FORM XIX

[See rule 59(2)(b)]

: M/s Pyome Infra Solution Private Limited, No.8, "Sai Prabhu", 1st floor,
Name and address of Contractor SirurPark, ‘B’Street, Opp.MalleshwaramMantriMall,Sheshadripuram,Bangalore — 560103
Wage slips for the month of April 2023
Nature of work and Bangalore | Jigani Ind. Area
Principle Employer :Tata Power Solar Systems Ltd.,_O & M
location of work Unit - 06
Employee ID PY02545 Designation Sr Technician
Name of the Employee Abhinandan Bank Name State Bank of India
ESI IP No. 4940210639 Account No. 40688450652
UAN No. 100626347337 / 12187 Sunday in Days / HR.
Payable Days 30 Overtime in Days / HR. 0
Fixed Component Amount Earning Amount Deduction Component Amount
Basic 16375 Basic 16375 PF 1965
DA 2870 DA 2870 ESI 0
CCA 144 CCA 144 PT 200
HRA 7697 HRA 7697
Conveyance Allowance 0 Conveyance Allowance 0 TDS 0
Medical Allowance 0 Medical Allowance 0 KLWF 0
Special Allowance 0 Special Allowance 0 Canteen 268
Washing Allowance 0 Washing Allowance 0 Society 0
Others 0 Attendance Bonus 0 Insurance 0
Others 0 Overtime Wages 0 Advance 0
Leave with Wages 0 Leave with Wages 0 Fines 0
N & F Holiday Wages 0 N & F Holiday Wages 1622 Damages 0
Statutory Bonus 0 Statutory Bonus 0 Other Ded 0
Sun / Other Wages 0 Sun / Other Wages 0 Uniform 0
Others Maternity Wages
0 0 Others 0
Others 0 Arrears 0 Others 0
Grand Total 27086 Grand Total 28708 Grand Total 2433
Nett Payment 26275 Signature of the employee

This is computer generated pay slip hence no signature required