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GOVERNMENT OF KARNATAKA

No: LD 285 LET 2021

Karnataka Government Secretariat,

Vikasa Soudha,

Dr. B.R. Ambedkar Veedhi,

Bangalore, dated:29/01/2026.

Notification

Whereas, the draft of the Code on Social Security Karnataka Rules, 2021 which the

Government of Karnataka proposed to make in exercise of the powers conferred by Section 154 and

156 of the Code on Social Security, 2020 (Central Act No.36 of 2020) was published as required by

sub-section (1) of the said section for the information of all the persons likely to be effected in

Notification No: E-LD 285 LET 2021 dated, 18/04/2022 in Part- IV- A of Karnataka Gazette dated

04/04/2022, inviting objections and suggestions from all the persons likely to be effected thereby

within the period of thirty days from the date of publication of the said Notification in the Gazette.

And whereas, the said Gazette was made available to the public dated 04/04/2022.

And whereas, the objections and suggestion received on the said draft rules was considered.

Now therefore, in exercise of powers conferred by Section 154 and 156 of the Code on Social

Security, 2020 (Central Act No.36 of 2020), the draft of the Code on Wages (Karnataka) Rules, 2026

is hereby published as required by sub-section (1) of the said section for the information of all the

persons likely to be effected thereby and notice is hereby given that the said draft will be taken into

consideration after the expiry of forty five days from the date of its publication in the Official Gazette.

Any objection or suggestion which may be received by the State Government from any person

with respect to the said draft before the expiry of the period specified above will be considered by the

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Part – IVA

, 29

, 2026

, 09

)

BENGALURU, THURSDAY, 29, JANUARY, 2026 ( MAGHA , 09, SHAKAVARSHA, 1947)

. 103

No. 103

State Government. Objections and suggestions may be addressed to the Secretary to Government,

Labour Department, Vikasa Soudha, Dr. B.R. Ambedkar Veedhi, Bengaluru.

CHAPTER - I

PRELIMINARY

1. Title and commencement.- (1) These rules may be called the Code on Social Security (Karnataka)

Rules, 2026.

(2) They shall come into force from the date of commencement of the Code on Social Security,

2020 (Central Act No. 36 of 2020).

2. Definitions.- (1) In these rules, unless the subject or context otherwise requires,-

a) “Board” means the Karnataka Unorganized Workers Social Security Board or the

Karnataka Building and Other Construction Workers Welfare Board, as the case

may be;

b) “Chairperson” means the Chairperson of the Karnataka Unorganized Workers’

Social Security Board or the Karnataka Building and Other Construction Workers

Welfare Board, as the case may be;

c) “Cess collector” means an officer appointed by the State Government for collection

of cess under the Code ;

d) “Code” means the Code on Social Security 2020 (Central Act 36 of 2020);

e) ‘contribution’ means the amount of contribution payable by the unorganized

worker, the self-employed person or other beneficiary as a member of the scheme

or the aggregators as provided under clause (c),(d),(e) and (f) of sub-section(3)of

section 114 and includes the amount given by the Central and the State Government

from time to time as per the scheme notified under sub-section(1 )of section 114

f) “Form” means a form appended to these rules;

g) “Government” means the Government of Karnataka;

h) “Scheduled Bank” means a bank included in the Second Schedule of the Reserve

Bank of India Act, 1934 (Central Act 2 of 1934); and

i) “Section” means a section of the code.

(2) All the other words and expressions used herein but not defined, and defined in the code,

shall have the same meaning as respectively assigned to them in the Code.

CHAPTER - II

SOCIAL SECURITY ORGANISATIONS

PART-A: KARNATAKA UNORGANISED WORKERS’ SOCIAL SECURITY BOARD

3. Constitution of the Karnataka Unorganised Workers’ Social Security Board under sub-

section (9) and the manner in which members shall be nominated from each categories under

sub-section (12) of section 6:

(1) The Karnataka Unorganised Workers’ Social Security Board shall be constituted under sub-

section (9) of Section 6 of the Code by notification in the official Gazette to exercise the

powers conferred on, and to perform the functions assigned to, it under this code.

(2) The State Government shall nominate seven representatives from unorganised workers and

seven representatives from employers of unorganised workers, under sub clauses (i) and (ii)

of clause (d) of sub-section (10) of Section 6 in such manner, as decided by the State

Government.

Provided that out of seven persons nominated representation shall be given to persons

belonging to Scheduled Castes, Scheduled Tribes, Minorities and Women.

(3) The State Government shall nominate two members of Karnataka Legislative Assembly under

sub-clause (iii) of clause (d) of sub-section (10) of Section 6.

(4) Five members representing eminent persons from civil society as under sub-clause (iv) of

clause (d) of sub-section (10) of Section 6.

(5) The State Government shall nominate ten members under sub-clause (v) of clause (d) of sub-

section (10) of Section 6 representing Departments of State Government, concerned with the

matters related to the welfare of the workers.

(6) The State Government shall nominate a Member-Secretary by notification as under clause (e)

of sub-section (10) of section 6.

(7) No person shall be chosen as, or continue to be, a member of the Board, if such person attracts

any provision(s) of section 8.

Provided that all the members, except the Chairperson, of the Karnataka Unorganised

Workers’ Social Security shall be amongst persons of eminence in the field of labour welfare,

management, finance, law and administration.

4. Term of office and conditions of service of the members under sub-section (12) of section 6:

(1) A member, other than an ex-officio member, shall hold office for a period of three years from

the date of his nomination. A member shall be eligible for re-nomination: Provided that a

member, other than an ex-officio member, shall not hold the office for more than two terms.

(2) The non-official member shall be removed by the Government from the Board, if they cease

to represent the interest for which he was nominated or if such person attracts any provisions

of section 8 of the Code.

(3) If the new Board is not reconstituted after the completion of the term of the Board, the existing

Board shall continue to discharge its functions till the new Board is reconstituted by the

Government through notification.

(4) A member nominated under sub-clause (iii) of clause (d) of subsection (10) of section 6 shall

cease to be a member of the Board if he ceases to be a member of Legislative Assembly.

5. Resignation of member of the Board under sub-section (12) of section 6:

(1) A member of the Board, not being an ex-officio member, may resign from office by a letter

in writing addressed to the Government.

(2) The seat of such a member shall fall vacant from the date on which his resignation is accepted

or on the expiry of thirty days from the date of receipt of intimation of resignation, whichever

is earlier.

(3) The power to accept the resignation of a member shall vest in the Government, and on

accepting the resignation, the Chairperson shall report to the Board at its next meeting.

6. Reconstitution of the Board.―

(1) The State Government shall initiate the process for reconstitution of the Karnataka

Unorganised Workers’ Social Security Board, prior to six months of expiry of the term of the

Board.

(2) If the new Board is not re-constituted after completion of the term of the Board, such

arrangements may be made for discharging the functions of the Board as may be decided by

the State Government, by notification, for the period till the new Board is constituted.

(3) All actions taken pursuant to the arrangement under sub-rule (2), shall have the same effect

as if it has been carried out by the Board itself.

7. Manner of filling up vacancies under sub-section (12) of section 6: When a vacancy occurs

or is likely to occur on completion of the term of a member in the Board, the Chairperson shall submit

a report to the Government and on receipt of such report, the Government may, by notification,

nominate a person to fill the vacancy:

Provided that if the vacancy occurs for removal or resignation of a Member, the Chairperson

shall communicate this to the Government and Government shall nominate and the person so

nominated shall hold office for the remainder of the term of office of the member in whose place he

or she is nominated.

8. Allowances to Members under sub- section (12) of section 6:

(1) The travelling allowance of an official member of the Board shall be governed by the rules

applicable to him/her for journey performed by him/her on official duty shall be paid by the

Authority paying his or her salary.

(2) The non-official member of the Board shall be paid travelling allowances for attending the

meetings of the Board at such rates as are admissible to Class-I officer of the Government and

daily allowances shall be calculated at the maximum rate admissible to Class-I officers of the

Government in their respective places.

9. Procedure for transaction of business, meetings and quorum, etc., of the Board under

sub-section (14) of section 6:

(1) The Board shall meet at such places and at such times as may be decided by the Chairperson.

(2) The Board shall meet at least once in four months and as and when required with a notice to

all members within a period of seven days.

(3) In case of any matter of urgency, meeting may be called by the Chairperson after informing

the member in advance about the subject matter of discussion and reasons of urgency.

(4) The Chairperson shall preside over every meeting of the Board in which he or she is present

and in his or her absence, the Vice Chairperson shall preside over such a meeting at his or her

place.

(5) (i) Ordinarily, fifteen days’ notice shall be given to the members of the Board of a proposed

meeting:

Provided that the Chairperson, if he or she is satisfied that it is expedient to call an

emergency meeting for considering any matter which in his or her opinion is urgent, he or she

may issue a notice giving such reasonable time as he or she may consider necessary.

(ii) No business except which is included in the list of business for a meeting of the Board

shall be considered at the meeting without the permission of the Chairperson.

(6) Every matter considered at a meeting of the State Board shall be decided by a majority of the

votes of the members present and voting. In the event of an equality of votes, the Chairperson

shall exercise an additional casting vote:

Provided that the Chairperson may, if he thinks fit, direct that any question shall be

decided by the circulation of necessary papers to members of the State Board and by securing

their opinions in writing. Any such question shall be decided in accordance with the opinion

of the majority of members received within the time-limit allowed and if the opinions are

equally divided, the opinion of the Chairperson shall prevail:

Provided further that any member of the State Board may request that the question

referred to members for written opinion be considered at a meeting of the State Board and

thereupon the Chairperson may, if the request is made by not less than three members, direct

that it be so considered

Provided that if in a meeting, less than one third are present, the Chairperson may

adjourn the meeting to another date informing the members present and giving notice to other

members that he or she proposes to dispose of the business at the adjourned meeting whether

there is prescribed quorum or not, and it shall thereupon be lawful for him or her to dispose

of the business at the adjourned meeting irrespective of numbers attending.

