal EmployerForm - XVIISee rule 241(1)(a)Rigister of Wagesby
Principal EmployerForm - XVIIISee rule 241(1)(a)Form of Register of
Wages-cum-Muster-Rollby Principal EmployerForm - XIXSee rule
241(1)(b)Register of Deductions for Damages or Lossby Principal
EmployerForm - XXSee rule 241(1)(b)Register of Finesby Principal
EmployerForm - XXISee rule 241(1)(b)Register of Advancesby
Principal EmployerForm - XXIISee rule 241(1)(c)Register of
Overtimeby Principal EmployerForm - XXIIISee rule 241(2)(a)Wage
Bookby Principal EmployerForm - XXIVSee rule 241(2)(b)Service
Certificateby Principal EmployerTo Building WorkerForm - XXVSee
rule 242Annual Returns of Employer to be sent to the Registering
Officerby Principal EmployerGovt.of A.P,Registering OfficerYear
Ending 31st December ..Form - XXVISee rule 74(b)Register of
Periodical Test - Examination of Lifting Appliance and Gear,
ect.Competent PersonForm - XXVIISee rule 33-A(2)Application for the
Registration of Building WorkersBy Building WorkerSecretary,APBOCW
Welfare BoardAlong with Form XXVII together with the certificate of
employment(containing details of name,age,father name &
R.address,no. of days worked during the preceding 12 months) issued
by Registered Establishment,ALO.Trad Union of Construction
workers.With 2 passport size photographs,age proff by School
certificate or Doctor's certificate and Fees of rs.50/-Form -
XXVIIISee rule 33-A(5)Nomination FormBy Building
WorkerSecretary,APBOCW Welfare BoardForm - XXIXSee rule
33-A(6)Register of BeneficiariesSecretary,APBOCW Welfare BoardForm
- XXXSee rule 33-B(i)Identity CardSecretary,APBOCW Welfare BoardTo
Building WorkerNote :
SchedulesThe A.P Building & Other Construction Workers
(Regulation of Employment and Conditions of Service)
Rules,1998SchedulesRulesDetailsSchedule ISee Rules 56(a),71(a) and
72Manner of Test and examination before Taking Lifting Appliance,
Lifting Gear and Wire Rope into use for the First TimeSchedule
IISee Rule 230(a)Notifiable Occupational Diseases in Building and
Other Construction WorkSchedule IIISee Rule 231(b)Contents of a
First Aid BoxSchedule IVSee Rule 226(c)Articles of Ambulance
RoomSchedule VSee Rule 227Contents of Ambulance Van or
CarriageSchedule VISee Rule 34Permissible Exposure in case of
Continuous NoiseSchedule VIISee Rules 81(iv)and
223(a)(iii)Periodicity of Medical Examination of Building
WorkersSchedule VIIISee Rules 209(1) and 209(2)Number of Safety
officers,Qualification,Duties.Ect.Schedule IXSee Rule 225Hazardous
ProcessSchedule XSee Rule 225(b)Service and facilities to be
provided in occupational health centersSchedule XISee Rules 199(2)
and 225(c)Qualification of Construction Medical
Officer(CMO)Schedule XIISee Rule 152(a)Permissible Levels of
Certain Chemical Substance in the Work Environment
SRINIVAS:1)Roof Work2)Steel erection3)Work under and over
water4)Demolition5)Work in confined space
Schedule VISCHEDULE VIPermissible Exposure in case of Continuous
Noise[See Rule 34]Total time of exposure (continuous or a number of
short-term exposures) per day(in hours)Sound pressure level (in
dBA)1289069249539721001.510211053/41071/21101/4115
FORM IFORM I[See rules 23 (1)]APPLICATION FOR REGISTRATION OF
ESTABLISHMENTS EMPLOYING BUILDING WORKERS1. Name and location of
the establishment where Buildingor other construction work is to be
carried on2. Postal address of the establishment3. Full name and
permanent address of theEstablishment, if any4. Full and address of
the Manager or personResponsible for the supervision and controlOf
the establishment5. Nature of building or other construction
workCarried /is to be carried on in the establishment6. Maximum
number of building workersEmployed on any day7. Estimated date of
commencement of building or theOther construction work8. Estimated
date of completion of the building or otherConstruction work9.
