[FORM-T? Combined Muster Roll-cum-Register of Wages [Sce Rule 24(9-B}of the Kamataka Shops and blishments Rules, 196: of 1 Forms Land Il of Rule 22(4) .Form LV of Rule 28(2 and (5) of the Karnataka Minimum Wages Rules, 19 Commercial Es Forms V and VII of Rule 29(1) 2. Form | of Rule 3(1) of the Kamataka Payment of Wages Rules, 1963 3. Form XIII of Rule 75, Forms XV, XVI, XX, XXL XXII and XXII of Rule 78(1 (aii), Gi) and Gii) of Contract Labour (Regulation and Abolition) (Kamataka) Rules 4. Form XII] of Rule 43, Forms XVII XVII, XIX, XX, XX1, XNILof Rule 46(2)(a). (¢) and (d) of the Inter-State Migrant Service) Karnataka Rules, 1981 Month! Year Name and address of the Name and Address of the Establishment Employer ST [Name of the MaleiFemale | Designation’ | Dateot | FSINo._| PF Wages fixed No | employee Father Department | Joining NO. | including Husband Name VDA I 2 3 a 5 6 8 Ariendance Noof | Total TEER EE fe 8 [2 [OTT PII T Je] Payable | OT days | hours Ts 20 [ar [2 a 26 [2 30 [3 worked Please mention the date of suspension of employees. any 0) coy [an Month Year Famed waves and other allowances Basic ]DA? [HRA [Con | Med [Aten | Spl [OT [NFH | Mater] Others] Subsist | Total VDA veya | Allo | dance | Al nity ence nee | wance | Bonus Benefit allowa nee if any 3 + =e is [79 [20 [2 22 23 24Deductions SPF [PT ] TDS | Sosy [ims Silay | Fines | Damages | Oiers | Toul | Net] Medeor - ash