Form VIII

[See Rule-21(1)]

REGISTER OF WORKERS EMPLOYED IN AN ESTABLISHMENT, WAGES, OVERTIME, FINE,

DEDUCTION FOR DAMAGE OR LOSS

Name of the Establishment: Name of the Employer:

Name of the Owner: PAN/TAN of the Employer:

Labour Identification Number (LIN):

Duration of Payment Total no. Total overtime Rates of wages

Sl. No. in of Wages Wage of days (hours worked or

Name of the Designation/

Employee (Monthly/Fortnightly/ Period worked production in

employee Department

Register Weekly/Daily/ Piece From- To during the case of piece Basic DA Allowances

rated) period workers)

1 2 3 4 5 6 7 8 9 10

Damage or loss

Attendance

Nature of acts and caused to the

Amount of

Overtime omissions for which Amount of employer by Total amount of Date of

deduction from

earning fine imposed with fine imposed neglect or wages paid Payment

wages Date Signature

date default of the

employee

11 12 13 14 15 16 17 18 19