Particulars of demand draft, enclosed(Name of the bank, amount,
demand draft No. andDate)DECLARATION BY THE EMPLOYER(i) I hereby
declare that the particulars given above are true to the best of my
knowledge and belief.(ii) I undertake to abide by the provisions of
the Building and Other the rules made there underConstruction
Workers (Regulation of Employment and Conditions of Service) Act,
1996, andPrincipal employerSeal and stamp
FORM IVFORM IV[See rules 26 (3) and 239 (1) ]NOTICE OF
COMMENCEMENT / COMPLETION OF BUILDING OR OTHER CONSTRUCTION WORK1.
(I) Name and address (permanent) of theEstablishment .(ii) Name of
the employer and address.2. Name and situation of place where
theBuilding and other construction is proposed tobe carried on3.
No. and date of certificate of registration4. Name and address of
the person in charge of theConstruction work5. Address to which the
communications relating toBuilding or other construction work may
be sent6. Nature of work involved and the facilities includingPlant
or machinery provided7. The arrangement storage of explosives, if
any, to beUsed in building or other construction work8. In case the
notice is for commencement of work,The approximate duration of
workI/We hereby intimate that the construction of building having
registration no. dated is likely to commence/has commenced and
shall be completed on ..Signature of employerTo:with sealThe
Inspector...
FORM XIIIFORM XIII[See Rule -230(a)]Notice of Poisoning and
Occupational diseases1.Name and address of the employer :
________________________________________________________2.Name of
the building workers and his work number, if any :
____________________________________3.Address of the building
worker
:______________________________________________________________________________________________________________________________________________________________________________________4.Sex
and Age
:__________________________________________________5.Occupation :
___________________________________________________6.State exactly
what the patient was doing at the time of contracting the disease
:___________________________________________________________________________________7.Nature
of poisoning or disease from which the building worker is suffering
from : __________________Date: ____________________Signature of the
Employer/Construction medical OfficerNote: When a building worker
contracts ant diseases specified in Schedule-XII,a notice in this
form shall be sent forthwith to The Chief Inspector of Inspectionof
Building and other Construction.
Form- XIVForm- XIV[See Rule 210(7)]Notice of Accidents and
Dangerous Occurrences1. Name of the Project/ Work :
________________________________________________________________2.
Location and address of Construction work
:___________________________________________________3. Stage of
Construction work :
________________________________________________________________4.
Particulars of Employer :
___________________________________________________________________(a)
Main contractor Firm/Company:i. Name :ii. Address :iii. Phone
numbers :iv. Nature of Business :(b) Main contractor
Firm/Company:i. Name :ii. Address :iii. Phone numbers :iv. Nature
of Business :5. Particulars of Injured persons:(a) Name: (First)
(Middle) (Last) :(b) Home address :(c) Occupation :(d) Status of
the worker- Casual/ Permanent :(e) Sex: Male/ Female :(f) Age :(g)
Experience :(h) Marital status: Married/ Unmarried/ Divorced :6.
Particulars of Accident:(a) Exact place where accident occurred(b)
Date(c) Time(d) What the injured person was doing at the time of
accident(e) Weather conditions(f) How long employed by you for this
particular job(g) Particulars of equipment/ machine/tool involved
and condition of the same after the Accident occurred7. Nature of
Injuries:(a) Fatal(b) Non- fatal(c) If non-fatal; state precisely
the nature of injuries(Describe in detail the nature of injury, for
instance fracture of right arm, sprain etc.)(d) First aid: Given:
Not given:(e) If not given, the reasons(f) Name and designation of
the person by whom first aid was given(g) If admitted to
Hospital,i. Name of the Hospitalii. Address of the hospitaliii.
Phone numberiv. Name of the Doctor8. Mode of transport
used:Ambulance Truck Tempo Taxi Private Car9(a) How much time was
taken to shift the injured person? If very late, state the
reasons(b) How the reporting was made:Telephone Telegram Special
Messenger letter(c) Who visited the accident site first and action
was proposed by him(d) What are the actions taken for
investigations of the accident by theemployer (Describe about
photographs/ video film/ measurements taken etc.)10. Particulars of
the person given witness:(a) Name Address Occupation1. .2. .3. .4.
