The Occupational Safety, Health and Working Conditions (Andhra Pradesh) Rules, 2026
Form XII (A)
Official text
Open in the official PDF (p. 458)
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{See rule 32(5) (b)}
{Half Yearly Return (January toJune/ July to December) to be
submitted by Contractor to be filed electronically to the Inspector-
cum-Facilitator concerned}
1. Name and address of the contractor:
2. Name and address of the principal employer and LIN:
3. LIN of the contractor:
4. License number of the contractor(if applicable):
5. Name of the contract work with location/station:
6. Details of the number of Contract Workers, Wages Paidetc.:
r s e r e s
u e g o h a
bo ag wa act
r
t
t
La
of
w
t
of
contr ploye
SIC
PF th
of
7
date
o)
Sl.No
Month
No
of
Contrac
employed
a
Tom
to
alunt
paid
in
a
month
Over
time
Bonus
Date
and
amoun
bill
received
by
from
Principal
em
ECR
number
of
E
ECR
number
of
E
Wages
paid
by
month
or
due
applicable
(Yes/N
Remarks
1 January
2 February
3 March
4 April
5 May
6 June
Signature of the contractor:
Date: