The Uttar Pradesh Code on Wages Rules, 2026
Form I
Official text
Open in the official PDF (p. 63)
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[See Rule 17 (8), Rule 19 (4) and Rule 20]
REGISTER OF WAGES, OVERTIME, FINE, DEDUCTION FOR DAMAGE AND LOSS
Name of the Establishment: Name of the Employer:
Name of the Owner: PAN/TAN of the Employer:
Labour Identification Number (LIN)
Sl. no. in Name Designation Department Duration of Wage Total Total Rates of wages
Employee of the payment of Period no. of overtime Basic DA Allowances
Register employee Wages Form-To days (hours
(Monthly worked worked or
fortnightly/ during production
Weekly/ the in case of
Daily/ piece period piece
rated) workers)
1 2 3 4 5 6 7 8 9 10 11
Amount of wages earned Deductions Net
Basic DA Allowances Over Total EPF ESIC Society In- Insu- Advances Recovery Recovery Total Others Payment
time wages come rance of Fines on deduc-
earned Tax account tions
of
damages/
losses
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Date of Receipt by Nature of acts Amount of Damages or loss Signature of
Payment employee/ Bank and omissions fine imposed caused to the employer/ employer
transaction ID for which fine employer by representatives**
imposed neglect or default
with date of the employee
28 29 30 31 32 33
** if it is necessary to maintain the register in physical form.
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