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    Form U Annual Returns Excel Format

    Uploaded by

    Nisha Yadav
    This document is a combined annual return form providing employment information for an establishment, including the number of employees, nature of work, wages and benefits paid, leave details, and details of any deductions from salaries or contract labor. The form requires information such as the employer's name and address, number of employees, man-days worked, wages paid, welfare measures provided, and maternity benefits given. The employer must certify the accuracy of the information provided in the form.

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    Download as XLS, PDF, TXT or read online from Scribd

    Form U Annual Returns Excel Format

    Uploaded by

    Nisha Yadav
    2K views2 pages
    This document is a combined annual return form providing employment information for an establishment, including the number of employees, nature of work, wages and benefits paid, leave details, and details of any deductions from salaries or contract labor. The form requires information such as the employer's name and address, number of employees, man-days worked, wages paid, welfare measures provided, and maternity benefits given. The employer must certify the accuracy of the information provided in the form.

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    This document is a combined annual return form providing employment information for an establishment, including the number of employees, nature of work, wages and benefits paid, leave details, and details of any deductions from salaries or contract labor. The form requires information such as the employer's name and address, number of employees, man-days worked, wages paid, welfare measures provided, and maternity benefits given. The employer must certify the accuracy of the information provided in the form.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    2K views2 pages

    Form U Annual Returns Excel Format

    Uploaded by

    Nisha Yadav
    This document is a combined annual return form providing employment information for an establishment, including the number of employees, nature of work, wages and benefits paid, leave details, and details of any deductions from salaries or contract labor. The form requires information such as the employer's name and address, number of employees, man-days worked, wages paid, welfare measures provided, and maternity benefits given. The employer must certify the accuracy of the information provided in the form.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 2

    FORM U

    COMBINED ANNUAL RETURN


    [See Rule 24(9-C) of Karnataka Shops & Commercial Establishment Rules, 1963]

    In lieu of
    1) Form XXV of (Rules 82(2) of the Contract Labour (Regulation & Abolition) Karnataka Rules, 1974
    2) Form III (Rule 22(4)) Karnataka Minimum Wages Rules, 1958
    3) Form XX (Rule 20(1)) Karnataka Payment of Wages Rules, 1963
    4) Form L (Rule 16) Karnataka Maternity Benefits Rules, 1963

    1 Name of the Establishment

    2 Full Postal Address


    Location Address Telephone Fax E-mail
    a) Establishment

    b) Registered / Head Office

    3 Name and Residential Address of the Employer or a person Responsible for Conduct and Control of the Business :
    Name Designation Residential Address Telephone Mobile E-mail
    1 2 3 4 5 6
    (o)

    ( R)

    4 Name and Residential Address of the Manager / Authorised Signatory


    Name Designation Residential Address Telephone Mobile E-mail
    1 2 3 4 5 6
    Manager (O)

    ( R)

    Authorised Signatory (O)

    ( R)

    5 Nature of business of the Establishment

    6-A) Particulars of employment

    No. of Persons on Total Amount of


    No. of Persons on Roll as Roll as on 1-1-200 No. of Man hours salary / wages paid
    on 1.1.200 (beginning (at the end of the No. of man days worked worked including including O.T. wages
    of the year) year) No. of Days worked during the year O.T. during the year and Allowances

    Men Men

    Women Women
    Total Total

    6-B) No. of employees whose employment is ceased :

    No. of employees discharged / dismissed / Amount of


    terminated / retrenched / resigned / retired Amount of Compensation subsistence allowance
    during the year paid No. of employees suspended during the year paid
    7 Particulars of Earned Leave with Wages

    No. of employees paid


    Total No. of Persons No. of employees eligible No. of employees availed / granted Earned wages / salary in lieu
    Category of Employees Employed for Earned Leave Leave of Earned Leave
    i) Men

    ii) Women

    8 Whether the following Welfare Measures are provided ?

    i) Canteen Yes / No / Not Applicable

    ii) Creches Yes / No / Not Applicable

    iii) Shelters, Rest Rooms and Lunch Rooms Yes / No / Not Applicable
    iv) Transport Facility Yes / No / Not Applicable

    9 Maternity Benefits : 9-A) Particulars of Maternity Benefits :


    Total number of Women workers who worked for a period of 160 days in the last 12 months immediately preceding the date of
    1 delivery

    2 Number of Women workers discharged / dismissed in the last 12 months


    Number of Women workers for whom pre-natal confinement and post-natal confinement is provided by the employer with
    3 free of cost

    4 a Before Delivery

    Number of women workers died b After Delivery

    9-B) Leave / Additional Leave details :


    Item No. of women applied fo leave Leave sanctioned Leave rejected
    Miscarriage

    Illness (Additional Leave under Sec 10)

    C) Maternity benefit paid

    No. of Leaves Total benefit paid in


    Item No. of claims received sanctioned No. of claims rejected Rupees
    Confinement

    Miscarriage

    Illness

    Medical Bonus

    10 Particulars of Deductions made from Salary (Wages) :


    No. of Employees involved Total amount of Deductions made
    i) Fines

    ii) Damages / Loss

    iii) Breach of Contract

    iv) Others
    Total

    11 Contract Labour

    No. of
    Name and Address of the Period of Contract No. of contract Mandays
    Contractors From / To Nature of Work workmen employed No. of days worked Worked

    i)

    ii)

    iii)

    Certifited that the information furnished above is, to the best of my knowledge and belief, is correct.

    Signature of Employer / Manager / Authorised Signatory


    Dated Name (IN CAPITALS)
    Place Designation

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