The Occupational Safety, Health and Working Conditions (Central) Rules, 2026
Form XV
Official text
Open in the official PDF (pp. 284–285)
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(See Rule 72(1)(iii))
REGISTER FOR WAGES, OVERTIME AND DEDUCTIONS
(The register may also be maintained electronically capturing, inter-alia the following details)
Name of Establishment:
Name of the Employer/owner:
PAN/TAN of the Employer
Registration Number of the establishment
(Labour Identification Number (LIN) shall be
the Registration Number of the Establishment)
Wage Period from dd/mm/yyyy to dd/mm/yyyy
(Monthly/Fortnightly/Weekly/Daily/Piece Rated)
1. Serial Number
2. Employee Code Number
3. Name of the employee
4. Designation
5 Department
6 Duration of Payment of wages (Monthly/Fortnightly/Weekly/Piece
rated)
7 Wage Period from- to
8 Total number of days worked during the wage period
9 Total overtime hours worked or overtime production in case of piece
workers
Rate of Wage
10 a)Basic
11 b)DA
12 c)Other allowance
Amount of wages earned
13 Basic
14 DA
15 Allownaces
16 Overtime
17 Total wages earned
Deductions
18 EPF
19 ESIC
20 Society
21 Income Tax
22 Insurance
23 Advances
24 Recovery of Fine
25 Recovery on amount of damages/losses
26 Total deductions
27 Others
28 Net Payment
29 Date of Payment
30 Receipt by employee/Bank Transaction ID
31 Nature of acts and omissions for which fine imposed with date
32 Amount of fine imposed
33 Damage or loss caused to the employer by neglect or default of the
employee
34 Signature of Employer/Employer Representative*
*Note: Required in case register is maintained physically