(7) The Chairperson may debar any member, other than ex-officio members, from taking part in

the Meetings of the Board if,-

(i) he or she absents himself or herself from three consecutive meetings of the Board without

written information to and consent of the Chairperson; or

(ii) in the view of the Government such member ceased to represent the interest which he or

she purports to represent in the Board.

PART-B: KARNATAKA BUILDING AND OTHER CONSTRUCTION WORKERS’

WELFARE BOARD

10. Constitution of the Karnataka Building and other Construction Workers’ Welfare

Board under sub-section (1) and members under (3) of section 7.-

(1) The Karnataka Building and other Construction Workers’ Welfare Board shall be constituted

by notification in the official Gazette under sub-section (1) of section 7 of the Code.

(2) The Board shall consist of following members, namely:-

(i)

The Minister for Labour, Government of Karnataka as the ex-officio Chair person;

(ii)

A member nominated by the Central Government;

(iii) Not more than four persons representing the building and other construction

workers nominated by the Government;

(iv) Not more than four persons from among the employers of building and other

construction workers or associations nominated by the Government;

(v)

The Additional Chief Secretary/Principal Secretary/ Secretary to Government,

Labour Department, Government of Karnataka, ex-officio Member;

(vi) The Commissioner of Labour, Government of Karnataka, ex-officio Member;

(vii) Not more than two Official Members from among the following Departments as

notified by the Government;

(a) The Director of the Department of Factories, Boilers, Industrial Safety and

Health, ex-officio Member;

(b) The Principal Secretary/Secretary, Public Works Department or his nominee,

ex-officio Member;

his nominee, ex-officio Member;

(d) The Principal Secretary/ Secretary, Urban Development or his nominee, ex-

officio Member.

Provided that, one of the Member nominated under clause (iii) or (iv)

above shall be a women.

(viii) The Chief Executive Officer of the Board shall be the Member Secretary.

11. Term of Office of nominated member.– A nominated member of the Board other

than ex-officio member, shall subject to the pleasure of the Government, hold office for a period not

exceeding three years from the date of his nomination or till the reconstitution of the Board whichever

is earlier.

12. Reconstitution of the Board.- The Government shall initiate the process for

reconstitution of the Board, six months prior to the expiry of the term of the Board.

(1) If the new Board is not re-constituted after completion of the term of the Board, such

arrangements may be made for discharging the function of the Board as may be decided by

the State Government for the period till the new Board is constituted, through a notification.

(2) Consequent upon institution of such arrangement, all actions taken shall have the same effect

as if it has been carried out by the Board itself.

13. Procedure for meetings of the Board.- (1) Subject to any rules made by the

Central Government in this regard, the Board shall meet at least once in four months or earlier as may

be necessary at such place as may be determined by the Chairperson.

(2) Members of the Board shall be given seven clear day’s notice of the meeting specifying the

date, time and place of the meeting and business to be transacted thereat:

Provided that, seven days notice shall not be necessary where, in the opinion of

Chairperson, business of an emergent nature has to be transacted.

(3)(a) The quorum for the meeting shall be one third of the total members, having the presence

of at least one member each representing the Government, employers and the workers.

(b) If there is no quorum as laid down in sub-rule 3(a) above, the Chairperson shall after waiting

for thirty minutes after the expiration of the appointed hour, adjourn the meeting to such

hour on some other future day as he may deem fit. A notice of such adjourned meeting shall

be sent to every member of the Board and the business which would have been brought

before the original meeting, had there been a quorum there at shall be brought before the

adjourned meeting and may be disposed of at such meeting, whether the required quorum is

there or not.

members present and voting shall be held only if required at the meeting. In case of equality

of votes, the Chairperson shall have the casting vote.

(d) Votes shall be taken by show of hands and the names of persons voting in favour and against

any proposition shall be recorded only if any member requests the Chairperson to do so.

(e) The Board shall keep minutes of the proceedings of each meeting of the Board, and shall

include therein the names of the members present.

(f) A copy of such minutes shall be submitted by the Board to the State Government as soon as

they are confirmed by the Board.

(4)The Chairperson shall preside over every meeting of the Board in which he is present and in

his absence the Vice chairperson shall preside over such meeting in his place with the consent of the

chairperson.

14. Allowance to Members.- (1) The travelling allowance of an official member of the

Board shall be governed by the rules applicable to him for journey performed by him on official

duties and shall be paid by the authority paying his salary.

(2) The non-official members of the Board shall be entitled to the payment of travelling and

daily allowance as per the provisions of the Payment of Travelling Allowance to (to Non-official

Members of Committees, Commissions or other Bodies) Rules, 2015 or as may be determined by

the respective Board.

15. Resignations and manner of filling vacancies.- (1)Any member of the Board may at

any time resign by writing under his hand addressed to the Government and his seat shall become

vacant on acceptance of resignation.

(2) In the event of any vacancy occurring on account of death, resignation, disqualification or

removal or otherwise, the Board shall forthwith communicate the occurrence to the State

Government, and the vacancy shall be filled in not later than ninety days from the date of

occurrence of the vacancy. The Chairperson or member so nominated shall hold the office for the

remainder of the term of office of the Chairperson or member, as the case may be, in whose place

he is nominated.

(3) If a member changes his address, he shall notify his new address to the Chief Executive

Officer or Member Secretary as the case may be, who shall thereupon enter his new address in the

official record:

Provided that, if a member fails to notify his new address, the address in the official records

shall for all purposes be deemed to be the member’s correct address.

16. Terms and conditions of service of Officers and Employees of the

Board.- ( 1 ) The terms and conditions of service, salaries and allowances of the Secretary, Member

Secretary, other officers and employees of the Board shall be as follows, namely:-

(i) The Chief Executive Officer shall be an IAS officer in the senior scale or an officer from

the Central Services Group–‘A’ Senior Scale and the term of such deputation shall not

exceed more than three years;

(ii) The Other officers and employees of the Board may also be deputed from the Labour

Department of the State Government for a maximum period of three years or as may be

prescribed in the Cadre and Recruitment Rules or by notification as the case may be;

(iii) The salaries and allowances payable to the Member Secretary, Secretary or other

officers and employees of the Board shall not be higher than those admissible to the

State Government employees of equivalent cadre and rank; and

(iv) The cadre strength, and method of recruitment, promotions and creation of any posts

and disciplinary action shall be as determined by the Cadre and Recruitment Rules of

the Boards.

(2) The Chief Executive Officer or the Member Secretary, as the case may be, of the respective

Board shall have the power to conduct the day to day administration of the Board subject to the

provisions of the Code, Rules and directions

(3) The Chief Executive Officer or Member Secretary of the Board shall have full

disciplinary powers of the Board and the Chief Executive Officer shall have full disciplinary

powers of a Head of the Department as per the Karnataka State Civil Services Rules, 1958, the

Karnataka Civil services (Classification, Control and appeal) Rules, 1957 and the Karnataka

Government Servants (Conduct) Rules, 1966 over deputed officials of the Board.

(4) The Secretary of the Board shall be the Head of the Department insofar as the

affairs of the Board are concerned and shall have powers of administrative approval

up to Rs. 2.5 crore each time and general delegation of powers as per the orders of

the Finance Department issued from time to time.

(5) The official place of business of the Board shall be at Bengaluru.

(6) The Chief Executive Officer or Member Secretary, as the case may be, shall have the

power to allocate official responsibilities and duties within and between the officials and

employees of the Board subject to general or special orders of the Government.

(7) The Board shall be responsible for executing its projects and schemes.

CHAPTER – III

EMPLOYEES STATE INSURANCE COURT

17. Manner and time within which second appeal may be filed to the Employees Insurance

Court by the Insured Person or the Corporation under clause (b) of sub-section (7) of section

37: The Insured Person or the Corporation may file an second appeal to the Employees’ Insurance

Court in by presenting an application in Form-I within ninety days from the date of receipt of the

copy of order of the Medical Appellate Tribunal or of the Medical Appeal Tribunal to the Insured

Person or the Corporation, as the case may be;

Provided that the Employees’ Insurance Court may entertain the appeal after the period of

ninety days, if it is satisfied that the appellant had sufficient reasons for not presenting the appeal

within the prescribed period.

18. Constitution, matters and procedures to be followed by the Employees' Insurance

Court under sub-section (2) and (3) of Section 50.-

(1) The State Government, by notification, shall constitute an Employees' Insurance Court under

section 48, for such local area as may be specified in the notification.

(2) An Application under section 49 shall be presented in triplicate in Form-II and shall contain

the following particulars, namely:-

(a) Name of the Court in which Application is brought.

(b) Name including age and occupation

statement to that effect and the name, age, occupation and postal address of his or her guardian,

next-of-kin, or any other person authorized to act on his or her behalf.

(d) The fact constituting the cause of action and the date when it arose.

(e) The facts showing that court has jurisdiction.

(f) The relief which the applicant claims.

(3) Every application shall be verified in the same manner as a pleading in a Civil Court.

(4) All documents on which the application is based or has desired by applicant shall be appended

to application with an accurate list thereof;

(5) All applications shall be entered in a register in Form-III to be maintained by the Court.

(6) Every application to the Court shall be brought within three years on which the cause of action

arose or as the case may be, the claim becomes due;

(7) Where at any stage it appears to the Court that the application should be presented to another

Court, or should be entertain by the another Court, the first mention Court shall transfer the

application along with the file of the case to the Court empowered to deal with it and shall

inform the applicant and the opposite party accordingly and the Court to which the application

along with the file is transferred shall continue the proceedings as if the previous proceedings

or any part of it had been taken before it.

(8) The Court shall follow the rules of Code of Civil Procedure (5 of 1908) in respect of

summoning of the parties, service of summons, procedure of hearing, framing of issues,

statement and production of evidence, method of recording evidence, cross examination of

witness and other related matters.

(9) The fee payable on an application in respect of any matter referred to in Section 49 shall be

Rs. 100/- (rupees one hundred), however, the State Government may enhance the fees by

notification, from time to time.

