Form V

Made under The Code on Wages, 2019G.O.Rt. No. 124, 29 Jun 2026

Official text

Open in the official PDF (pp. 23–24)

Tables and forms lose their layout when extracted; the PDF is the authoritative version.

(See rule 43)

WAGE SLIP

Date of issue

Name of the Establishment

Address

Period

1. Name of employee

2. Father’s/Mother’s/Spouse Name

3. Designation

4.UAN. of the Worker

5. Bank Account Number

6. Wage period

7. Rate of wages payable

a. Basic

b. DA

c. 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.

Source: The Code on Wages (Andhra Pradesh) Rules, 2026, G.O.Rt. No. 124 — Andhra Pradesh Gazette Extraordinary (as ordered by G.O.Rt. No. 124), pp. 23–24 of the PDF. Open our copy at p. 23 · official download · all sources

Text from the Government Order that orders the notification's publication in the Andhra Pradesh Gazette; the Gazette issue itself was not found on the AP e-Gazette.