FORMS UNDER CL(R&A) ACT, 1970
(For Principal Employers)
FORM I
(See Rule 17(1)]
Application for Registration of Establishments Employing Contract Labour
1. Name and location of the Establishment.
2. Postal address of the Establishment.
3. Full name and address of the Principal Employer (furnish father's name in the case of individuals).
4. Full name and address of the manager or person responsible for the supervision and control of the Establishment.
5. Nature of work carried on in the Establishment.
6. Particulars of Contractors and Contract Labour :
(a) Names and Addresses of Contractors.
(b) Nature of work in which contract labour is employed or is to be employed.
(c) Maximum number of contract labour to be employed on any day through each contractor.
(cc) Estimated date of commencement of each contract work under each contractor.
(d) Estimated date of termination of employment of contract labour under each contractor.
7. Particulars of Demand Draft enclosed (Name of the Union Bank, Amount, Demand Draft No. and Date).
I hereby declare that the particulars given above are true to the best of my knowledge and belief.
Principal Employer.
Seal and Stamp
Office of the Registering Officer
Form V
[See Rule 21(2)]
Form of Certificate by Principal Employer
Certified that I have engaged the applicant (name of the contractor) as a contractor in my establishment. I undertake to be bound by all the provisions of the Contract Labour (Regulation & Abolition) Act, 1970 and the Contract Labour (Regulation & Abolition) Central Rules, 1971, in so far as the provisions are applicable to me in respect of the employment of contract labour by the applicant in my establishment.
Place: Signature of Principal Employer
Date: Name and address of the establishment
FORM VI-B
[See Rule 81(3)]
Notice of commencement/completion of contract work
(1) Name of the principal employer and address ..
(2) No. and date of Certificate of Registration
(3) I/We hereby intimate that the contract work (Name of work) given to (name and address of the contractor) having licence No dated . has been commenced / completed with effect from (date)/on (date).
Signature of the Principal Employer
To
The Inspector,
FORM XII
[See Rule 74]
Register of Contractors
1. Name and address of the Principal Employer . ...
2. Name and address of the establishment
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Period of contract |
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Sl. No. |
Name and address of contractor |
Nature of work on contract |
Location of contract work |
From |
To |
Maximum No. of workmen employed by contractor |
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FORM XXV
[See Rule 82(2)]
Annual Return of Principal Employer to be sent to the Registering Officer
Year ending 31st December ....
1. Full name and address of the Principal Employer.
2. Name of Establishment:
(a) District
(b) Postal Address
(c) Nature of operation/industry/work carried on.
3. Full name of the manager or person responsible for supervision and control of the establishment.
4. Number of Contractors who worked in the establishment during the year (Give details in Annexure).
5. Nature of work/operation on which contract labour was employed.
6. Total number of days during the year on which contract labour was employed.
7. Total number of man-days worked by contract labour during the year.
8. Maximum number of workmen employed directly on any day during the year.
9. Total number of days during the year on which direct labour was employed.
10. Total number of man-days worked by directly employed workmen.
11. Change, 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.
Principal Employer
Place .
Date ...
ANNEXURE TO FORM
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Name and Address of the Contractor |
Period of contract From-To |
Nature of work |
Maximum number of workers employed by each contractor |
No. of days worked |
No. of man-days worked |
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(For
Contractors)
FORM IV
[See Rule 21 (1)]
Application for Licence
1. Name and address of the contractor (including his father's name in case of individuals).
2. Date of birth and age (in case of individuals).
3. Particulars of Establishment where Contract Labour is to be employed-
(a) Name and address of the Establishment ;
(b) Type of business, trade, industry, manufacture or occupation, which is carried on in the Establishment ;
(c) Number and date of Certificate of Registration of the Establishment under the Act ;
(d) Name and address of the Principal Employer.
4. Particulars of Contract Labour-
(a) Nature of work in which Contract Labour is employed or is to be employed in the Establishment ;
(b) Duration of the proposed contract work (give particulars of proposed date of commencing and ending) ;
(c) Name and address of the Agent or Manager of Contractor at the work-site ;
(d) Maximum number of Contract Labour proposed to be employed on the Establishment on any date;
5. Whether the contractor was convicted of any offence within the preceding five years. If so, give details.
6. Whether there was any order against the contractor revoking or suspending licence or forfeiting security deposits in respect of an earlier contract. If so, the date of such order.
7. Whether the contractor has worked in any other establishment within the past five years. If so, give details of the Principal Employer, Establishment, and nature of work.
8. Whether a certificate by the Principal Employer, in Form V is enclosed.
*9. Amount of licence fee , name of the Union Bank , demand draft No. and date.
10. Amount of security deposit, name of the Union Bank, demand draft No. and date
*Note:- The application shall be accompanied by demand draft and the challan for the appropriate amount and a certificate in Form V from the principal employer dated of the receipt of the application with demand draft and the challan for fees/security deposit.
Declaration.- I hereby declare that the details given above are correct to the best of my knowledge and belief.
Signature of the Applicant(Contractor)
Place .
Date
Note.-The application should be accompanied by a Treasury Receipt for the appropriate amount and a certificate in Form V from the Principal Employer.
(To be filled in the office of the Licensing Officer)
Date of receipt of the application with challan for fees/Security Deposit
Signature of the Licensing Officer.
FORM V-A
[See Rule 24(1-A)]
Application for Adjustment of Security Deposit
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Name and address of the Contractor |
No. and date of licence |
Date of expiry of previous licence |
Whether the licence of the contractor was suspended or revoked |
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(1) |
(2) |
(3) |
(4) |
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No. and date of the demand draft of security deposit in respect of the previous licence |
Amount of previous security deposit |
No. and date of the demand draft of the balance security deposit, if any, required on the fresh contract |
No. and date of certificate of registration of the establishment in relation to which the new licence is applied for |
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(5) |
(6) |
(7) |
(8) |
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Name and address of the principal employer |
Particulars of fresh contract |
Remarks |
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(9) |
(10) |
(11) |
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Place:
Date:
Signature of the Applicant.
FORM VI-A
[See Rule 25(2)(viii)]
Notice of commencement/completion of contract work
I/We Shri/M/s .. (Name and address of the contractor) hereby intimate that the contract work.
.. (Name of work) in establishment of (Name and address of principal employer) for which licence No , dated .. has been issued to me/us by the licencing officer (name of the headquarter), has been commenced/completed with effect from (date)/on (date).
Signature of Contractor
To
The Inspector,
..
..
FORM VII
[See Rule 29(2)]
Application for Renewal of Licence
1. Name and address of the contractor.
2. Number and date of the licence.
3. Date of expiry of the previous licence.
4. Whether the licence of the contractor was suspended or revoked.
5. Name of the Bank number and date of the demand draft enclosed. Date of receipt of the application with demand draft number and date.
Place ...
Signature of the Applicant
Date
(To be filled in the Office of the Licensing Officer)
Date of receipt of the application with
Treasury Receipt No. and date. Signature of the Licensing Officer
FORM XIII
[See Rule 75]
Register of Workmen Employed by Contractor
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Name and address of Contractor |
Name and address of establishment in/ under which |
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contract is carried on .. |
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Nature and location of work . |
Name and address of Principal Employer .. |
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Sl. No. |
Name and surname of workmen |
Age and Sex |
Father's/ |
Nature of Employment/ Designation |
Permanent home address of workmen (Village and Tahsil/ Taluk and District) |
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6 |
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Local address |
Date of Commencement of employment |
Signature or thumb-impression of workmen |
Date of termination of employment |
Reasons for termination |
Remarks |
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10 |
11 |
12 |
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FORM XIV
[See Rule 76]
Employment Card
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Name and address of Contractor |
Name and address of Establishment in / under which |
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contract is carried on |
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Nature of work and location of work |
Name and address of Principal Employer . |
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Name of workmen |
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.. |
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2. |
Sl. No. in the register of workmen |
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employed .. |
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3. |
Nature of employment/Designation |
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.. |
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4. |
Wages rate (with particular of unit, in case |
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of piece-work) |
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5. |
Wage period . |
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6. |
Tenure of employment |
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7. |
Remarks . |
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Signature of Contractor |
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FORM XV
[See Rule 77]
Service Certificate
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Name and address of contractor |
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Name and address of establishment in/ |
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under which contract is carried on |
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Nature and location of work |
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Name and address of the wor- |
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Name and address of Principal Employer |
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man |
.. |
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... ... .. |
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... ... .. |
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Age or Date of Birth |
.. |
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Identification Marks |
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Father's / Husband's name |
.. |
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Sl. No. |
Total period for which employed |
Nature of work done |
Rate of wages (with particulars of unit in case of piece work) |
Remarks |
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From |
To |
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FORM XVI
[See Rule 78(1) (a)(i)]
Muster Roll