(10) The fee and costs payable in respect of any other matters shall be such as is prescribed by

the relevant laws for the time being in force.

(11) All fees and costs referred to in this rule shall be collected by way of Court fee stamps

19. Manner of commencement of proceedings before the Employees' Insurance Court, fees

and procedure thereof under sub-section (1) of Section 51:

(1) The proceeding before an Employees' Insurance Court shall be commenced by application by

the Corporation, aggrieved person or the employer of an establishment as the case may be.

(2) Subject to the provisions of Chapter IV of the Code and rules made by the Government, all

proceedings before the Employees' Insurance Court shall be instituted in the Court appointed

for the local area in which the insured person was working at the time the question or dispute

arose.

(3) If the Court is satisfied that any matter arising out of any proceedings pending before it can be

more conveniently dealt with by any other Employees' Insurance Court in the same State, it

may, subject to any rules made by the Government in this behalf, order such matter to be

transferred to such other Court for disposal and shall forthwith transmit to such other Court

the record connected with that matter.

(4) The Government may transfer any matter pending before any Employees' Insurance Court in

the State to any such Court in another State with the consent of the Government of that State.

(5) The Court to which any matter is transferred under clause (iii) or (iv) shall continue the

proceedings as if they had been originally instituted in it.

CHAPTER – IV

GRATUITY

20. Bank or other financial institution in which the gratuity shall be invested for the

benefit of minor under the third proviso to sub-section (1) of Section 53.- The competent

authority shall invest the Gratuity amount for the benefit of minor under the third proviso to sub-

section (1) of section 53 of the code, in term deposit with the State Bank of India or any Nationalised

Bank.

Explanation.― "Nationalised Bank" means a corresponding new bank specified in the First

Schedule to the Banking Companies (Acquisition and Transfer of Undertakings) Act, 1970 (5 of

1970) with reference to section 3 of that Act or a corresponding new bank specified in the First

Schedule to the Banking Companies (Acquisition and Transfer of Undertakings) Act, 1980 (40 of

1980) with reference to Section 3 of that Act

21. Time, form and manner of nomination by an employee under sub-section (1), the time

to make fresh nomination under sub-section (4), the form and manner of modification of a

nomination under sub-section (5) and the form for fresh nomination under sub-section (6) of

Section 55.-

(1) A nomination under sub-section (1 )of section 55 of the Code shall be made in Form IV and

submitted in duplicate by personal service by the employee, after taking proper receipt or

by sending through Registered Post Acknowledgment due or electronically to the employer

by an employee,-

(i) who is already in employment on the date of commencement of these rules,

ordinarily, within ninety days from such date; or

(ii) who completes one year, after the date of commencement of these rules,

ordinarily, within thirty days of the completion of one year:

Provided that, nomination in Form IV shall be accepted by the employer after the specified

period, if filed and no nomination so accepted shall be invalid merely because it was filed after the

specified period.

(2) Within thirty days of the receipt of a nomination in Form IV under sub-rule (1), the employer

shall get the service particulars of the employee, as mentioned in the form of nomination,

verified with reference to the records of the establishment and return to the employee, after

obtaining a receipt thereof, the duplicate copy of the nomination in Form IV duly attested

by him or his authorised representative and the other copy shall be maintained in the

establishment.

(3) An employee who has no family at the time of making a nomination shall, within ninety days

of acquiring a family, submit in the manner

specified in sub-rule (1), a fresh

nomination, as required under sub-section (4) of Section 55 of the Code in duplicate in Form

IV to the Employer, and thereafter the provisions of sub-rule (2), shall apply mutatis mutandis

as if it was made under sub-rule (1).

(4) A notice of modification of a nomination, including cases where a nominee predeceases an

employee, shall be submitted in duplicate in Form IV to the employer in the manner

prescribed in sub-rule (1), and thereafter the provisions of sub-rule (2) shall apply mutatis

mutandis as if it were made under sub-rule (1)

(5) A nomination or a fresh nomination or a notice of modification of nomination shall be signed

by the employee, or, if illiterate, shall bear his thumb impression, in the presence of two

witnesses, who shall also sign a declaration to that effect in the nomination, fresh nomination

or notice of modification of nomination, as the case may be.

(6) A nomination, fresh nomination or notice of modification of nomination, shall take effect

from the date of receipt thereof by the employer.

22. Time within which and the form in which a written application shall be made under sub-

section (1) of Section 56.-

(1) An employee or nominee, as the case may be, who is eligible to receive gratuity under the

code or any person authorised, in writing, to act on their behalf, shall apply, ordinarily within

thirty days from the date the gratuity became payable, in Form- V either electronically or by

registered post acknowledgement due or in person to the employer:

Provided that where the date of superannuation or retirement is known, the

employee may apply to the employer before thirty days of the date of superannuation or

retirement.

Provided further that a nominee may give application in plain paper with relevant

particulars which shall be accepted

(2) A legal heir of an employee who is eligible for payment of gratuity under the third proviso to

sub-section (1) of section 53 of the Code shall apply ordinarily within one year from the date

the gratuity became payable to him in Form –V to the employer.

(3) An application for payment of gratuity filed after the expiry of the periods specified in this

rule shall also be entertained by the employer, if the applicant adduces sufficient cause for the

delay in preferring the claim, and no claim for gratuity under the Code shall be invalid merely

because the claimant failed to present the his application within the specified period. Any

dispute in this regard shall be referred to the Competent Authority of the area for his decision.

(4) Within fifteen days of the receipt of an application under sub-rule (1) for payment of gratuity,

the employer shall,-

(i) if the claim is found admissible on verification, issue a notice in Form- VI

to the applicant employee, nominee or legal heir, as the case may be,

specifying the amount of gratuity payable and fixing a date, not being later

than the thirtieth day after the date of receipt of the application, for

payment thereof, or

(ii) if the claim for gratuity is not found admissible, issue a notice in Form- VI

to the applicant employee, nominee or legal heir, as the case may be,

specifying the reasons why the claim for gratuity is not considered

admissible. In the case of denial of gratuity a copy of the notice shall be

endorsed to the competent authority.

(5) In case of payment of gratuity is due to be made in the employer's office, the date

fixed for the purpose in the notice under sub- clause (i) of sub- rule (4) shall be re-

fixed by the employer, if a written application in this behalf is made by the payee

explaining why it is not possible for him to be present in person on the date specified.

(6) If the claimant for gratuity is a nominee or a legal heir, the employer may ask for such

witness or evidence as may be deemed relevant for establishing his identity or

maintainability of his claim, as the case may be. In that case, the time limit specified

for issuance of notices under clause (i) of sub-rule (4) shall be operative with effect

from the date such witness or evidence, as the case may be, called for by the employer

is furnished to the employer.

(7) A notice under sub -section (2) of section 56 of the code in Form- VI shall be served

on the applicant either by personal service after taking receipt or by registered post

with acknowledgement due or electronically.

(8) The gratuity payable under the Code shall be paid through Demand Draft or by

crediting in the bank account of the eligible employee, nominee or legal heir, as the

case may be.

23. Form of Application to competent authority for direction under clause (b) of subsection (5)

of section 56.-

(1) If an employer,-

(i) refuses to accept a nomination under rule 21, or

(ii) issues a notice under clause (i) of sub-rule (4) of rule 22 either specifying an amount

of gratuity which is considered by the applicant less than what is payable or

rejecting eligibility to payment of gratuity, or

(iii) having received an application under rule 22 fails to issue notice as required under

clause (i) of sub-rule (4) of rule 22 within the time specified therein, the claimant

employee, nominee or legal heir, as the case may be, shall within six months of the

occurrence of the cause for the application, apply in Form-VII to the competent

authority for issuing a direction under sub-section (5) of section 56 with as many

extra copies as are the opposite party:

Provided that, the competent authority may accept any application on

sufficient cause being shown by the applicant, after the expiry of the specified

period

(2) Application under sub-rule (1) and other documents relevant to such an application shall be

presented in person to the competent authority or shall be sent by registered post

acknowledgement due or electronically.

24. Procedure for dealing with application for direction.-

1. On receipt of an application under rule 23, the competent authority shall, by issuing a notice

in Form-VIII, by electronically or registered post acknowledgment due or in person call upon

the applicant as well as the employer to appear before him on a specified date, time and place,

either by himself or through his authorised representative together with all relevant documents

and witnesses, if any.

2. Any person desiring to act on behalf of an employer or employee, nominee or legal heir, as

the case may be, shall present to the competent authority a letter of authority from the

employer or the person concerned, as the case may be, on whose behalf he seeks to act together

with a written statement explaining his interest in the matter and praying for permission so to

act. The competent authority shall record thereon an order either according his approval or

specifying, in the case of refusal to grant the permission prayed for, the reasons for the refusal.

3. A party appearing by an authorised representative shall be bound by the acts of the

representative.

4. After completion of hearing on the date fixed under sub-rule (1) or after such further evidence,

examination of documents, witnesses, hearing and inquiry, as may be deemed necessary, the

competent authority shall record his finding as to whether any amount is payable to the

applicant under the Code. A copy of the finding shall be given to each of the parties.

5. If the employer concerned fails to appear on the specified date of hearing after due service of

notice without sufficient cause, the competent authority may proceed to hear and determine

the application ex-parte. If the applicant fails to appear on the specified date of hearing without

sufficient cause, the competent authority shall dismiss the application:

Provided that, an order under sub-rule (5) may, on good cause being shown

within thirty days of the said order, be reviewed and the application re-heard after giving

not less than fourteen days' notice to the opposite party of the date fixed for rehearing of

the application.

6. Place and time of hearing: The sittings of the competent authority shall be held at such

times and at such places as he may fix and he shall inform the parties of the same in such

manner as he thinks fit.

7. Administration of oath: The competent authority shall authorise a clerk of his office to

administer oaths for the purpose of making affidavits.

8. Summoning and attendance of witnesses: The competent authority may, at any stage

of the proceedings before him, either upon or without an application by any of the parties

involved in the proceedings before him, and on such terms as may appear to the

competent authority just, issue summons to any person in Form-VIII either to give

evidence or to produce documents or for both purposes on a specified date, time and

place.

