MINIMUM WAGES RULES, 1960

FORM – III
[Rule 22 (4) (iii)]
Return for the year ending the 31 st December
1. Name of the establishment
and postal address
2. Name and residential address of
The / Owner Contractor.
3. Name and residential address of the
Managing Agent / Director / Partner
Incharge of the day to day affairs of the
Corporate or association.
4. Name and residential address of the
Manager / Agent if any.
5. Number of days worked during the year.
6. Number of man days worked during the
Year.
7. Average daily number of person employed
During the year.
(i) Adults
(ii) Children
8. Total wages paid in cash.
9. Total cash value of the wages paid in kind.
10. Deductions
No. of cases Total Amount
(a) Fines
(b) Deductions for
damage or loss
(c) Deductions for
breach of contract
11. Disbursement from fines.
Purpose Amount
(a)
(b)
(c)
(d)
12. Balance of fine fund in hand at the end of the year.