FORM-15

{See rule 77(1) (b)}

Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 1
Employee Name HARISH
100954360820
UAN/EPF No.
Father’s Name RAMPHAL YADAV
Designation Electrician ESI No 1114992936
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 11622 O.T Hours 8 P.F 1395
HRA 0 O.T Amount 1461 ESI 389
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 968 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1784
Rs :
Net
NHF Arrears Conv. Payments 20461
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 7366 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 83212300008968

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 2
Employee Name ANIL KUMAR
100954360831
UAN/EPF No.
Father’s Name PREM CHAND
Designation Electrician ESI No 1114992989
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 11622 O.T Hours P.F 1395
HRA 0 O.T Amount 0 ESI 364
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 968 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1759
Rs :
Net
NHF Arrears Conv. Payments 19025
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 7366 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 65136969863

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 3
Employee Name SANDEEP KUMAR
100954360849
UAN/EPF No.
Father’s Name SH LALCHAND
Designation Electrician ESI No 1114992997
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 11622 O.T Hours 8 P.F 1395
HRA 0 O.T Amount 1461 ESI 389
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 968 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1784
Rs :
Net
NHF Arrears Conv. Payments 20461
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 7366 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 50100006524812

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 4
Employee Name SHISH PAL
100954360910
UAN/EPF No.
Father’s Name RAGI RAM
Designation Envirnmental Asstistant ESI No 1114913872
Sex and
Identification Male No. of Days worked 2
Marks
Earnings Deductions
Basic 638 O.T Hours P.F 77
HRA 0 O.T Amount 0 ESI 14
Conveyance Advance Bonus PT
WASHING Mobile
LWW 55 ALLOWANCE Deduction
ADV Bonus 53 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 91
Rs :
Net
NHF Arrears Conv. Payments 713
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 58 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 55157405987

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 5
Employee Name SUDAMA BARAIK
100954360877
UAN/EPF No.
Father’s Name SH GODRA BARAIK
Designation Envirnmental Asstistant ESI No 1508147804
Sex and
Identification Male No. of Days worked 29
Marks
Earnings Deductions
Basic 9249 O.T Hours 8 P.F 1110
HRA 0 O.T Amount 803 ESI 218
Conveyance Advance Bonus PT
WASHING Mobile
LWW 800 ALLOWANCE Deduction
ADV Bonus 770 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1328
Rs :
Net
NHF Arrears Conv. Payments 11130
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 836 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 35726330060

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 6
Employee Name DIPAK KUMAR
100954360934
UAN/EPF No.
Father’s Name CHANDRAPAL SINGH
Designation Envirnmental Asstistant ESI No 1114913387
Sex and
Identification Male No. of Days worked 7
Marks
Earnings Deductions
Basic 2233 O.T Hours P.F 268
HRA 0 O.T Amount 0 ESI 49
Conveyance Advance Bonus PT
WASHING Mobile
LWW 193 ALLOWANCE Deduction
ADV Bonus 186 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 317
Rs :
Net
NHF Arrears Conv. Payments 2497
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 202 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 434602010898518

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 7
Employee Name BIPIN KUMAR
100954360923
UAN/EPF No.
Father’s Name SUKHVIR KUMAR
Designation Envirnmental Asstistant ESI No 1114913398
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 9568 O.T Hours 16 P.F 1148
HRA 0 O.T Amount 1605 ESI 239
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 797 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1387
Rs :
Net
NHF Arrears Conv. Payments 12276
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 865 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 607110110004665

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 8
Employee Name AJAY G BIRADAR
UAN/EPF No.
Father’s Name
Designation Envirnmental Asstistant ESI No 1115171199
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 9568 O.T Hours 8 P.F 1148
HRA 0 O.T Amount 803 ESI 225
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 797 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1373
Rs :
Net
NHF Arrears Conv. Payments 11488
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 865 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 5602500100921901

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code. 9
Employee Name SOAHN KUMAR
UAN/EPF No.
Father’s Name Rajesh Kumar
Designation Envirnmental Asstistant ESI No 1115171218
Sex and
Identification Male No. of Days worked 30
Marks
Earnings Deductions
Basic 9568 O.T Hours 28 P.F 1148
HRA 0 O.T Amount 2809 ESI 260
Conveyance Advance Bonus PT
WASHING Mobile
LWW 828 ALLOWANCE Deduction
ADV Bonus 797 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 1408
Rs :
Net
NHF Arrears Conv. Payments 13459
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 865 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C 37264046521

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code.
Employee Name
UAN/EPF No.
Father’s Name
Designation ESI No
Sex and
Identification No. of Days worked 218
Marks
Earnings Deductions
Basic 75690 O.T Hours 76 P.F 9084
HRA 0 O.T Amount 8942 ESI 2147
Conveyance Advance Bonus PT
WASHING Mobile
LWW 6016 ALLOWANCE Deduction
ADV Bonus 6304 Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions 11231
Rs :
Net
NHF Arrears Conv. Payments 111510
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance 25789 Employee Signature
Allow
Maternity Bene Site Allow Bank A/C

PDF created with pdfFactory Pro trial version www.pdffactory.com

 FORM-15
{See rule 77(1) (b)}
Wage Slip

For the month of Oct-2017

Golden Star Facilities & Services Pvt.
Amazon Sellers Services Pvt. Ltd.
Name and Address
Ltd.
Name and Establishment
H.No. 1-98/9/3/9 & 10, Plot No. 25 & Ground floor of A-43,Mohan
address of the in/under which
26, Meghana’s, 2nd Floor, Image Cooperative Industrial Estate,
Contractor contract is carried
Gardens Road, Madhapur,Hyderabad- Main Mathura Road, Badarpur,South
on
500 081. T.S. Delhi, New Delhi-110044
Housekeeping & Maintenance Work
Nature and
Location of Work Amazon Sellers Services Pvt. Ltd., Ground floor of A-43,Mohan Cooperative Industrial Estate,Main
Mathura Road, Badarpur,South Delhi, New Delhi-110044
Name and address Amazon Sellers Services Pvt. Ltd.
of principal Ground floor of A-43,Mohan Cooperative Industrial Estate,
employer Main Mathura Road, Badarpur,South Delhi, New Delhi-110044
EMP. Code.
Employee Name
UAN/EPF No.
Father’s Name
Designation ESI No
Sex and
Identification No. of Days worked
Marks
Earnings Deductions
Basic O.T Hours P.F
HRA O.T Amount ESI
Conveyance Advance Bonus PT
WASHING Mobile
LWW ALLOWANCE Deduction
ADV Bonus Arrears Basic LWF
Total
Special Allow Arrears HRA Deductions
Rs :
Net
NHF Arrears Conv. Payments
Rs :
Arrears Site
Others
Allow
Arrears Special
Site Allowance Employee Signature
Allow
Maternity Bene Site Allow Bank A/C

PDF created with pdfFactory Pro trial version www.pdffactory.com