WAGE SLIP
FORM XIX [See Rule 78(1) (b) of Contract Labour
(Regulation & Abolition) Central Rules 1971]
Name and address of Contractor: - Emp. Name:- «NAME»
Emp. Code:- «CODE»
Safety pass No:- «SAFETY_PASS_NO»
Father's /Husband's name:- «FATHER_NAME_»
UAN No: - «UAN_NO»
Aadhar No: - «AADHAR_NO»
Bank A/c No: - «BANK_AC_NO» ESIC No:- «ESIC_NO»
Nature of work and location of work: - Pan No:- «PAN_NO»
«SKILL_TYPE» IFSC Code:- «IFSC_CODE»
For the Week/Fortnight/Month ending:-
Monthly (Nov’2024)
This month PL earned: - «PL_DAYS_» Cumulative. PL as on date: - «TOTAL_PL»
1. No. of days worked: - «PRESENT» Days W/o «WO» Days Ho «HO» Days Paid Days «DAYS_WORKED_»
2. Basic + VDA: - «BASIC__VDA»
3. Amount of overtime wages: - NIL
4. Gross wages payable details:-
Basic + VDA: - «CAL_BASIC__VDA»
VWAA: - «CAL_VWAA»
VTPA: - «CAL_VTPA»
FP: - «CAL_FP»
Total Earnings:- «CAL_TOTAL_SALARY»
Gross Total Earnings:- «CAL_TOTAL_SALARY»
5. Deductions, if any
PF:- «PF_»
ESIC:- «ESIC»
Total Deduction:- «TOTAL_DED»
6. Net amount of wages paid:- «NET_PAID»
(Credit to bank A/c :-«BANK_AC_NO»)
Initials of the Contractor or his
Representative