Form XXIV

[See Rule - 50(11)]

Annual Report

1. Name and address of the industrial premises.................

2. Number and date of license………………………….

3. Name of employer…………………………

4. Name of the Principal Employer, if the Employer is working as contractor for a Principal

Employer………………………

5. Average number*of employers employed daily in the industrial premises.................

Men

Women

Transgender

Total

6. Average monthly number of home-workers employed (i.e., who work at their homes)

7. Normal hours worked in the industrial premises................................:.

8. Number of days worked in the year in the industrial premises.................

9. Number of employees who were granted leave during the Calendar year……..

(1) Adolescents

(a) Employed in the industrial premises.................

(b) Employed in homes..........,......

(2) Other than Adolescents

(a) Employed in the industrial premises ……………………..

(b) Employed in homes..........,......

10. Number of female employees who were given maternity benefit during the year......,..........

(a) Employed in industrial premise ....,.....,. .....................,

(b) Employed in homes.................

Certified that the information furnished above is correct to the best of my knowledge and belief.

Date: Signature:

Note: Partial attendance for less than half a day or working day shall be neglected and attendance

for half or more shall be treated as full attendance.

*The average daily number shall be calculated by dividing the aggregate number of attendance

of working days by the number of the working days in the year. An Attendance on separate

shifts, e.g., night and day shifts shall be counted separately.

**The average shall be calculated by dividing the aggregate number of workers on the Home-

workers Employment Register during each of the preceding 12 months by twelve.