9. Service of summons or notice:

(i) Subject to the provisions of clause (ii) any notice, summons, process or order

issued by the competent authority may be served either personally or by

registered post acknowledgement due or electronically or in any other manner as

prescribed under the Code of Civil Procedure, 1908 (5 of 1908).

(ii) Where there are numerous persons as parties to any proceeding before the

competent authority and such persons are members of any trade union or

association or are represented by an authorised person, the service of notice on

the Secretary, or where there is no Secretary, on the principal officer of the trade

union or association, or on the authorised person shall be deemed to be service

on such persons.

10. Maintenance of records of cases by the competent authority:

(i) The competent authority shall record the particulars of each case under section

56 of the Code and at the time of passing orders shall sign and date the particulars

so recorded.

(ii) The competent authority shall, while passing orders in each case, also record the

findings on the merits of the case and file it together with the memoranda of

evidence with the order sheet.

(iii) Any record, other than a record of any order or direction, which is required by

these rules to be signed by the competent authority, may be signed on behalf of

and under the direction of the competent authority by any subordinate officer

appointed in writing for this purpose by the competent authority.

11. Direction for payment of gratuity: If a finding is recorded under sub-rule (4) that the

applicant is entitled to payment of gratuity under the Code, the competent authority shall

issue a notice to the employer concerned in Form-IX electronically or registered post

acknowledgment due or in person specifying the amount payable and directing payment

thereof to the applicant under intimation to the competent authority within thirty days

from the date of the receipt of the notice by the employer. A copy of the notice shall be

endorsed to the applicant employee, nominee or legal heir, as the case may be.

25. Appeal under sub-section (8) of section 56:

(i) The Memorandum of appeal under sub-section (8) of section 56 of the Code shall

be submitted to the appellate authority with a copy thereof to the opposite party and

the competent authority either through delivery in person or under registered post

acknowledgement due or electronically.

(ii) The Memorandum of appeal shall contain the facts of the case, the decision of the

competent authority, the grounds of appeal and the relief sought.

(iii) There shall be appended to the Memorandum of appeal a certified copy of the

finding of the competent authority and direction for payment of gratuity.

(iv) On receipt of the copy of Memorandum of appeal, the competent authority shall

forward records of the case to the appellate authority.

(v) Within fourteen days of the receipt of the copy of the Memorandum of appeal, the

opposite party shall submit his comments of each paragraph of the memorandum

with additional pleas, if any, to the appellate authority with a copy to the appellant.

(vi) The appellate authority shall record its decision after giving the parties to the appeal

a reasonable opportunity of being heard. A copy of the decision shall be given to the

parties to the appeal by electronically or registered post or in person and a copy

thereof shall be sent to the competent authority returning his records of the case.

(vii) The Competent authority shall, on receipt of the decision of the appellate authority,

make necessary entry in the records of the case maintained by him.

(viii)

On receipt of the decision of the appellate authority, the competent authority

shall, if required under that decision, modify his direction for payment of gratuity

and issue a notice to the employer concerned in Form-IX specifying the modified

amount payable and directing payment thereof to the applicant, under intimation to

the competent authority within fifteen days of the receipt of the notice by the

employer. A copy of the notice be endorsed to the appellant employee, nominee or

legal heir, as the case may be, and to the appellate authority.

26. Application for recovery of gratuity under section 129: Where an employer fails to pay

the gratuity due under the Code in accordance with the notice by the competent authority under sub-

rule (24) the employee concerned, his nominee or legal heir, as the case may be, to whom the gratuity

is payable may apply to the competent authority in duplicate in Form -X for recovery thereof under

section 129 of the Code.

27. Manner of registration of an establishment by the employer under sub-section (3) and

the manner of composition of the Board of Trustees of the approved gratuity fund and the

manner in which the competent authority may recover the amount of the gratuity payable to

an employee from the insurer under sub-section (4) of Section 57.-

1. The State government shall notify the manner of registration of an establishment by the

employer under sub-section (3) of Section 57 in Form-XI.

2. The composition of the Board of Trustees of the approved gratuity fund shall be notified by

State Government.

3. Any amount directed to be paid under section 57 shall be recoverable as an arrear of land

revenue.

28. Competent Authority and Appellate Authority.-

(1) Appointment of Competent Authority: The competent authority shall be appointed by the

State Government by notification as required under sub-section (1) of Section 58 of the code.

(2) The Government may by notification appoint any officer above the rank of the Competent

Authority appointed under sub-rule (1) as Appellate Authority for the purpose of section 56

of the Code.

CHAPTER -V

MATERNITY BENEFIT

29. Compliant to be made under section 72:-

(1) A complaint under sub-section (1) of section 72 shall be made in writing in Form- XII as the

case maybe.

(2) When a complaint referred to in section 72 is received by an Inspector-cum-Facilitator, he

shall examine the relevant records maintained by the employer in this behalf, examine any

person employed in the establishment and take down necessary statement for the purpose of

the enquiry and if he is satisfied that the maternity benefit or the amount has been improperly

withheld, he shall direct the employer to make the payment to the woman or to the person

claiming the payment under section 63, as the case may be, immediately or within a specified

period:

Provided that the time limit for disposal of complaint shall not exceed 90 days from

the date of filing of complaint. In case of non-appearance by either of parties, a maximum of

three opportunities may be given before disposal of the complaint.

30. Authority to whom an appeal may be preferred under Section 72:

(1) An appeal against the decision of the Inspector-cum-Facilitator under sub-section (2) of

section 72 shall lie to the Competent Authority to be notified.

(2) The aggrieved person shall prefer an appeal in writing to the competent Authority in Form-

XIII and file other supporting documents.

(3) When an appeal is received, the competent Authority shall call from the Inspector-cum-

Facilitator before a fixed date, the record of the case. The competent Authority shall, if

necessary, also record the statements of the aggrieved person and of the Inspector-cum-

Facilitator and seek clarification if any is required.

(4) Taking into account the documents, the evidence produced before him and the facts presented

to him or ascertained by him, the prescribed Authority shall give his decision within a period

of 90 days from filing of application before him. In case of nonappearance by either of the

parties, a maximum of three opportunities may be given before disposal of the appeal

CHAPTER -VI

EMPLOYEE’S COMPENSATION

31. Amount towards funeral expenses if the injury results in death of the employee: The

Employer shall deposit a sum not less than rupees twenty five thousand with the competent Authority

towards the expenditure of the funeral of the deceased employee which shall be paid to the eldest of

the surviving dependant or where the employee did not have a dependant or was not living with his

dependant at the time of his death, to a person who actually incurred such expenditure.

Provided that, the State Government may, by notification from time to time, enhance the

amount specified above.

32. Conditions when application for review is made without certificate of a medical

practitioner under sub-section (1) of section 79.- Application for review of a half monthly payment

under section 79 may be made without being accompanied with a medical certificate,-

(a) by the employer, on the ground that’s since the right to compensation was determined

the workman’s wages have increased;

(b) by the workman, on the ground that since the right to compensation was determined his

wages have diminished;

compensation, has ceased to pay the same, notwithstanding the fact that there as been

no changed in the workman’s condition such as to warrant such cessation;

(e) either by the employer or by the workman, on the ground that the determination of the

rate of compensation for the time being in force was obtained by fraud or undue

influence or other improper means; and

(f) either by the employer or by the workman, on the ground that the determination of

compensation, there is a mistake or error apparent on the face of the record.

33. Interval for medical examination under the proviso to sub-section (1) of section 84.-

A workman who is in receipt of a half-monthly payment shall not be required to submit himself for

medical examination elsewhere than at the place where he is residing for the time being more than

twice in the first month following the accident or more than once in any subsequent month.

34. Class of employers and the form of notice-book under sub-section (4) of section 82.-

A notice book in Form XIV shall be maintained in all establishment where in 500 work men or more

are employed as required under sub-section (4) of section 82 of the Code.

35. Form of statement of fatal accidents to be submitted by the employer under sub-

section (1) of section 88.- The notice under section 88 of the Code shall be in Form XV.

36. Manner of Recording Memorandum for the purpose of sub-section (1) of Section 89.-

(1) Memorandum of Agreement sent to the Competent Authority under sub-section (1) of section 89

of the Code shall be in duplicate and shall be in as close conformity as the circumstances of the case

admit with Form XVI-A,XVI-B,XVI-C as the case may be.

(2) The Register of Memorandum shall be in Form XVI-D.

37. Qualifications and Experience for Competent authority under sub-section (1) of

Section 91.- Subject to the provisions of the section 91 of the Code, the State Government may by

notification appoint any Gazetted Officer of not less than five years of experience of in the state labour

department who has a Diploma in Personnel Management or who has been notified as a Conciliation

Officer under Section 43 of the Industrial Relations Code, 2020 (Central Act No.35 of 2020) to be

the Competent Authority for such area as it thinks fit for the purpose of this Code.

38. Procedure of Competent Authority.- Save as otherwise provided in these rules, procedure

to be followed by Competent Authority in the disposal of cases under the Code or these rules and by

the parties in such cases shall be regulated in the following manner, namely:-

(1)Applications.-

(i) Any application of the nature referred to in section 93 of the Code may be sent to the

Competent Authority by registered post or may be presented to him or to any of

his subordinates authorised by him in this behalf and, if so sent or presented, shall,

unless the Competent Authority otherwise directs, be made in duplicate in Form

XVII-A or XVII-B as the case may be and shall be signed by the applicant.

(ii) There shall be appended to every such application a certificate, which shall be signed

by the applicant to the effect that the statement of facts contained in the application

is to the best of his knowledge and belief accurate.

(2)Production of documents.-

(i) When the application for relief is based upon a document, the document shall be

appended to the application.

(ii) Any other document which any party desires to tender in evidence shall be produced

at or before the first hearing.

(iii) Any document which is not produced at or within the time specified in sub-rule (1)

or (2) as the case may be, shall not without the sanction of the Competent Authority

be admitted in evidence on behalf of the party who should have produced it.

