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SI.No Name of Workman Father's/Husband's Sex Designation Date on W ages of Total overti me Normal Normal overtime Normal overtime Total Date on which
Name and which overtime worked or Hours rate rate earnings earnings earnings overtime payment
Department overtime on each prod uction in made
on work occasion case of piece--
was put in rates
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
I
Na me and Address of Principal Emplo1•er: : M indt ree Ltd,RVCE Post-Glo ba l Village .Mysore Road,Ba naga luru-560059
I I I I W het her w or ker I Nam e of per son in whose I Amo unt o f I Date of Recove ry I
SI .No
Name of
Father's/ Husband's Partic ul ars of showed ca use against pre sence employee's deduc tion No. o f I First I Last I Remarks
Workman
II Name
l I
Des1gna t 1on
4
Damages or Loss
S I
Dat e o f Damage
6 I
ded uct io n
1 I
explanatio n .was hea r d
a I
imposed
9
Instalm ent s
10 I
Inst al ments
11
. Inst alments
I 12 I ll