FORM - C

REGISTER OF FINES AND UNPAID ACCUMULATIONS FOR THE YEAR' 2022

[See rule 29]
TAMIL NADU LABOUR WELFARE FUND ACT, 1972 & RULES, 1973

AMG PACE Private limited,

New no 24, Old no 10, 1st Floor, 4th avenue,
Name and Address of the Establishment: Ashok nagar Town, Mambalam Taluk, Chennai
District - 600083.

Quarter Quarter Quarter Quarter

Details of fines and unpaid accumulations ending 31st ending 30th ending 30th ending 31st
March June September December

(1) (2) (3) (4) (5)

1 Total realisations under Fines Nil Nil Nil

Total amount being unpaid

2 Nil Nil Nil
accumulations* of--

(i) Basic wages Nil Nil Nil

(ii) Overtime Nil Nil Nil

Dearness allowance and other

(iii) Nil Nil Nil
allowances

(iv) Bonus Nil Nil Nil

(v) Gratuity Nil Nil Nil

Any other item of unpaid

(vi) Nil Nil Nil
accumulations

3 Deductions under standing orders Nil Nil Nil

Deductions under Payment of Wages

4 Nil Nil Nil
Act.

For AMG PACE Private limited,

Authorised Signatory

* See definition of "Unpaid Accumulations" under section 2 (i) of the Tamil Nadu Labour Welfare Fund Act,
1972