(iv) Nothing in this rule applies to any document which is produced for the purpose of

cross-examining a witness or handed to a witness to refresh his memory.

(3)Application presented to wrong Competent Authority.-

(i) If it appears to the Competent Authority on receiving the application that it should

be presented to another Competent Authority he shall return it to the applicant

after endorsing upon it the date of the presentation and return, the reason for

returning it and the designation of the Competent Authority to whom it should be

presented.

(ii) If it appears to the Competent Authority at any subsequent stage that an application

should have been presented to another Competent Authority, he shall send the

application to the Competent Authority empowered to deal with it and shall

inform the applicant and the opposite party if he has received a copy of the

application under sub-rule(8) accordingly.

(iii) The Competent Authority to whom the application is transferred under sub-clause

(2) may continue the proceedings as if the previous proceedings or any part of it

had been taken before him, if he is satisfied that the interests of the parties will

not thereby be prejudiced.

(4)Examination of applicant.-

(i) On receiving such application, the Competent Authority may examine the applicant

on oath, or may send the application to any officer authorised by Government in

this behalf and direct such officer to examine the applicant and his witnesses and

forward the record thereof to the Competent Authority.

(ii) The substance of any examination made under sub-clause (i) shall be recorded, in

the manner provided for the recording of evidence in section 97 of the Code.

(5)Summary dismissal of application.-

(i) The Competent Authority may, after considering the application and the result of any

examination of the applicant under sub- rule (4) summarily dismiss the application,

if, for reasons to be recorded, he is of opinion that there are no sufficient grounds

for proceeding thereon.

(ii) The dismissal of the application under sub-clause (i) shall not preclude the applicant

from presenting a fresh application.

(6)Preliminary inquiry into application.- If the application is not dismissed under sub -rule (e)

the Competent Authority may, for reasons to be recorded, call upon the applicant to produce

evidence in support of the application before calling upon any other party and, if upon

Considering such evidence the Competent Authority is of opinion that there is no case for the

relief claimed, he may dismiss the application with a brief statement of his reasons for so

doing.

(7)Notice to opposite party.- If the Competent Authority does not dismiss the application under

sub rule (5) or (6), he shall send to the party from whom the applicant claims relief (hereinafter

referred to as the opposite party) a copy of the application, together with a notice of the date

on which he will dispose of the application, and may call upon the parties to produce on that

date any evidence which they may wish to render.

(8)Appearance and examination of opposite party.-

(i) The opposite party may, and if so, required by the Competent Authority, shall at of

before the first hearing or within such time as the Competent Authority may permit,

file a written statement dealing with claim raised in the application, an any such

written statement shall form part of the record.

(ii) If the opposite party contests the claim, the Competent Authority may, and, if no written

statement has been filed, shall, proceed to examine him upon the claim, and shall

reduce the result of the examination to writing.

(9)Framing of Issues.-

(i) After considering any written Statement and the result of any examination of the

parties, the Competent Authority shall ascertain upon what material propositions

of fact or law the parties are at variance, and shall thereupon proceed to frame and

record the issues upon which the right decision of the case appears to him to

depend.

(ii) In recording the issues, the Competent Authority shall distinguish between those

issues which in his opinion concern points of fact and those which concern points

of law.

(10) Power to postpone trial of issues of fact where issues of law arise.- When issues both of

law and of fact arise in the same case, and the Competent Authority is of opinion that the

case may be disposed of on the issues of law only, he may try those issues first, and for

that purpose may, if he thinks fit, postpone the settlement of the issues of fact until after

the issues of law have been determined.

(11) Diary.- The Competent Authority shall maintain under his hand a brief dairy of the

proceedings on an application.

(12) Reasons for postponement to be recorded.- lf the Competent Authority finds it

impossible to dispose of an application at one hearing, he shall record the reasons which

necessitate a postponement.

(13) Judgment.-

(i) The Competent Authority, in passing orders, shall record concisely in a judgment

his finding on each of the issues framed and his reasons for such findings.

(ii) The Competent Authority, at the time of signing and dating his judgment, shall

pronounce his decision, and thereafter no addition or alteration shall be made

to the judgment other than the correction of clerical or arithmetical mistake

arising from any accidental slip or omission.

(14) Summoning of witnesses.- lf an application is presented by any party to the

proceedings for the citation of witnesses the Competent Authority shall, on payment of

the prescribed fees and issue summons for the appearance of such witnesses unless he

considers that their appearance is not necessary for the just decision of the case.

(15) Exemption from payment of costs.- lf the Competent Authority is satisfied that the

applicant is unable, by reason of poverty, to pay the specified fees, he may remit any or all

of such fees.

(16) If the case is decided in favour of the applicant the specified fees which, had they not been

remitted, would have been due to be paid, may be added `to the cost of the case and

recovered in such manner as the Competent Authority in his order regarding costs may

direct.

(17) Right of entry for local inspection.- The Competent Authority before whom any

proceeding relating to an injury by accident is pending may at any time for the purpose of

making a local examination enter the place where workman was injured, or where the

workman ordinarily performed his work, or for examining any persons likely to be able to

give information relevant to the proceedings:

Provided that, the Competent Authority shall not enter any premises of any industrial

establishment except during the ordinary working hours of that establishment, save with the

permission of the employer or of some person directly responsible to him for the management of the

establishment.

(18) Procedure in connection with Local Inspection.-

(i) If the Competent Authority proposes to conduct a local inspection with a view

to examining on the spot the circumstances in which an accident took place he

shall give the parties or their representatives notice of his intention to conduct

such inspection, unless in his opinion the urgency of the case renders the giving

of such notice impracticable.

(ii) Such notice may be given orally or in writing and in the case of an employer,

may be given to any person upon whom notice of a claim can be served under

sub-section (3) of section 82 of the Code or to the representatives of any such

person.

(iii) Any party or the representative of any party, may accompany the Competent

Authority at a local inspection.

(iv) The Competent Authority after making a local inspection, shall note briefly in

a memorandum any facts observed, and shall show the memorandum to any

party who desires to see the same, and on payment of the prescribed fee shall

supply any party with a copy thereof.

(v) The memorandum shall form part of the record.

(19) Power of summary examination.-

(i) The Competent Authority during a local inspection or at any other time, save at

a formal hearing of a case pending before him, may examine summarily any

person likely to be able to give information relative to such case whether such

person has been or is to be called as a witness in the case or not, and whether

any or all the parties are present or not,

(ii) No oath shall be administered to a person examined under sub-clause (i).

(iii) Statements made by person examined under sub-clause (i) if reduced to writing,

shall not be signed by the person making the statement, nor shall they except

as hereinafter provided, be incorporated in the record or utilized by the

Competent Authority for the purpose of arriving at a decision in the case.

(iv) If a witness who has been examined under sub- clause (i) makes in evidence

any material statement contradicting any statement made by him in such

examination and reduce to writing, the Competent Authority may call his

attention to such statement, and shall in that case direct that the parties be

furnished with the relevant part of such statement, for the purpose of examining

or cross-examining the witnesses.

(v) Any statement or part of statement which is furnished to the parties under clause

(iv) shall be incorporated in the record.

(vi) Where a case is settled by agreement between the parties the Competent

Authority may incorporate in the record any statement made under sub- clause

(i) and may utilise such statement for the purpose of justifying his statement or

refusal to accept, the agreement reached.

(20) Procedure where indemnity is claimed under section 85(2).-

(i) Where the opposite party claims that if compensation is recovered against him,

he will be entitled under sub-section (2) of Section 85 to be indemnified by a

person not being a party to the case, he shall when first called upon to answer

the application present a notice of such claim to the Competent Authority

accompanied by the prescribed fee, and the Competent Authority shall

thereupon issue notice to such person in Form XVIII-A.

(ii) If any person served with a notice under sub-clause(i) desires to contest the

applicant's claim for compensation or the opposite party's claim to be

indemnified, he shall appear before the Competent Authority on the date fixed

for the hearing of the case or on any date to which the case may be adjourned

and, if he so appears, shall have all the rights of a party to the proceedings in

default of so appearing he shall be deemed to admit the validity of any award

made against the opposite party and to admit his own liability to indemnify the

opposite party for any compensation recovered from him:

Provided that, if any person so served appears subsequently satisfies the

Competent Authority that he was prevented by any sufficient cause from appearing,

the Competent Authority shall after giving notice to the aforesaid opposite party,

hear such person and may set aside or vary any award made against such person

under this rule upon such terms as may be just.

(iii) If any person served the with a notice under claim sub-clause(i) whether or not

he desires to contest the applicant’s claims for compensation or the opposite

party's claim to be indemnified, claims that being a contractor he is himself a

principal and is entitled to be indemnified by a person standing to him in the

relation of a contractor from whom the workman could have recovered

compensation, he shall on or before the date fixed in the notice under sub-

clause(i) present a notice of such claim to the Competent Authority

accompanied by the prescribed fee and the Competent Authority shall thereupon

issue notice to such person in Form XVIII-B.

(iv) If any person served with a notice under sub-clause (iii) desires to contest the

applicant's claim for compensation, or the claim under sub- clause (iii) to be

indemnified he shall appear before the Competent Authority on the date fixed

in the notice in Form XVIII-B on or any date to which the case may be

adjourned and, if he so appears shall have all the rights of a party to the

proceedings in default of so appearing, he shall be deemed to admit the validity

of any award made against the original opposite party or the person served with

a notice under sub- clause (i) and to admit his own liability to indemnify the

party against whom such award is made for any compensation recovered from

him:

Provided that, if any person so served appears subsequently and satisfies the

Competent Authority that he was prevented by any sufficient cause from

appearing, the Competent Authority shall, after giving notice to all parties on

the record, hear such person, and may set aside or vary any award made against

such person under this rule upon such terms as may be just.