.5. .(b) Whether temporary/permanent11. Particulars in case of
Fatal-Date Time12. Whether registered with Building and Other
Construction Workers Welfare Board13. If yes, give registration
number(s)I certify that to the best of my knowledge that to the
best of my knowledge and belief,the above particulars are correct
in every respect.Place: ______________Signature of Employer/
Responsible person/ SupervisorDate: ______________Designationcc:
forwarded for information and follow-up action:123Note: If more
than one person is involved, then for each person, information to
be filled up in separate forms
FORM XVFORM XV[See Rule 240]Register of Building Workers
Employed by the EmployerName and address/location where the
building or other construction work is carried on/ is to be carried
on
:____________________________________________________________________________________________________________________________________________________________________________________________________________________Name
and permanent address of the Establishment
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Nature
and location of work..Sl. No.Name and Surname of workmanAge and
SexFathers/ Husbands nameNature of employment/ degisnationPermanent
Home address of Workman(Village and Taluka and Distt.)Local
AddressDate of Commencement of employmentSignature or Thumb
impression of workmanDate of termination of employmentReasons for
terminationIf the building worker is/was beneficiary the date of
registration as a beneficiary, the registration no. and the name of
welfare boardRemarks12345678910111213
FORM XVIFORM XVI[See Rule 241(1)(a)]Muster RollName and
permanent address of the Establishment
______________________________________________________________________________________________________________________________________________________________________________________________________Name
and address/location where the building or other construction work
is carried on/ is to be carried on
_____________________________________Nature of building or other
construction work: _________________________Name and address of the
EmployerFor the month of ________________________________Sl.
No.Name of the Building workerFathers/ Husbands
nameSex12345678910111213141516171819202122232425262728293031Remarks
FORM XVIIFORM XVII[See Rule 241(1)(a)]Register of WagesName and
address/location where the building or other construction work is
carried on/ is to be carried on
:____________________________________________________________________________________________________________________________________________________________________________________________________________________Name
and permanent address of the Establishment
_______________________________________________Name and Address of
the Employer
:_____________________________________________________________Nameof
the building or other construction work..Wage Period
:___________________________________Sl. No.Name and Surname of
workmanSerial No. in the Register of WorkmanDegisnation/Nature of
work doneNo. of days workedUnits of Work DonDaily rate of wages/
piece rateAmount of Wage earnedDeductions, if any (indicate
nature)Net Amount paidSignature/Thumb impression of the
workerInitial of Employer or his representativeBasic wagesDearness
allowancesOvertimeOther cash payments (nature of payment to be
indicated)Total12345678910111213
FORM XIXFORM XIX[See Rule 241(1)(b)]Register for Deductions for
Damage or LossName and address/location where the building or other
construction work is carried on/ is to be carried on
:____________________________________________________________________________________________________________________________________________________________________________________________________________________Name
and Permanent address of building workers:Name and permanent
address of the Employer :Nature of building or other construction
work..Sl. No.Name of workerFathers/ Husband nameDesignation/ Nature
of employmentParticulars of damage or lossDate of damage or
lossWhether building worker showed cause against deductionName of
person in whose presence building workers explanation was
heardAmount of deduction imposedNo. of installmentsDate of
recoveryFirst InstallmentLast Installment123456789101112
FORM XXFORM XX[See Rule 241(1)(b)]Register of FinesName and
address/location where the building or other construction work is
carried on/ is to be carried on
:____________________________________________________________________________________________________________________________________________________________________________________________________________________Name
and permanent address of the Establishment :Name and permanent
address of the Employer :Sl. No.Name of building
workerFathers/Husbands nameDesignation/ Nature of
employmentAct/Omission for which fine imposedDate of Offencewhether
building worker showed cause against finName of person in whose
presence building workers explanation was heardWage periods and
wages payableAmount of fine imposedDate on which fine
releasedRemarks123456789101112
FORM XXIFORM XXI[See Rule 241(1)(b)]Register for AdvancesName
and address/location where the building or other construction work
is carried on/ is to be carried on
:____________________________________________________________________________________________________________________________________________________________________________________________________________________Name
and permanent address of the Establishment :Nature of building or
other construction work..Name and permanent address of the Employer
:Sl. No.Name of building workerFathers/Husbands nameDesignation/
Nature of employmentWage period and wages payableDate and amount of
advance givenPurpose(s) for which advance givenNo. of installments
by which advance to be repaidDate and amount of each installment
repaidDate on which last installment was
repaidRemarks1234567891011
FORM XXIIFORM XXII[See Rule 241(1)(c)]Register for OvertimeName
and address/location where the building or other construction work
is carried on/ is to be carried on
:_____________________________________________________________________________________________________________________________________________________________________________Name
and permanent address of the Establishment :Sl. No.Name of building
workerFathers/Husbands nameSexDesignation/ Nature of employmentDate
on which overtime workedTotal hours of overtime worked or
production in case of piece ratedNormal rates of wagesOvertime rate
of wagesOvertime earningsDate on which overtime wages
paidRemarks123456789101112
FORM XXIIIFORM XXIII[See Rule 241(2)(a)]Wage BookName and
address of EmployerName and permanent address of the
EstablishmentName and Address of the Establishment where building
or other construction work is carried onNature of building or other
construction workFor the week/fort night/month ending
___________________1. No. of days
worked_______________________________________________________________________2.
