Address of Company

Address_1
Address_2

Sr.
No.

E.Code

E0001

ESI No.

Name
Ajay

Father's/Husband Name
Madan Lal

Gross
Salary

D.O.J.

26156

01/01/1900

D.O.L

O.Balanc
FL
8

O.Balance
CL

Availed
SL

###

FL

CL
8

C.Balance
SL

FL
4

CL
- -

Jan-15
SL

FL

CL

SL

Feb-15
From

26

To

FL

CL

SL

From

5,20,21

Mar-15
To

FL

CL

SL

Apr-15
From

06

To

FL

CL

SL

May-15
From

To

FL

CL

SL

May-15

Jun-15
From

To

FL

Jul-15

CL

SL

From

To

FL

CL

SL

From

To

Name of Company
Sr. No.

E.Code

Name

Father's/Husband Name

E0001

Ajay

Madan Lal

Adult S.N

Salary

D.O.J.

E0001

12995

01/01/1900

D.O.L

Max. EL
in Year
15

###
###
O.Bal
21

Availed
7

T.W.D
286

C.Y EL
14

C. Bal
28
###

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Ajay

Father's Name

Madan Lal

Date of Joinig into service

01-Jan-1900

Tocken No.

E0001

No

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year

3
Period for which festival holidays/ Casual/ Sick leave applied for

Festival

Casual

Sick

5,20,21

1 CL 2 SL

06

1 FL 1 CL

1 FL 1 CL 1 SL

1 FL

1 FL 1 CL

2 FL 1 CL

1 CL 1 SL

From

To
26

Kind of Leave
1 FL

1 FL 1 CL
9

Page 7 of 48

1 CL

4
Whether
granted or
refused

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Abhimanyu

Father's Name

R.P Singh

Date of Joinig into service

11-May-2015

Tocken No.

E0002

No

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year

3
Period for which festival holidays/ Casual/ Sick leave applied for

Festival

Casual

Sick

0.5

0.5 CL

1 FL

1 FL 1 CL

2 FL 2 CL

0.5

2 FL 0.5 CL

1 CL 1 SL

From

To

Page 8 of 48

Kind of Leave

4
Whether
granted or
refused

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Divya

Father's Name

Rajesh Pahuja

Date of Joinig into service

19-Nov-2014

Tocken No.

E0003

Yes

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To
26

Kind of Leave
1 FL

1 FL

1 FL

Page 9 of 48

4
Whether
granted or
refused

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Sandeep

Father's Name

Puran Chand Yadav

Date of Joinig into service

16-Apr-2012

Tocken No.

E0004

No

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To

Kind of Leave

0
1 FL

Page 10 of 48

4
Whether
granted or
refused

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Sumit

Father's Name

Hansraj Panchal

Date of Joinig into service

01-Apr-2013

Tocken No.

E0005

Yes

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To
26

Kind of Leave
1 FL

1 FL

Page 11 of 48

4
Whether
granted or
refused

Dec-15
2

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Ashish Kumar

Father's Name

Suraj Bhan

Date of Joinig into service

01-Dec-2014

Tocken No.

E0006

Yes

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To

Kind of Leave

1 FL

Page 12 of 48

4
Whether
granted or
refused

Nov-15
Dec-15
1

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Upender Kumar

Father's Name

Date of Joinig into service

19-Nov-2014

Tocken No.

Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

E0007

Yes

Whether covered by the Employee's State Insurance Scheme

1

Ram Lal

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To
26

Kind of Leave
1 FL

1 FL

1 FL

Page 13 of 48

4
Whether
granted or
refused

Oct-15
Nov-15
Dec-15
3

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Gaurav

Father's Name

Shyam Sunder

Date of Joinig into service

02-Feb-2009

Tocken No.

E0008

Yes

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15
Aug-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year

3
Period for which festival holidays/ Casual/ Sick leave applied for

Festival

Casual

Sick

From

To

Kind of Leave

26

1 FL

27,28

2 CL

1 FL

Page 14 of 48

4
Whether
granted or
refused

Sep-15
Oct-15
Nov-15
Dec-15
2

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Sanjay

Father's Name

Dharam Singh

Date of Joinig into service

01-Nov-2013

Tocken No.