(v) In any proceeding in which a notice has been served on any person under sub-

clause (i) or sub- clause (iii), the Competent Authority shall, if he awards

compensation, record in his judgment a finding in respect of each of such

persons whether he is or is not liable to indemnify any of the opposite parties,

and shall specify the party, if any, whom he is liable to indemnify.

(21) Procedure in connected cases.–

(i) Where two or more cases pending before a Competent Authority arise out of the

same accident, and any issue involved is common to two or more such cases,

such cases may so far as the evidence bearing on such issues is concerned, be

heard simultaneously.

(ii) Where action is taken under sub- clause (i), the evidence bearing on the common

issue or issues shall be recorded on the record of one case and the Competent

Authority shall certify under his hand on the record applies to such other case

and the fact that the parties to such other case had the opportunity of being

present, and if they were present, of cross-examining the witnesses.

(22) Certain provisions of Civil Procedure Code, 1908 (Central Act No. 5 of 1908) to apply.

Save as otherwise expressly provided in the Code or these rules, the following provisions of

the First Schedule to the Code of Civil Procedure, 1908 (Central Act No. 5 of 1908), namely,

those contained in Order V, Rule 9 to 30; Order VII, Rules 9 to 18; Order IX; Order XIII;

Order XVI; Order XVII and Order XXIII, Rules 1 to 3; shall apply to proceedings before

Competent Authority, in so far as they may be applicable thereto;

Provided That,-

(a) for the purpose of facilitating the application of the said provisions, the

Competent Authority may construe them with such alterations not affecting

the substance as may be necessary or proper to adopt them to the matter before

him;

(b) the Competent Authority may, for sufficient reasons proceed otherwise than in

accordance with the said provisions, if he is satisfied that the interests of the

parties will not thereby be prejudiced.

(23) Any form other than a receipt for compensation which is by these rules required to the signed

by a Competent Authority may be signed under his direction and on his behalf by any officer

subordinate to him appointed by him in writing for this purpose.

(24) Apportionment of compensation among dependants.– The provisions of this part,

except those contained in Sub-rule (8), (9) and (20) shall, as far as may be, apply in the

case of any proceedings relating to the apportionment of compensation among

dependants of a deceased workman.

(25) Every application made to the Competent Authority under section 93 of the code shall be

disposed off by the Competent within six months from the date it is presented to the

Competent Authority:

Provided that, if the Competent Authority is unable to dispose off the application

within the stipulated period of six months, he shall at the time of final disposal of the

application state the reasons therefore in the Dairy Maintained under sub -rule (11) of this

rule.

CHAPTER- VII

CESS IN RESPECT OF BUILDING AND OTHER CONSTUCTION WORKERS

39. Time limit for payment of cess under section 101.- Every employer shall pay cess

payable within thirty days from the date of receipt of the assessment order.

40. Fees for appeal under sub-section (2) of Section 105.― An employer aggrieved by an

order of the assessment may file an appeal against such order, to the Appellate Authority as notified

by the State Government in this regard with a non-refundable fee equivalent to one-half percent, but

not exceeding rupees twenty five thousand, of the amount in dispute or penalty or both, as the case

may be, under such appeal.

CHAPTER –VIII

FINANCE AND ACCOUNTS

41. Accounts.-

(1) The income and expenditure of the Social Security Organisation shall be maintained in such

forms and registers as required by the Karnataka Financial Code,1958 and the Rules and

Notifications made there under.

(2) Approval of the Budget:- The budget estimates for every financial year shall be prepared

and laid before the Board on or before the 31^st day of January of the previous financial year

and after it is approved by the Board the same shall be forwarded to the State Government for

approval on or before the 10^th February. The State Government shall approve the Budget

before the 28^th February, after making such amendments and alterations as it considers

necessary.

(3) The budget amended or altered and approved shall constitute the budget of the Board for the

financial year and shall be issued under the seal of the Board and signed by the officers or

officers of the Board duly authorized in this behalf.

(4) An authenticated copy of the approved budget shall be forwarded to the State Government

before the 15^th of March.

(5) The Board shall submit to the State Government and Central Government as soon as may be

after the 1^st of April every year and not later than 31^st day of October an Annual Report in

Form XIX on the working of the Board during the preceding year ending on 31^st March of

the year along with audited copy of Accounts together with an Auditor’s report.

(6) The Boards may from time to time invest any moneys vested in it which are not immediately

required for expenses of the Board in any Nationalised Bank, scheduled Banks or Government

Securities as the Board thinks it fit and proper.

(7) The Boards may open such accounts in the name of the Chief Executive Officer or Member

Secretary as the case may be, necessary for receipt of fees, subscription amount, cess or any

other source of income to the Boards and Administrative account as the case may be.

(8) All accounts of the Board shall be held in the name of the Chief Executive officer or Member

Secretary, as the case may be, and he shall be the drawing and disbursing officer.

(9) All expenses for the administration of the Fund, fees and allowances of the Members of the

Board, salaries, leave salaries, joining time pay, travelling allowance, compensatory

allowance, charge allowances, pension contribution and other benefits of personal expenses

for the legitimate needs of the Board and the stationery expenses shall be met from

administrative account of the Board.

42. Holding of Property etc, by Social Security Organisation.- The conditions to acquire, hold,

sell or otherwise transfer any movable or immovable property under sub-section (1), conditions to

invest moneys, re-invest or realise investments under sub-section (2) terms to raise loans and take

measures for discharging such loans under sub-section (3) and terms to constitute for the benefit of

officers and staff or any class of them, provident or other benefit funds under sub-section (4) of section

120 of the code shall be as decided by the Board by a resolution approved by not less than 2/3

majority.

CHAPTER –IX

AUTHORITIES, ASSESSMENT, COMPLIANCE AND RECOVERY

43. Maintenance of records and registers under section 123.-

1. Every employer shall maintain the following registers electronically or otherwise and shall be

kept available at the office of the establishment or the nearest convenient building within the

precincts of the establishment; A combined register in Form XX showing the following

details namely,-

(i) Wage paid to the employees;

(ii) Leave, leave wages, wages for overtime work and attendance;

(iii) Employees identification number;

(iv) Statutory deduction from wages in – respect of chapter III and IV of the Code;

(v) Register for Number of days for which work performed by the employees in Form XXI;

(vi) Register for Number of hours of work performed by the employees in Form XXI;

(vii) Register for Total number of employees in Form XXI;

(viii) Register for Persons recruited for a particular period in Form XXII;

(ix) Register for Occupational details of employees in Form XXII;

(x) Register of dangerous occurrences, accidents, injuries in-respect of which compensation

paid and the amount of compensation paid in Form XXIII;

(xi) Register of cess paid in Form XXIV;

(xii) Register of vacancies for which suitable candidates were not available in Form XXV;

2. The State Government may by notification prescribed the manner and the form to be displayed

by the employer in work place from time to time under Section 123 (b).

44. Register of Women Employees.-

(1) The employer of every establishment in which women are employed shall prepare and maintain a

therein particulars of all women employees in the establishment.

(2) The register shall always be available for inspection scheme for the Inspector-cum-facilitator.

(3) The employer may enter in the register of women employees such other particulars as may be

required for any other purpose of the Code.

45. Records.- The electronic records maintained under the provisions of Chapter V and

Chapter VI of this Code and rules framed under shall be preserved for a period of three years from

the date their preparation.

46. Annual Returns.-

(1) The employer to which the provisions of Chapter V and Chapter VI of the Code applies,

on or before the last day of February in each year, upload a unified consolidated annual return in

Form XXVII online on the web portal of the State Government giving information as to particulars

specified in respect of the preceding year:

Provided that, during inspection, the Inspector-cum-Facilitator may require the production of

accounts, book, register and other documents maintained in electronic form or otherwise.

Explanation.- For the purpose of this sub-rule, the expression “electronic form” shall have the

same meaning as assigned to it in clause (r) of section 2 of the Information technology Act, 2000

(Central Act 21 of 2000).

(2) If the employer to which the code applies sells, abandons or discontinues the working of

the establishment, then, he shall, within one month of the date of such sale or abandonment or four

months of the date of such discontinuance, as the case may be, upload online on the web portal of the

State Government a further unified consolidated annual return in Form XXVII referred to in sub-

rule (1) in respect of the period between the end of the preceding year and the date of sale,

abandonment or discontinuance.

47. Inspection Scheme.-

(1) The Government may by notification lay down an inspection scheme which may provide

for a web-based inspection and calling of information under this code electronically and such other

related to inspections for implementing the provisions of the code except those under Chapter III and

Chapter IV

(2) The Government may by notification appoint such persons as it thinks fit for such

geographical area as may be specified to be Inspector-cum-Facilitator for the purposes of

implementing the provisions of this Code except for the purposes of Chapter III and Chapter IV under

the control and supervision of the Government

CHAPTER- X

OFFENCES AND PENALTIES

48. Compounding of offences: The State Government may by notification in the official

Gazette appoint an officer to compound the offences as required under sub-section (1) of section 138

of the State Labour Department for such area as it thinks fit for the purpose of compounding of

offences under sub-section (1) of the section 138 of the Code in respect of those provisions for which

the State Government is the appropriate Government.

49. Manner of compounding of offences by the officer specified under sub-section (1) of

section 138:-

1. Any accused person intending to compound the offence alleged against him which is

compoundable under this Code may submit an application in Form XXVIII to the officer

notified by the Government for the purpose of compounding of offences under sub-section

(1) of section 138 (herein after referred to as the compounding officer).

2. If prosecution is pending before the Judicial First Class Magistrate Court under sub section

(3) of Section 136 the compounding officer shall sent an intimation of the receipt of

application for composition to the court concerned.

3. The Compounding officer, after due enquiry, found that the offence is compoundable, issue

an order of composition directing to deposit the amount within fifteen days from the date of

receipt of order.

4. On receipt of the amount of composition, the compounding officer shall issue intimation in

writing to the Judicial First Class Magistrate Court where the prosecution is pending to

discharge the accused.

5. The accused person failed to remit the compounding amount within the time prescribed, in

sub rule (3), he is liable for a fine according to sub section (7) of section 138.