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Name and address of contractor |
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Name and address of establishment in/ |
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under which contract is carried on |
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Nature and location of work |
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Name and address of Principal Employer |
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. . |
For the month of ... .. |
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Sl. No. |
Name of workman |
Father's / Husband's name |
Sex |
Dates |
Remarks |
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1 2 3 4 5 |
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FORM XVII
[See Rule 78(1) (a)(i)]
Register of Wages
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Name and Address of Contractor |
Name and address of Establishment in / under |
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which contract is carried on . |
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Nature and location of works |
... |
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... |
Name and address of Principal |
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Employer
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Wage period: Monthly ... |
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Sl. No. |
Name of workman |
Serial No. in the register of workman |
Designation / nature of work done |
No. of days worked |
Units of works done |
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1 |
2 |
3 |
4 |
5 |
6 |
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Daily-rate of wages/piece rate |
Amount of wages earned |
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Basic wages |
Dearness Allowances |
Overtime |
Other cash payments (Nature of payment to be indicated) |
Total |
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8 |
9 |
10 |
11 |
12 |
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Deductions, if any, (indicate nature) |
Net amount paid |
Signature / Thumb impression of workman |
Initial of contractor or his representative |
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14 |
15 |
16 |
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FORM XVIII
[See Rule 78(1)(a)(i)]
Form of Register of Wages-cum-Muster Roll
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Name and address of Contractor |
Name and address of establishment in/under which |
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contract is carried on . |
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Name and address of Principal Employer . |
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... |
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Wage period: Weekly/Fortnightly |
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Nature and location of work |
From to ... |
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... |
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Sl. No. |
Sl. No. in Register of workmen |
Name of employee |
Designation/ nature of work |
Daily attendance/ units worked
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Total attendance / units of work done |
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1 |
2 |
3 |
4 |
5 |
6 |
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Daily-rate of wages/piece-rate |
Amount of wages earned |
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Basic Wages |
Dearness allowance |
Overtime |
Other cash payment (nature of payments to be indicated) |
Total |
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8 |
9 |
10 |
11 |
12 |
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Deduction, if any, (indicate nature) |
Net amount paid |
Signature / Thumb impression of workman |
Initials of contractor or his representative |
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14 |
15 |
16 |
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FORM XIX
[See Rule 78(1) (b)]
Wage Slip
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Name and address of Contractor |
Name and Father's / Husband's name of the |
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workman . |
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.. |
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Nature of work and location of work |
For the Week/Fortnight/Month ending ... |
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.. |
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... |
.. |
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1. |
No. of days worked |
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2. |
No. of units worked in case of piece |
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rate workers .. |
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3. |
Rate of daily wages/piece-rate |
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4. |
Amount of overtime wages |
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.. |
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5. |
Gross wages payable |
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.. |
.. |
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6. |
Deductions, if any |
.. |
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.. |
.. |
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7. |
Net amount of wages paid |
.. |
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.. |
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Initials of the
Contractor or his
Representative
FORM XX
[See Rule 78(1) (a) (ii)]
Register of Deductions for Damage or Loss
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Name and address of Contractor |
Name and address of Establishment in / under |
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which contract is carried on . |
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... |
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Name and location of work . |
Name and address of Principal Employer |
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... |
... |
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Sl. No. |
Name of workman |
Father's / Husband's name |
Designation/ Nature of Employment |
Particulars of damage or loss |
Date of Damage or loss |
Whether workman showed cause against deduction |
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2 |
3 |
4 |
5 |
6 |
7 |
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Name of person in whose presence employee's explanation was heard |
Amount of deduction imposed |
No. of installments |
Date of recovery |
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First installment |
Last installment |
Remarks |
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9 |
10 |
11 |
12 |
13 |
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FORM XXI
[See Rule 78(1) (a) (ii)]
Register of Fines
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Name and address of Contractor |
Name and address of Establishment in / under |
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which contract is carried on . |