E0009

Yes

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15
Jul-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year
Festival

Casual

Sick

3
Period for which festival holidays/ Casual/ Sick leave applied for
From

To
26

Kind of Leave
1 FL

1 FL

Page 15 of 48

4
Whether
granted or
refused

Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
2

Form No. B

National Festival Holidays, Casual & Sick Leave Register

[Under the Punjab Industrial Establishment (NATIONAL FESTIVAL HOLIDAYS, CASUAL & SICK LEAVE) Rules 1965]

Name of Company

Name of Company

Address

Address_1
Address_2

Employee Name

Father's Name

Date of Joinig into service

30-Dec-1899

Tocken No.

Whether covered by the Employee's State Insurance Scheme

1
Serial No.

Jan-15
Feb-15
Mar-15
Apr-15
May-15
Jun-15

2
Number of festival holidays/
Casual/ Sick leave at the
beginingof the year

3
Period for which festival holidays/ Casual/ Sick leave applied for

Festival

Casual

Sick

From

To

Page 16 of 48

Kind of Leave

4
Whether
granted or
refused

Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15

Page 17 of 48

[See Rule 7 (2)]

egister

les 1965]

5
Remarks
FL

CL

SL

-1

Page 18 of 48

[See Rule 7 (2)]

egister

les 1965]

5
Remarks
FL

CL

SL

6.5

6.5

5.5

3.5

Page 19 of 48

[See Rule 7 (2)]

egister

les 1965]

uja

5
Remarks
FL

CL

SL

Page 20 of 48

[See Rule 7 (2)]

egister

les 1965]

d Yadav

5
Remarks
FL

CL

SL

Page 21 of 48

[See Rule 7 (2)]

egister

les 1965]

nchal

5
Remarks
FL

CL

SL

Page 22 of 48

[See Rule 7 (2)]

egister

les 1965]

5
Remarks
FL

CL

SL

Page 23 of 48

[See Rule 7 (2)]

egister

les 1965]

5
Remarks
FL

CL

SL

Page 24 of 48

[See Rule 7 (2)]

egister

les 1965]

der

5
Remarks
FL

CL

SL

Page 25 of 48

[See Rule 7 (2)]

egister

les 1965]

gh

5
Remarks
FL

CL

SL

Page 26 of 48

[See Rule 7 (2)]

egister

les 1965]

5
Remarks
FL

CL

SL

Page 27 of 48

Page 28 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Ajay
E0001

S.No. in the Register of Adult/ Child worker

Date of Discharge
Note :- Separate page will be alloted to each worker.

Date of entry into service

01-Jan-1900

31-Jan

12132.00

Whether leave in
accordance with scheme
under section
79 (8) refused

Total of col. 9 and 10

Number of days of
lay of

P.

Leave to
credit

10

11

12

26

22

22

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

Number of days of
work performed

Rs.