6. The accused person failed to remit the composition amount as per sub rule (3) and (5), the

compounding officer shall issue a certificate for that amount to the District Collector who

shall recover the same as arrears of land revenue.

7. The provisions of section 320 of the Code of Criminal Procedure, 1973 shall apply to such

compositions.

CHAPTER- XI

EMPLOYMENT INFORMATION AND MONITORING

50. Manner and form of reporting vacancies and form of filing the return by the employer,

to the concerned career centre under sub-section (2) of section 139.—

1. Reporting of Vacancies to Career Centres:

(a) After the commencement of this Code in the State or area thereof, the employer in every

establishment in public sector in that State or area shall, before filling up any vacancy in

any employment in that establishment, report that vacancy or cause to be reported to such

Career Centre as may be specified in the notification by the State Government.

(b) The employer in every establishment in private sector or every establishment pertaining

to any class or category of establishments in private sector shall, before filling up any

vacancy in any employment in that establishment, report that vacancy or cause to be

reported to such Career Centre from such date as may be specified in the notification by

the State Government.

reported by the employers. Career Centre to which the vacancies are reported, would

provide a unique vacancy reporting number for the vacancy reported and convey it to the

employer in writing, through email or digitally or through any other such media

immediately but in any case not later than three working days from the date of receipt of

reporting of vacancies.

Explanation.— (1) Establishment in “public sector” means an establishment owned,

controlled or managed by.—

(i) the Government or a Department of the Government

(ii) a Government company as defined in clause (45) of Section 2 of the Companies Act, 2013

( No. 18 of 2013);

(iii) a corporation (including a co-operative society) or an autonomous organization or an

authority or a body established by or under a Central or State Act, which is owned

,controlled or managed by the Government; and

(iv) a local authority.

(2) “Establishment in private sector” means an establishment which is not an establishment

in public sector and with ordinarily 50 or more employees or such number of employees as may be

notified by the State Government.

2. Type of vacancies and respective Career Centre for reporting of vacancies.—

(a) The following vacancies, namely.-

(i) All vacancies in posts of Technical and Scientific nature carrying a minimum

pay or pay level or both as notified by the State Government, occurring in

establishments in respect of which the State Government is the appropriate

Government under the Code; and

(ii) Vacancies which an employer may desire to be circulated to the Career

Centres outside the State or Union Territory in which the establishment is

situated shall be reported to such Career Centre as may be specified by the State

Government by notification.

(b) Vacancies which have been reported to the Career Centre and for which recruitment is to

be made on State or Inter-State or all India basis, shall also be reported to Career

Centre(Central) or uploaded on a digital portal as specified by the Central Government

by notification.

3. Form and manner of reporting of vacancies:

(a) The vacancies shall be reported in writing or through valid official email or digitally to the

Career Centre specified by the State Government.

(b) The vacancies shall be reported in the format given at Form XXIX, furnishing as many

details as practicable, separately in respect of each type of vacancy.

sub-rule(3), shall be reported in writing or through official email or digitally as the case

may be, to the specified Career Centre.

4. Time limit in the reporting of vacancies.—Vacancies, required to be reported to the Career

Centre, shall be reported at least fifteen days before the last date of receipt of the applications

of the prospective candidates for purpose of appointment or taking interview or test against

the vacancies reported.

5. Maintenance of records.—

(a) After commencement of this Code in any state or area thereof, the employers in every

establishment in the public sector in that state or area shall maintain records manually or

electronically or digitally about:

(i) Total number of employees (regular, contractual or fixed term employment) on

31st March of every year;

(ii) Persons recruited during the year ending on 31stMarch;

(iii) Occupational details of its employees on 31st March of every year; iv)

Vacancies for which suitable candidates were not available during the year

ending on 31st March; and

(v) Approximate number of vacancies likely to occur during the next financial year.

(b) State Government may by notification, require that from such date as may be specified

in the notification, the employer in every establishment in private sector or every

establishment pertaining to any class or category of establishment in private sector shall

maintain records manually or electronically or digitally about

(i) Total number of employees (regular, contractual or fixed term employment) on

31stMarch of every year;

(ii) Persons recruited during the year ending on 31stMarch;

(iii) Occupational details of its employees on 31st March of every year;

(iv)Vacancies for which suitable candidates were not available during the year

ending on 31st March; and

(v) Approximate number of vacancies likely to occur during the next financial

year.

6. Submission of returns.—An employer shall furnish to the concerned Career Centre yearly

returns in form EIR (Employment Information Return) as given at Form-XXX Yearly returns shall

be furnished manually or, electronically, or digitally, as the case may be, as specified by the respective

State Government in notification, within thirty days of the due date namely 31st March of the year.

7. Declaration of Executive Officer.—The Director of Employment, controlling the work of

Career Centres of the respective State Government, will declare in writing an officer looking after the

work of Career Centres as “Executive Officer” for each district for the purpose of enforcement

/implementation of Chapter XIII (Employment Information and Monitoring) of the Code. He shall be

the officer who shall exercise the rights and perform duties referred to in section 139 of the Code, or

authorize any person in writing to exercise those rights and perform duties.

8. Levy of penalty under the Chapter XIII of the Code.—The Director of Employment or an

officer of equivalent or above rank, controlling the work of Career Centres, of the respective State

shall be the competent authority to approve institution or sanction the institution of levy of penalty

for an offence under the Code as mentioned in section133.

CHAPTER- XII

MISCELLANEOUS

51. Such other sources of funding and the manner of administering and expending of the fund

under sub-section (5) of section 141.―

1. There shall be established a Social Security Fund by the State Government for the welfare of

the Unorganised Workers under sub-section (5) of Section 141 and shall be named as

Karnataka Unorganised Workers’ Social Security Fund.

2. In addition to source of fund mentioned in clause (i) sub-section (5) of Section 141, the amount

received from the following sources shall be credited to this fund, namely:-

(i) Amount given by the State Government for the establishment of the fund.

(ii) The amount of grant given by the Central Government, the State Government

and other authorities and statutory bodies.

(iii) Amount received for registration or renewal of beneficiaries and their

contribution.

(iv) Amount received for implementation of the scheme notified by the Central

Government.

(v) Amount received for implementation of the scheme notified by the State

Government.

(vi) Contribution or donation or any other financial support from employer, their

association or from Corporate Social Responsibility (CSR) Fund as determined by

the State Government by general or special order.

(vii) Funds received under sub-section (1) Section 115 of the Occupation Safety,

Health and Working Conditions Code, 2020 relating to the State Government.

(viii) Any other source which is approved by the State Government through

notification.

3. The State Government shall identify other sources for funding or replenishing the Social

Security Fund, from time to time.

4. The fund shall be administered by the State Government through Karnataka Unorganised

Workers’ Social Security Board.

5. The Karnataka Unorganised Workers’ Social Security Board may also engage any institution

for the administration of the fund, in the manner, as notified by the State Government and in

such case directions of the State Government, if any, shall be complied by such institution for

the administration of the Social Security Fund.

6. The statement of accounts of Social Security Fund shall be maintained by the Karnataka

Unorganised Workers’ Social Security Board or the institution engaged by the Karnataka

Unorganised Workers’ Social Security Board, as the case may be, in the form and manner as

specified by the State Government and shall be submitted to the State Government from time

to time.

7. The accounts of the Social Security Fund shall be audited by the Accountant General,

Karnataka

By order and in the name of

Governor of Karnataka,

(Praveena Kumara Hanni)

Desk Officer-3,

Labour Department.

To,

Sir,

FORM-I

[See rule 17]

APPEAL TO EMPLOYEES' INSURANCE

COURT

The Authority,

(Appointed under the Code)

…………………………………………… (Address)

I……..................................... ,

the

undersigned,

employee

……...........................................… (Name and full address of the establishment) feel aggrieved by the

order of ..................................................... under sub section 7(a) of section 37 for the reasons attached hereto,

prefer this second appeal under sub-section 7(b) of section 37 and request that the said

...................... be ordered….........................................................

A copy of the order of ................................................................................................in this behalf is

enclosed.

Date .......................

Signature or thumb impression

of the Aggrieved person

Signature of an Attester in case the person is not

able to sign and affixes thumb impression.

FORM-II

[See rule 18 (2)]

APPLICATION TO EMPLOYEES’ INSURANCE COURT

the

Employees,

Insurance

Court

……………......................….............................

……..

………………………………………..........................................................................................

…………………………………………………………………………….......................................

Applicant

(Name, address and cause of action)

Against

……………………………………………………………….………………………………………

Opposite Party (name and address) Other Particulars of Application specified in rule 18(2)

……………………………………….……………….……....……….......……………………….…

…………………………………...………………………………………….....................................

Date ……………….

Signature of Applicant

(Verification by the Applicant)

The statement of facts contained in this application is to the best of my knowledge and belief, true and correct.

Date ………….… Signature

FORM III

[See rule 18(5)]

REGISTER OF APPLICATIONS

Date of presentation of

application

No of proceedings

Name

Place of

residence

Application

description

Particulars

Claim amount of value if

any

When the cause of action

occurred

Days for the parties to

appear

Appearance

Appeal

Execution

Remarks, if any

Applicant

Opposite

party

Applicant

Opposite

party

Applicant

Opposite

party

Applicant

Opposite

party

Date of

decision

Judgement

in appeal

Date of

application

Appeal

against

whom

Reasons

and

amount of

money

Cost

Date of

order

transferrin

g to

another

FORM-IV

[See rule 21(1) to 21(4)]

NOMINATION/FRESH NOMINATION/MODIFICATION OF NOMINATION

(Strike out the words not applicable)

To…………………………………………………………………………………………

(Give here name or description of the establishment with full address)

I, Shri/Shrimati/Kumari…………………………………(Name in full here)whose particulars are given in the

statement below, hereby nominate the person(s) mentioned below/ have acquired a family within the meaning

of clause (33) of section 2 of Code on Social Security, 2020 with effect from the …………………(date here)

in the manner indicated below and therefore nominate afresh the person(s) mentioned below to receive the

gratuity payable after my death as also the gratuity standing to my credit in the event of my death before that

amount has become payable, or having become payable has not been paid and direct that the said amount of

gratuity shall be paid in proportion indicated against the name(s) of the nominee(s).

