The Occupational Safety, Health and Working Conditions (Central) Rules, 2026
Form XVI
Official text
Open in the official PDF (p. 286)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
(See rule 72(2))
Wage slip
Date of issue:
Name of the Establishment .................................................................................
Address:............................................ Period:............................................
1. Name of the Employee:
2. Father’s/Mother’s/Spouse’s
Name:
3. Designation:
4. UAN:
5. Bank Account Number:
6. Wage period:
7. Rate of wages payable a) Basic b) D.A. c) other
allowances
8. Total attendance/unit of work
done:
9. Overtime wages
10. Gross wages payable
11. Total deductions a) PF b) ESI c) Others
12. Net wages paid
Employer/Pay-in-charge signature*
*Note: Required in case register is maintained physically.