Total of cols. 4 to 7

To

Number of days of
leave enjoyed

Wages earned
during the
wages period

Number of days of
maternity leave

Calendar Year of service

From

Madan Lal

Date and amount of payment made in lieu of leave due

Number of days
worked during the
Calendar year

Wages
Period

Father's/Husband Name

Leave
enjoyed

From

To

Balance of leave on credit

Name of Employee

13

14

13,14,21,22

18

21

Jan-15

01-Jan

Feb-15

01-Feb

28-Feb

12132.00

21

21

23

19

Mar-15

01-Mar

31-Mar

12132.00

24

24

24

20

Apr-15
May-15

01-Apr

30-Apr

12132.00

24

24

26

01-May

31-May

12132.00

24

26

27

8,21

21

Jun-15

01-Jun

30-Jun

12132.00

24

25

28

24

21

Jul-15

01-Jul

31-Jul

12132.00

27

27

29

22

Aug-15

01-Aug

31-Aug

12995.00

23

23

30

23

Sep-15

01-Sep

30-Sep

12995.00

25

25

11

32

25

Oct-15

01-Oct

31-Oct

12995.00

25

25

12

33

26

Nov-15

01-Nov

30-Nov

12995.00

22

22

13

34

27

Dec-15

01-Dec

30-Dec

12995.00

25

25

14

35

28

149899

286

293

14

35

Page 29 of 48

22

28

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Abhimanyu
E0002

S.No. in the Register of Adult/ Child worker

11-May-2015

Whether leave in
accordance with scheme
under section
79 (8) refused

Leave to
credit

Total of col. 9 and 10

Date of entry into service

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

To

Number of days of
lay of

From

Wages earned
during the
wages period

Number of days of
work performed

Calendar Year of service

Number of days
worked during the
Calendar year
Wages
Period

R.P Singh

Date and amount of payment made in lieu of leave due

Total of cols. 4 to 7

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To
13

Balance of leave on credit

Name of Employee

14

Jan-15

30-Dec

30-Dec

Feb-15

30-Dec

30-Dec

Mar-15

30-Dec

30-Dec

Apr-15
May-15

30-Dec

30-Dec

01-May

31-May

10500.00

Jun-15

01-Jun

30-Jun

15500.00

26

Jul-15

01-Jul

31-Jul

15500.00

26.5

Aug-15

01-Aug

31-Aug

15500.00

Sep-15

01-Sep

30-Sep

Oct-15

01-Oct

31-Oct

Nov-15

01-Nov

Dec-15

01-Dec

18

26

26.5

24

24

15500.00

24

24

15500.00

23

23

30-Nov

15500.00

22.5

22.5

30-Dec

15500.00

25

25

119000

189

189

18

Page 30 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Divya
E0003

S.No. in the Register of Adult/ Child worker

05-Jun-2015

Whether leave in
accordance with scheme
under section
79 (8) refused

Leave to
credit

Total of col. 9 and 10

Date of entry into service

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

To

Number of days of
lay of

From

Wages earned
during the
wages period

Number of days of
work performed

Calendar Year of service

Number of days
worked during the
Calendar year
Wages
Period

Rajesh Pahuja

Date and amount of payment made in lieu of leave due

Total of cols. 4 to 7

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To
13

Balance of leave on credit

Name of Employee

14

Jan-15

30-Dec

30-Dec

Feb-15

30-Dec

30-Dec

Mar-15

30-Dec

30-Dec

Apr-15
May-15

30-Dec

30-Dec

30-Dec

30-Dec

Jun-15

01-Jun

30-Jun

5200.00

22

22

Jul-15

01-Jul

31-Jul

5806.00

25

25

Aug-15

01-Aug

31-Aug

6000.00

23

23

Sep-15

01-Sep

30-Sep

5900.00

24.5

24.5

Oct-15

01-Oct

31-Oct

6280.00

25

25

Nov-15

01-Nov

30-Nov

6280.00

23

23

Dec-15

01-Dec

30-Dec

6280.00

20

25

41746

162.5

167.5

Page 31 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Sandeep
E0004

S.No. in the Register of Adult/ Child worker

08-Jun-2015

Whether leave in
accordance with scheme
under section
79 (8) refused

Leave to
credit

Total of col. 9 and 10

Date of entry into service

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

To

Number of days of
lay of

From

Wages earned
during the
wages period

Number of days of
work performed

Calendar Year of service

Number of days
worked during the
Calendar year
Wages
Period

Puran Chand Yadav

Date and amount of payment made in lieu of leave due

Total of cols. 4 to 7

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To
13

Balance of leave on credit

Name of Employee

14

Jan-15

30-Dec

30-Dec

Feb-15

30-Dec

30-Dec

Mar-15

30-Dec

30-Dec

Apr-15
