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FORM - R
REGISTER OF WAGES
[See sub-rule (5) of Rule 11]
THE TAMIL NADU SHOPS AND ESTABLISHMENT ACT, 1947 AND RULES, 1948
Name of the Establishment: Wage Period:
NANI FUEL STATION
Name of the Employer / Contractor with Address: Month November Year 2019
Daily rated / Piece-rated/ Monthly
Impression / Cheque No. and Date
Wages earned Deductions
Wages Period - Weekly/Fortnight
Total No. of days worked during
Daily rate of wages / Piece rate
Units of work done/Number of
Bank/Advice of the Bank to be
Name of the Person Employed
Signature with Date or Thump
Other Allowances/Cash Payment
Designation / Nature of work
the Week/Fortnight/Month
in case of payment through
Leave wages including cash in
Employees' State Insurance
Other Deduction (indicate
Total unpaid amounts
Nature to be specified
Dearness Allowance
Overtime earned
Overtime Rate
Serial Number
Provident Fund
accumulated
days worked
Gross Wages
Fine (if any)*
Basic Wages
lieu of kinds
Net Wages
appended
/ Month
Nature)*
rated
Sex
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23)
1 Dhilipkumar M Manager Monthly 5500 3500 9000
M Cashier
Thamizhazhagan Monthly 5500 3500 9000
2
3 Suresh M Cashier Monthly 5500 3500 9000
Kanimozhi F Cashier Monthly 5500 3500 9000
4
M
Yovan P.O Monthly 5250 3500 8750
5
M Monthly 5250 8750
Saravanan P.O 3500
6
7 Vellaisamy M P.O Monthly 5250 3500 8750
8 Rajkumar M P.O Monthly 5250 3500 8750
M
Nandhakumar P.O Monthly 5250 3500 8750
9
M P.O
10 Jayakumar Monthly 5250 3500 8750
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