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... |
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Name and location of work . |
Name and address of Principal Employer |
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... |
... |
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Sl. |
Name of workman |
Father's/ Husband name |
Designation / nature for employment |
Act/ Omission for which fine imposed |
Date of offence |
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2 |
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6 |
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Whether workman showed cause against fine |
Name of person in whose presence employee's explanation was heard |
Wage periods and wages payable |
Amount of fine imposed |
Date on which fine realised |
Remarks |
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8 |
9 |
10 |
11 |
12 |
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FORM XXII
[See Rule 78(1) (a) (ii)]
Register of Advances
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Name and address of Contractor |
Name and address of establishment in / under |
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which contract is carried on . |
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... |
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Name and location of work . |
Name and address of Principal Employer |
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... |
... |
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Sl. |
Name of workman |
Father's/ Husband name |
Nature of employment/ Designation |
Wage period and wages payable |
Date & amount of advance given |
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2 |
3 |
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5 |
6 |
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Purpose(s) for which advance made |
No. of installments by which advance to be repaid |
Date & amount of each installment repaid |
Date on which last installment was repaid |
Remarks |
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8 |
9 |
10 |
11 |
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FORM XXIII
[See Rule 78(1) (a) (iii)]
Register of Overtime
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Name and address of Contractor |
Name and address of establishment in / under |
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which contract is carried on . |
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... |
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Name and location of work . |
Name and address of Principal Employer |
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... |
... |
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Sl. No. |
Name of workman |
Father's / Husband's name |
Sex |
Designation/ nature of employment |
Date on which overtime worked |
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1 |
2 |
3 |
4 |
5 |
6 |
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Total overtime worked or production in case of piece-rated |
Normal rate of wages |
Overtime rate of wages |
Overtime earnings |
Date on which overtime wages paid |
Remarks |
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8 |
9 |
10 |
11 |
12 |
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FORM XXIV
[See Rule 82(1)]
Return to be sent by the Contractor to the Licensing Officer
Half-Year-Ending ..
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1. |
Name and address of the Contractor |
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2. |
Name and address of the establish- |
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ment |
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3. |
Name and address of the Principal |
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employer |
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4. |
Duration of Contract: From ..to . |
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5. |
No. of days during half year on which- |
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(a) |
the establishment of the Principal |
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employer had worked |
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(b) |
the contractor's establishment had |
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worked.. .. .. |
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6. |
Maximum number of contract labour emp- |
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loyed on any day during the half year: |
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Men |
Women |
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Children |
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Total
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7. |
(i) Daily hours of work and spread over- |
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(ii) |
(a) |
whether weekly holiday |
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observed and on what day- |
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(b) |
If so, whether it was paid for- |
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(iii) |
No. of man-hours of overtime worked
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8. |
Number of man-days worked by- |
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Men |
Women |
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Children |
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Total
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9. |
Amount of wages paid- |
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Men |
Women |
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Children |
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Total
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10. |
Amount of deduction from wages, if any- |
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Men |
Women |
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Children |
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Total
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11. |
Whether the following have been provided- |
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(i) |
Canteen |
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(ii) |
Rest-Room |
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(iii) |
Drinking water |
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(iv) |
Creches |
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.. |
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(v) |
First-Aid |
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(If the answer is 'yes' state briefly standards provided)
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Place |
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Signature of Contractor |
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Date .. |
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a)
Muster Roll,
b)
Register of Wages,
c)
Register of Deductions,
d)
Register of Overtime,
e)
Register of Fines,
f)
Register of Advances,
g) Wage Slip
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