The Uttar Pradesh Occupational Safety, Health and Working Conditions Rules, 2026
Form 40
Official text
Open in the official PDF (p. 522)
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{see sub-rule (2) of Rule 114}
Home worker’s log book
1. Name of home-worker:
2. Address of the home-worker, where is the manufacturing process is carried on:
3. Month and year:
4. Account of work done at home
Date Raw material supplied to the worker signature or thumb impression No. of beedis received
tendu patta tobacoo thread of the worker by the employer
1 2 3 4 5 6
No. of standard No. of sub-standard wages payable to the worker wages paid to
beedis or chhat beedis for standard beedis for sub-standard or worker
chhat beedis
7 8 9 10 11
Date Amount of wages to date signature or thumb impression Signature of the employer
in arrears of the worker
12 13 14 15