No. of units worked in case of piece rated
workers____________________________________________3. Rate of
daily/monthly wages/ piece
rate_____________________________________________________4. Amount
of overtime wages
________________________________________________________________5.
Gross wages
payable______________________________________________________________________6.
Deductions, if any, on account of the following:(a)
fines:_____________________________________(b) damage or
loss:____________________________(c) loans and
advances:_________________________(d) subscription towards
provident fund:__________(e) subscription towards the Building
Workers Welfare Fund______________________________________(f) any
other deductions e.g. subscription to co-operative society or
account of loans from co-operativesociety/housing loan or
contribution to any relief fund as per provisions of clause (P) of
sub-section-7of the Payment of Wages Act or for payment of any
premium of Life Insurance Corporation.7. Net amount of wages paid
____________________Initials of the Employeror his
Representative
FORM XXIVFORM XXIV[See Rule 241(2)(b)]Service CertificateName
and permanent address of the EstablishmentName and address/location
where the building or other construction work is carried on/ is to
be carried onName and location of work
:_________________________________________________________Name and
address of the workman
:____________________________________________________________________________________________________Age
or Date of birth
:______________________________________________Identification marks
:_______________________________________________________________Fathers/Husbands
name
:__________________________________________________________SL.No.Total
period for which employedNature of work doneRate of wages (with
particulars of units in case of piece work)If the building worker
was a beneficiary his registration No., Date and name of the
BoardReasons/ ground on which the employee
terminatedRemarksFromTo12345678Signature of the Employeror his
Representative
Form XXVFORM XXV[See rule 242]ANNUAL RETURN OF EMPLOYER TO BE
SENT TO THE REGISTERING OFFICERYear Ending 31 st December ..1Full
name and full address of the establishment of the building and
other construction work. (Place,post office,district )2Name and
permanent address of the establishment3Name and address of the
employer4Nature of building and other construction work carried
on.5Full name of the manager or person responsible for supervisior
and control of the establishment6Number of building workers
ordinarily employed.7Total number of days during the year on which
building workers were employed.8Total number of days worked by
buildig workers during the year.9Maximum number of building workers
employed on any day during the year.10The number of accident that
took place during the year as under :(a)The total number of
accidents.(b)The number of accidents resulting in disablment of
building workers for less than 48 hours,the number of building
workers involved and the number of man days lost(c)The number of
accident resulting in disablement of building workers beyond 48
hours, but not resulting in any permanent pertial or permanent
total disablement, the number of building workers involved and the
mumber of man-days lost on account of such accidents.(d)The number
of accidents resulting in permanent partial or total disablement of
man-days lost account of such accidents.(e)The number of accidents
resulting in deaths of building workers and the number of resultant
deaths.11Change, if any, in the management of the establishment,its
location,or any other particulars furnished to the Registering
Officer in the application for Registration indicating also the
dates.Place:Signature of the EmployerDate :
Form XXVIIForm-XXVII(See rule 33-A (2)Application for the
Registration of Building WorkersRegistration Number (To be filled
in by office)1. Name of the worker :2. Age and Date of Birth
:(Proof to be enclosed)3. Name of Father / Husband :4. Details of
Dependents (Name, Age andrelationship with the building worker) :5.
