Bata Hessarghata

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 K
2
Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
3
Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) o
4
Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a), & (d) of Int
SL No. [1]
Name of the Employee[2]
Emp No
Father/Husband Name
1 Geetha T A
2 Vishwanath S
779303 Amasegowdae
779307 Siddagangaiah T
WAGES
Male /
Female [3]
FEMALE
MALE
Trainee-K
Trainee-K
Designation/ Department
[4]
es, 1963 in lieu of]

VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958
ataka) Rules,1963
III of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974
of Rule 46(2)(a), & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karn
Date of Joining
[5]
PF No. [7]
2-Nov-14
31-Oct-14
BG/BNG/0035224/000/0637492
BG/BNG/0035224/000/0637331
ka) Rules, 1974

and Condition of Service) (Karnataka) Rules, 1981
Attendance (Plea
Esic 7(a)
Wage fixed
including
VDA [8]
10
10
11
12
13
14
15
16
17
18
19
20
21
5038301252
5038301236
7028 P
7028 P
P
P
W/O P
P
P
W/O P
P
P
P
P
P
P
P
P
W/O
P
Attendance (Please mention the date of suspension of employee, if any [9]
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
P
P
W/O P
P
P
P
P
P
P
W/O P
P
P
W/O P
P
P
P
P
P
P
W/O P
P
P
W/O P
P
P
P
P
30
31
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
43
44
31
31
0
0
Conveyance [15]
29
HRA [14]
28
EARNED
Basic+DA [12]
27
Total OT hour worked [11]
26
No. of payable days [10]
NAME AND ADDRESS OF THE ESTABLISHM
45
46
47
6736
6736
0
0
0
0
F THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Kor
MONTH / YEAR: Mar 15

Medical Allowance [16]
Att / Bonus [17]
Special bonus [18]
OT [19]
NFH [20]
Maternity Benefit [21]
Others [22]
S. Allowance,if any [23]
Total [24]
ESI [25]
EARNED WAGES AND OTHER ALLOWANCES
48
49
50
51
52
53
54
55
56
57
0
0
292
292
0
0
0
0
0
0
0
0
0
0
0
0
7028
7028
123
123
NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:
omplex, 80ft Road, Koramangala, Bangalore-560095
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA

ROAD BANGALORE KARNATAKA-560078
R: Mar 15
PF [26]
VPF
PT [27]
TDS [28]
Society [29]
Insurance [30]/LWF
Sal. Advance [31]
Fines [32]
Damage / Loss [33]
Others [34]
DEDUCTIONS
58
59
60
61
62
63
64
65
66
67
808
808
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HE PRINCIPAL EMPLOYER:
SI. No.
Total [35]
ENCE COLONY HESARAGHATTA MAIN

LORE KARNATAKA-560078
Net Payable
[36]
Mode of Payment
Cash / Cheque No.
[37]
Employee
Signature / Thumb
Impression [38]
68
69
70
71
931
931
6097 Cheque
6097 Cheque
FORM T
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 Karnata
2 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
3 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the C
4 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a), & (d) of Inter- Sta
SL No.
[1]
Emp No
Father/Husband Name
Male /
Female [3]
1 Geetha T A
2 Vishwanath S
Total
779303 Amasegowdae
FEMALE
MALE
AGES
Trainee-K
Trainee-K
[4]
963 in lieu of]

9(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958
1963
8(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974
2)(a), & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rule
Date of Joining
[5]
PF No. [7]
2-Nov-14 BG/BNG/0035224/000/0
31-Oct-14 BG/BNG/0035224/000/0
Esic 7(a)
10
5038301252
5038301236
Service) (Karnataka) Rules, 1981
Attendance (Please mention the
Wage fixed
including
VDA [8]
10
11
11
12
13
14
15
16
17
18
19
20
21
22
P
W/O
W/O
P
P
W/O
W/O
P
7028 P
7028 P
P
P
P
P
P
P
P
P
P
P
P
P
tendance (Please mention the date of suspension of employee, if any [9]
P
P
12
13
14
15
16
17
18
19
20
21
22
23
24
23
24
25
26
27
28
29
30
31
32
33
34
35
P
W/O
W/O
P
P
W/O
W/O
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
37
38
39
P
P
P
P
P
P
40
41
28
28
56
0
0
0
36
Conveyance [15]
28
HRA [14]
27
EARNED WAGES A
Basic+DA [12]
26
25
NAME AND ADDRESS OF THE ESTABLISHMENT: Te
42
43
44
45
6736
6736
0
0
0
0
0
0
0
0
0
STABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramanga
MONTH / YEAR: Feb 15
Att / Bonus [17]
Special bonus [18]
OT [19]
NFH [20]
Others [22]
Total [24]
ESI [25]
PF [26]
46
47
48
49
50
51
52
53
54
55
292
292
584
0
0
0
0
0
0
0
0
0
0
0
0
811
811
1622
0
0
0
7839
7839
15678
138
138
276
808
808
1616
ft Road, Koramangala, Bangalore-560095
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN

VPF
PT [27]
TDS [28]
Society [29]
Insurance [30]/LWF
Sal. Advance [31]
Fines [32]
Damage / Loss [33]
Others [34]
Total [35]
DEDUCTIONS
56
57
58
59
60
61
62
63
64
65
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
946
946
1892
AL EMPLOYER:
SI. No.
Y HESARAGHATTA MAIN
TAKA-560078
Net Payable
[36]
Mode of Payment
Cash / Cheque No.
[37]
Employee
Signature / Thumb
Impression [38]
66
67
68
6893 Cheque
6893 Cheque
13786
FORM T
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 Karnata
2 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963
3 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the C
4 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a), & (d) of Inter- Sta
SL No.
[1]
Emp No
Father/Husband Name
Male /
Female [3]
1 Geetha T A
2 Vishwanath S
779303 Amasegowdae
FEMALE
MALE
AGES
Trainee-K
Trainee-K
[4]
963 in lieu of]

9(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958
1963
8(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974
2)(a), & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rule
Date of Joining
[5]
PF No. [7]
2-Nov-14 BG/BNG/0035224/000/0637492
31-Oct-14 BG/BNG/0035224/000/0637331
Esic 7(a)
10
5038301252
5038301236
Service) (Karnataka) Rules, 1981
Attendance (Please mention t
Wage fixed
including
VDA [8]
10
11
12
11
12
13
14
15
16
17
18
19
20
21
22
23
P
W/O
W/O
P
7028 P
7028 P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
Attendance (Please mention the date of suspension of employee, if any [9]
13
14
15
16
17
18
19
20
21
22
23
24
25
26
24
25
26
27
28
29
30
31
32
33
34
35
36
37
P
W/O
W/O
P
P
W/O
W/O
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
31
38
39
40
41
42
P
W/O
W/O
P
P
P
P
P
P
P
43
44
31
31
0
0
Conveyance [15]
30
HRA [14]
29
EARNED WAG
Basic+DA [12]
28
27
NAME AND ADDRESS OF THE ESTABLISHMENT
45
46
47
6736
6736
0
0
0
0
F THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Kor
MONTH / YEAR: Jan-15

Att / Bonus [17]
Special bonus [18]
OT [19]
NFH [20]
Others [22]
Total [24]
ESI [25]
48
49
50
51
52
53
54
55
56
57
0
0
292
292
0
0
0
0
0
0
0
0
0
0
0
0
7028
7028
123
123
omplex, 80ft Road, Koramangala, Bangalore-560095
BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA

R: Jan-15
PF [26]
VPF
PT [27]
TDS [28]
Society [29]
Insurance [30]/LWF
Sal. Advance [31]
Fines [32]
Damage / Loss [33]
Others [34]
DEDUCTIONS
58
59
60
61
62
63
64
65
66
67
808
808
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HE PRINCIPAL EMPLOYER:
SI. No.
Total [35]
ENCE COLONY HESARAGHATTA MAIN

LORE KARNATAKA-560078
Net Payable
[36]
Mode of Payment
Cash / Cheque No.
[37]
Employee
Signature / Thumb
Impression [38]
68
69
70
71
931
931
6097 Cheque
6097 Cheque

Bata Hessarghata

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COMBINED MUSTER ROLL CUM REGISTER OF WAGES

Name of the Employee[2]

es, 1963 in lieu of]

ka) Rules, 1974

Attendance (Please mention the date of suspension of employee, if any [9]

Total OT hour worked [11]

No. of payable days [10]

NAME AND ADDRESS OF THE ESTABLISHM

MONTH / YEAR: Mar 15

Att / Bonus [17]

Special bonus [18]

Maternity Benefit [21]

S. Allowance,if any [23]

EARNED WAGES AND OTHER ALLOWANCES

NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

omplex, 80ft Road, Koramangala, Bangalore-560095

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA

Sal. Advance [31]

Damage / Loss [33]

ENCE COLONY HESARAGHATTA MAIN

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

Name of the Employee[2]

963 in lieu of]

Service) (Karnataka) Rules, 1981

Attendance (Please mention the

tendance (Please mention the date of suspension of employee, if any [9]

Medical Allowance [16]

Total OT hour worked [11]

No. of payable days [10]

NAME AND ADDRESS OF THE ESTABLISHMENT: Te

MONTH / YEAR: Feb 15

Att / Bonus [17]

Special bonus [18]

Maternity Benefit [21]

S. Allowance,if any [23]

EARNED WAGES AND OTHER ALLOWANCES

NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

ft Road, Koramangala, Bangalore-560095

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN

Sal. Advance [31]

Damage / Loss [33]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

Name of the Employee[2]

963 in lieu of]

Service) (Karnataka) Rules, 1981

Attendance (Please mention t

Attendance (Please mention the date of suspension of employee, if any [9]

Total OT hour worked [11]

No. of payable days [10]

NAME AND ADDRESS OF THE ESTABLISHMENT

MONTH / YEAR: Jan-15

Att / Bonus [17]

Special bonus [18]

Maternity Benefit [21]

S. Allowance,if any [23]

EARNED WAGES AND OTHER ALLOWANCES

NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

omplex, 80ft Road, Koramangala, Bangalore-560095

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA

Sal. Advance [31]

Damage / Loss [33]

ENCE COLONY HESARAGHATTA MAIN

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