FORM No. 14
[See Rule 120]
REGISTER OF LEAVE WITH WAGES FOR THE
YEAR . . . . . . . . . .
Serial
No. . . . . . . Name of Factory
. . . . . . . . Particulars
of Workers
Deptt
. . . . . . . . . . License No. . . . . . . . . . . .
. Adult / Child . . . . . . . . . . . . . . . . . . .
Serial
No. in the Register of Name
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Adult/Child
Workers . . . . . . . . . . . . . . . . . Father’s
Name. . . . . .. . . . . . . . . . . . . .
Date
of entry into service . . . . . . . . . . . . . . . . . Date of Discharge . .. . . . . . . . . .
. . . .
Date/amount
of payment made in
Lieu
of leave due . . . . . . . . . . . . . . . .
Number of days during the previous year
|
Total of Columns 1 to 4
|
Leave to Credit
|
Leave earned during the previous year
|
Total of Columns 6 & 7 Leave to credit
|
Whether leave in accordance with scheme under section
79(8) was refused
|
Leave enjoyed from
. . . . . . to. . . . . .
|
Balance of Leave at credit
|
Normal rate of wages
|
Cash equivalent of advantage accruing through concessional
sale of Food-grains and other articles
|
Rate of wages for the leave period (Total of column 12 and
13)
|
Date and refere-nce to paym-ent vide wages Register or
vouc-her
|
Remarks and Initials of Manager for each entry
|
|||
No. of days work per-formed
|
No. of days of lay-off
|
No. of days of maternity leave
|
No. of days of leave enjoyed
|
Balance of Leave
|
|||||||||||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
13
|
14
|
15
|
16
|
Note
: Separate Page will be allotted to each worker.
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