Permanent address :6. Present address :7. Are you a member of any
Trade Union?If so, state the name of the Union and its Regn. No.
:8. The place of work with location in detail(Certificate of
Employment to be enclosed):9. Nature of employment and skin
:Place:Signature of the Building WorkerDate:CertificateThis is to
certify that Sri/Smt / Kum is a building worker as definedin
Section 2 (e) of the Building and Other Construction . Workers
(Regulation of Employmentand Conditions of Service) Act, 1996 and
he is eligible for Registration as Beneficiary.Place:Signature of
the AuthorisedDate :Signatory
Affix Passport size photograph
Form-XXVIIIForm-XXVIIISee rule 33-A (5)Nomination
FormRegistration Number:I hereby nominate the persons/person below
to receive the Claims due to me under Building andother
construction workers (Regulation of employment and conditions of
service) Act.1996 in theevent of my death any amount due to me
becomes payable. The nominee(s) are also entitled toreceive any
other amount that may become payable under Building and other
constructionworkers (Regulation of employment and conditions of
service) Act, 1996.Name and Address of Address of WorkerName and
Relationship of the Nominee(s) with " the building workerAge of the
Nominee(s)Percentage of Share to be paid to each
nominee123Place:Signature or left-hand thumb-impressionDate:of the
Building workerCertified that the above declaration has been
signed/thumb impression has been impressedby Sri/Smt./Kum.after
he/she has read the entries (or) after theentries have been read
over to him/her by me and understood by
him/her.Place:President/Secretary of a Registered
TradeDate:Union/Labour Department Officer nor below the rank ofan
Assistant Labour Officer/Employer of a
RegisteredEstablishment/Chief Executive of the Government
Organisationinvolved in building or other construction
activity.
Form- XXXForm- XXXSee Rule 33-B(i)Identity CardRegistration
Number:Date:1. Name of the worker :2. Name of Father/Husband :3.
Age :4. Permanent Address :5. Details of Dependents (Name, Age
andrelationship with the Building worker :6. Present Address :7.
Occupation :8. If the member of any Trade Union,the Registration
Number of the Union :Registration should be renewed before
:Secretary,Andhra Pradesh BuikHng and OtherConstruction Workers
Welfare BoardDetails of Work Done By the Building Worker(During The
Year from 1-4-20 to 31-3-20)FromToWorked asName and Address of the
Employer/EstablishmentRemarksSignature of
Employer/Establishment
Affix Passport size photograph
Form I BOCW Cess RulesFORM I[See rule 7]1Name of Establishment
:Registration No. under Building and other Construction Workers
(Regulation of Employment and Condition of Service) Act, 1996.
Registering Authority2Address :3Name of Work :4No. of Workers
employed :5Date of commencement of workEstimated period work
:DateMonthYearMonthYear6Estimated cost of construction Details of
payment of cessStagesCostAmount Challan No. and DateAdvance-A
Deduction at Source-D Final-F1st Year2nd Year3rd Year4th
YearTotal:Signature of EmployerName of EmployerDateTO BE FILLED BY
ASSESSING OFFICER7Date of completion8Final cost9Date of
assessment10Amount assessed11Date of Appeal, if any12Date of order
in Appeal13..Amount as per Order in Appeal14Date of transfer of
cess to the Board15Amount transferred Challan No. and
dateSignatureDesignation
FormII Bocw CessFORM II[See rule 9 (1)]Notice of Stoppage or
Reduction of WorkI.Name of EstablishmentRegistration No. under
Building and Other Construction Workers (Regulation of Employment
and Condition of Service) Act, 1996Address:II.Date of commencement
of workEstimated period of work:DateMonthYearMonth YearEstimated
cost of work (original)Advance Cess/Deduction at sourceDate of
Assessment Order Amountof Cess AssessedIII. Modification to the
original estimatesReasonRevised date of completion/date of
stoppageActual cost estimatesActual cost incurredWhether work is
being handed over in any other person/agency for
completion.Yes/No.If yes. Name/Address of
suchPerson/agency.Signature of employerName of employerDateTO BE
USED BY ASSESSING OFFICERDate of revision of assessmentAmount of
cess after revisionCess already receivedCess to be recoveredCess to
be refunded, if anyReference to Board for
refund;Date/numberSignatureDesignation