May-15

30-Dec

30-Dec

30-Dec

30-Dec

Jun-15

01-Jun

30-Jun

4200.00

18

18

Jul-15

01-Jul

31-Jul

6000.00

26

26

Aug-15

01-Aug

31-Aug

5903.00

23.5

23.5

Sep-15

01-Sep

30-Sep

6000.00

24

25

Oct-15

01-Oct

31-Oct

6280.00

25

25

Nov-15

01-Nov

30-Nov

6175.00

19.5

21.5

Dec-15

01-Dec

30-Dec

6077.00

25

25

40635

161

164

Page 32 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Sumit
E0005

S.No. in the Register of Adult/ Child worker

10-Jun-2015

Whether leave in
accordance with scheme
under section
79 (8) refused

Leave to
credit

Total of col. 9 and 10

Date of entry into service

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

To

Number of days of
lay of

From

Wages earned
during the
wages period

Number of days of
work performed

Calendar Year of service

Number of days
worked during the
Calendar year
Wages
Period

Hansraj Panchal

Date and amount of payment made in lieu of leave due

Total of cols. 4 to 7

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To
13

Balance of leave on credit

Name of Employee

14

Jan-15

30-Dec

30-Dec

Feb-15

30-Dec

30-Dec

Mar-15

30-Dec

30-Dec

Apr-15
May-15

30-Dec

30-Dec

30-Dec

30-Dec

Jun-15

01-Jun

30-Jun

3800.00

16

16

Jul-15

01-Jul

31-Jul

5226.00

22

22

Aug-15

01-Aug

31-Aug

5903.00

22.5

24.5

Sep-15

01-Sep

30-Sep

5800.00

23

23

Oct-15

01-Oct

31-Oct

6077.00

25

25

Nov-15

01-Nov

30-Nov

6280.00

19.5

22.5

Dec-15

01-Dec

30-Dec

6179.00

23

24

39265

151

157

Page 33 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Ashish Kumar
E0006
31-Jan-2015

Leave to
credit

Whether leave in
accordance with scheme
under section
79 (8) refused

19-Nov-2014

Total of col. 9 and 10

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

Number of days of
lay of

To

Number of days of
work performed

Calendar Year of service

From

Wages earned
during the
wages period

Date of entry into service

Date and amount of payment made in lieu of leave due

Number of days
worked during the
Calendar year
Wages
Period

Suraj Bhan

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To
13

Balance of leave on credit

S.No. in the Register of Adult/ Child worker

Total of cols. 4 to 7

Name of Employee

14

Jan-15

01-Jan

31-Jan

4185.00

18

18

Feb-15

30-Dec

30-Dec

0.00

Mar-15

30-Dec

30-Dec

0.00

Apr-15
May-15

30-Dec

30-Dec

0.00

30-Dec

30-Dec

0.00

Jun-15

30-Dec

30-Dec

0.00

Jul-15

30-Dec

30-Dec

0.00

Aug-15

30-Dec

30-Dec

0.00

Sep-15

30-Dec

30-Dec

0.00

Oct-15

30-Dec

30-Dec

Nov-15

30-Dec

30-Dec

Dec-15

30-Dec

30-Dec

4185

18

18

Page 34 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Upender Kumar

Date of entry into service

28-Feb-2015

Date and amount of payment made in lieu of leave due

Number of days of
work performed

Number of days of
lay of

31-Jan

5419.00

P.

Whether leave in
accordance with scheme
under section
79 (8) refused

Rs.

Leave to
credit

Total of col. 9 and 10

To

10

11

12

23

13

13

Number of days of
leave enjoyed

From

Wages earned
during the
wages period

Wages
Period

Number of days of
maternity leave

Calendar Year of service

Number of days
worked during the
Calendar year

23

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

Date of Discharge
Note :- Separate page will be alloted to each worker.

02-Feb-2009

Balance of leave on credit

S.No. in the Register of Adult/ Child worker

Ram Lal

Father's/Husband Name

E0007

Total of cols. 4 to 7

Name of Employee

Leave
enjoyed

From

To
13

14

12

Jan-15

01-Jan

Feb-15

01-Feb

28-Feb

6000.00

22

22

14

14

Mar-15

30-Dec

30-Dec

0.00

Apr-15
May-15

30-Dec

30-Dec

0.00

30-Dec

30-Dec

Jun-15

30-Dec

30-Dec

Jul-15

30-Dec

30-Dec

Aug-15

30-Dec

30-Dec

Sep-15

30-Dec

30-Dec

Oct-15

30-Dec

30-Dec

Nov-15

30-Dec

30-Dec

Dec-15

30-Dec

30-Dec

0.00

11419

45

45

Page 35 of 48

14

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Gaurav
E0008
28-Feb-2015

Number of days of
lay of

31-Jan

6782.00

Leave to
credit

Whether leave in
accordance with scheme
under section
79 (8) refused

Number of days of
work performed

P.

01-Nov-2013

Total of col. 9 and 10

Rs.

