Form IV

Made under The Code on Wages, 2019S.O. 40, 12 Aug 2026

Official text

Open in the official PDF (p. 24)

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

EMPLOYEE REGISTER

[see rule 42(1)]

Name of theEstablishment : Name of theEmployer:

Name of theOwner : PAN/TAN of theEmployer:

Labour Identification Number (LIN):

Sl. Employee Name Surname Gender Father’s Date NationalitEducatioDate Desig- Category Type of

No. / y

Code of n Level of nation (HS/S/SSEmploy-

Spouse Birth Joining /U S)* ment

Name

1 2 3 4 5 6 7 8 9 10 11 12 13

Mobile No. UAN PAN ESIC AADHAAR Bank A/c Bank Branch Present Permanent

IP Number (IFSC) Address

Address

No.

14 15 16 17 18 19 20 21 22 23

Service Book Date of Reason for Mark of Photo Specimen Remarks

No. Exit Exit Identification Signature/Thumb

Impression

24 25 26 27 28 29 30

*(Highly Skilled/Skilled/Semi skilled/Unskilled)

Employer

Source: The Code on Wages (Rajasthan) Rules, 2026, S.O. 40 — Rajasthan Gazette Extraordinary, Part 4 (Ga), Sub-section (II), p. 24 of the PDF. Open our copy at p. 24 · official download · all sources