10

11

12

20

Number of days of
leave enjoyed

To

Number of days of
maternity leave

Calendar Year of service

From

Wages earned
during the
wages period

Date of entry into service

Date and amount of payment made in lieu of leave due

Number of days
worked during the
Calendar year
Wages
Period

Shyam Sunder

19

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To

Balance of leave on credit

S.No. in the Register of Adult/ Child worker

Total of cols. 4 to 7

Name of Employee

13

14

27

Jan-15

01-Jan

Feb-15

01-Feb

28-Feb

601.00

Mar-15

30-Dec

30-Dec

0.00

Apr-15
May-15

30-Dec

30-Dec

0.00

30-Dec

30-Dec

Jun-15

30-Dec

30-Dec

Jul-15

30-Dec

30-Dec

Aug-15

30-Dec

30-Dec

Sep-15

30-Dec

30-Dec

Oct-15

30-Dec

30-Dec

Nov-15

30-Dec

30-Dec

Dec-15

30-Dec

30-Dec

0.00

7383

20

21

Page 36 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

(As Amended up-to-date)

Sanjay
E0009
28-Feb-2015

Number of days of
lay of

31-Jan

5987.00

Leave to
credit

Whether leave in
accordance with scheme
under section
79 (8) refused

Number of days of
work performed

P.

01-Jan-2014

Total of col. 9 and 10

Rs.

10

11

12

24

Number of days of
leave enjoyed

To

Number of days of
maternity leave

Calendar Year of service

From

Wages earned
during the
wages period

Date of entry into service

Date and amount of payment made in lieu of leave due

Number of days
worked during the
Calendar year
Wages
Period

Dharam Singh

23

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

Date of Discharge
Note :- Separate page will be alloted to each worker.

Father's/Husband Name

Leave
enjoyed

From

To

Balance of leave on credit

S.No. in the Register of Adult/ Child worker

Total of cols. 4 to 7

Name of Employee

13

14

Jan-15

01-Jan

Feb-15

01-Feb

28-Feb

5943.00

20

21

Mar-15

30-Dec

30-Dec

0.00

Apr-15
May-15

30-Dec

30-Dec

0.00

30-Dec

30-Dec

Jun-15

30-Dec

30-Dec

Jul-15

30-Dec

30-Dec

Aug-15

30-Dec

30-Dec

Sep-15

30-Dec

30-Dec

Oct-15

30-Dec

30-Dec

Nov-15

30-Dec

30-Dec

Dec-15

30-Dec

30-Dec

0.00

11930

43

45

Page 37 of 48

REGISTER OF

Form No. 15 (Prescribed under Rule 94)

Section 83

LEAVE WITH WAGES

Father's/Husband Name

S.No. in the Register of Adult/ Child worker

Date of entry into service

Date of Discharge
Note :- Separate page will be alloted to each worker.

Date and amount of payment made in lieu of leave due

Whether leave in
accordance with scheme
under section
79 (8) refused

Total of col. 9 and 10

Leave to
credit

10

11

12

Balance of leave
from proceeding
year
Leave earned during
the year mentioned
in col. 1

P.

Number of days of
leave enjoyed

Rs.

Number of days of
maternity leave

To

Number of days of
lay of

From

Wages earned
during the
wages period

Wages
Period

Number of days of
work performed

Calendar Year of service

Number of days
worked during the
Calendar year

Total of cols. 4 to 7

Name of Employee

Leave
enjoyed

From

To
13

Balance of leave on credit

(As Amended up-to-date)

14

Jan-15

30-Dec

30-Dec

Feb-15

30-Dec

30-Dec

Mar-15

30-Dec

30-Dec

Apr-15
May-15

30-Dec

30-Dec

30-Dec

30-Dec

Jun-15

30-Dec

30-Dec

Jul-15

30-Dec

30-Dec

Aug-15

30-Dec

30-Dec

Sep-15

30-Dec

30-Dec

Oct-15

30-Dec

30-Dec

Nov-15

30-Dec

30-Dec

Dec-15

30-Dec

30-Dec

Page 38 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

15
16
17
18

12995

Page 39 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

15
16
17
18

15500

Page 40 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

uja

15
16
17
18

6280

Page 41 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

d Yadav

15
16
17
18

6280

Page 42 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

nchal

15
16
17
18

6280

Page 43 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

4
Rs. 447

15
16
17
18

5815

Page 44 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

9
Rs. 3231

15
16
17
18

6000

Page 45 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

der

3
Rs. 647

15
16
17
18

8410

Page 46 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

gh

Rs. 231

15
16
17
18

6000

Page 47 of 48

Normal rate of wages

Cash equivalent of
advantage accuring through
concessional sale of food
grains & other articals
Rate of wages for the leave
period (Total of cols. 15 &
16)

Remarks

Part I- Adult
Part II- Children

15
16
17
18

Page 48 of 48