I, Shri/Shrimati/Kumari……………………………(Name in full here) whose particulars are

given in the statement below, hereby give notice that the nomination filled by me on date ..... and

recorded under your reference No…………….dated………………. shall stand modified in the

following manner:-

*Strike out unnecessary portion.

2. I hereby certify that the person(s) mentioned is/are a member(s) of my family within the

meaning of clause (33) of section 2 of the Code on Social Security, 2020.

3. I hereby declare that I have no family within the meaning of clause (33) of section 2 of the said

Code.

4 (a) My father/mother/parents is/are not dependent on me.

(b) My husband's father/mother/parents is/are not dependent on my husband.

5. I have excluded my husband from my family by a notice dated the……………… to the

competent authority in terms of clause (33) of section 2 of the said Code.

6. Nomination made herein invalidates my previous nomination.

Nominee(s)

Sl. No.

Name in full with

full address of

nominee(s)

Relationship with

the employee

Age of

nominee

Proportion by which

the gratuity will be

shared

So on

Manner of acquiring a “Family”

(Here give details as to how a family was acquired, i.e., whether by marriage or parents being rendered

dependent or through other process like adoption)

Statement

1. Name of employee in full

2. Sex

3. Religion

4. Whether unmarried/married/widow/widower

5. Department/Branch/Section where employed

6. Post held with Ticket No. or Serial No., if any

7. Date of appointment

8. Permanent address and contact details:

Signature/Thumb-impression of the Employee

Certificate by the Employer

Certified that the particulars of the above nomination have been verified and recorded in this establishment.

Employer's Reference No., if any

Signature of the employer/Officer authorized

Designation

Date: Name and address of the establishment or rubber

stamp thereof.

Acknowledgement by the Employee

Received the duplicate copy of nomination in FORM-IV filed by me and duly certified by the employer

Date: ………………….

Signature of the Employee

FORM-V

[See rule 22(1) and (3)]

APPLICATION FOR GRATUITY BY AN EMPLOYEE/NOMINEE/LEGAL HEIR

(Strike out the words not applicable)

……………………………………………………………………………

(Give here name or description of the establishment with full address)

Sir/Madam,

I, ………………………………………….... (Name of employee/nominee/legal heir) / Nominee of

late…………………………………..……………. (Name of the employee)/ as a legal heir of

late………………………………..…………….(Name of the employee), want to apply for payment of gratuity

to which I am entitled under sub-section (1) of section 53 of the Code on Social Security, 2020 on account of-

(a) my superannuation/retirement/resignation after completion of not less than five years of

continuous service/total disablement due to accident/total disablement due to disease/ on

termination of contract period under fixed term employment with effect from the or;

(b) death of the aforesaid employee while in service/superannuation on………………after

completion of ...................................................... years of service/total disablement of the

aforesaid employee due to accident or disease while in service with effect from the or;

on…………………………(date) without making any nomination after completion of

……………..years of service/total disablement of the aforesaid employee due to accident or disease

while in service with effect from……………………

Necessary particulars relating to my appointment are given in the statement below.

Name of employee in full, (if, the gratuity is claimed by an employee)

a. Marital status of employee(unmarried/married/widow/widower)

b. Address in full of employee

Name of nominee/legal heir, (if the gratuity is claimed by nominee/legal heir)

a. Name of Employee

b. Marital status of nominee/legal heir(unmarried/married/widow/widower)

c. Relationship of nominee/legal heir with the employee

d. Address in full of nominee/legal heir

e. Date of death and proof of death of the employee

f. Reference No. of recorded nomination if available

Department/Branch/Section where last employed

Post held by employee.

Date of appointment.

FORM-VI

[See rule 33]

NOTICE FOR PAYMENT/REJECTING CLAIM OF GRATUITY

(Strike out the words not applicable)

……………………………………………………………………………………………… (Name

and address of the applicant employee/nominee legal heir)

You are hereby informed that

(a)

*as required under clause (i) of sub-rule (4) of rule 22 of the Karnataka Social

Security

Rules,

2022

that

sum

Rs.

……..……..

(Rupees……………………………..…) is payable to you as gratuity/as your share of gratuity in

terms

nomination

made

………….…..on

…………………

and……………..……recorded in

this

……………………as

legal

heir

of .................................................... an employee of this establishment.

(b)

*as required under clause (ii) of sub-rule (4) of rule 22 of the Karnataka Social Security Rules,

2022, that your claim for payments of gratuity as indicated on your application in FORM-V

under the said rules is not admissible for the reasons stated below:

Reasons (Here specify the reasons); or

2. *Please call at ……………………….…….. on……………….…………… (Here specify place)

…………………………..….. (date) at……………………….(time) for collecting your payment of

gratuity crossed cheque.

Amount payable shall be sent to you through demand draft or shall be credited in your bank

account as desired by you.

Brief statement of calculation

(a) Date of appointment.

(b) Date of termination/superannuation/resignation/ disablement/death.

(c)

Total

period

service

the

employee

concerned:

…………….

years… .......................months.

(d) Wages last drawn:

(e) Proportion of the admissible gratuity payable in terms of nomination/as a legal heir:

(f)

Amount payable:

*strike out para, if, not applicable

Place:

Date: Signature of the Employer/authorized officer

Name or description of establishment or rubber stamp thereof

Copy to the Competent Authority having jurisdiction

FORM-VII

[See rule 23 1) (iii)]

APPLICATION FOR DIRECTION

Before the Competent Authority under Chapter V of the Code

Application No.

Date :

BETWEEN

(Name in full of the applicant with full address) AND

(Name in full of the employer concerned with full address)

1. The

applicant

employee

the

above-mentioned

employer/a

nominee

late…………..………………… an employee of the above-mentioned employer/a legal heir of late

.............................................................. and employee of the above-mentioned employer, and is entitled

to payment of gratuity under section 53 of the Code on Social Security, 2020 on account of his

own/aforesaid employee's superannuation on ……………………………

(date) / his own retirement/aforesaid employees' resignation on (date)

completion

of…………………years of continuous service/his own /aforesaid employees' total disablement with

effect from ............................................ (date)due to accident/disease death of aforesaid employee

on…………….……….

2. The applicant submitted an application under Rule…………………… of the Karnataka Social Security

Rules, 2022 on the ................................ but the above-mentioned employer refused to entertain it/issued a

notice dated the……………. under clause

of sub-rule of rule ……………….offering an amount of

gratuity which is less than my due/issued a notice dated the ……………….. under clause…………. of

sub- rule…………of rule………………. rejecting my eligibility to payment of gratuity. The duplicate

copy of the said notice is enclosed.

3. The applicant submits that there is a dispute on the matter (specify the dispute).

4. The applicant furnishes the necessary particulars in the annexure hereto and prays that the Competent

Authority may be pleased to determine the amount of gratuity payable to the petitioner and direct the

above-mentioned employer to pay the same to the petitioner.

5. The applicant declares that the particulars furnished in the annexure hereto are true and correct to the best

of his knowledge and belief.

Place:

Date:

Signature/Thumb impression of the applicant

ANNEXURE

1. Name in full of applicant with full address

2. Basis

claim

(Death/Superannuation/Retirement/Resignation/Disablement of

Employee/Completion of contract period under Fixed Term Employment)

3. Name and address in full of the employee

4. Marital status of the employee (unmarried/married/widow/widower)

5. Name and address in full of the employer

6. Department/Branch/Section where the employee was last employed (if known)

7. Post held by the employee with Ticket or Sl. No., if any (if known)

8. Date of appointment of the employee (if known)

9. Date and cause of termination of service of the employee (Superannuation / retirement /

resignation /disablement / death/Completion of contract period under Fixed Term Employment)

10. Total period of service by the employee

11. Wages last drawn by the employee

12. If the employee is dead, date and cause thereof

13. Evidence/witness in support of death of the employee

14. If a nominee, No. and date of recording of nomination with the employer

15. Evidence/witness in support of being a legal heir if a legal heir

16. Total gratuity payable to the employee (if known)

17. Percentage of gratuity payable to the applicant as nominee/legal heir

18. Amount of gratuity claimed by the applicant

Place:

Date:

Signature / Thumb-impression of the applicant

FORM-VIII

[See rules 24 (1) and (8)]

NOTICE FOR APPEARANCE BEFORE THE COMPETENT AUTHORITY/SUMMON

(Strike out the words not applicable)

To,

(Name and address of the employer/applicant)

Whereas

Shri

……………………………..………………..an

employee

under

you/a

nominee(s)/legal heir(s) of Shri………………….……………………….an employee under the above-

mentioned employer, has/have filed an application under sub-rule (4) of rule 35 of the Karnataka Social

Security Rules, 2022 alleging that----

(A copy of the said application is enclosed, if summon is issued then copy of application is not required)

Now, therefore, you are hereby called upon/summoned to appear before the Competent Authority at

…………………..(place)either personally or through a person duly authorized in this behalf for the purpose

of answering all material questions relating to the application on the …….….. day of …………20….. at

……….'O' clock in the forenoon/afternoon in support of/to answer the allegation; and as the day fixed for your

appearance is appointed for final disposal of the application, you must be prepared to produce on that day all

the witnesses upon whose evidence, and the documents upon which you intend to rely in support of your

allegation/defence.

Take notice that in default of your appearance on the day before-mentioned, the application will be

dismissed/heard and determined in your absence.

Whereas your attendance is required to give evidence/you are required to produce the documents mentioned

in this list below, on behalf of ............................................................................... in the case arising out of

the claim for gratuity by………. Form……….…….. and referred to this Authority by an application under

section 56 of the Code on Social Security, 2020, you are hereby summoned to appear personally before

this Authority on the ……. day of

……..20…………….. at ………… ‘O’clock in the forenoon/afternoon and to bring with you for to send to

this Authority) the said documents.

To,

FORM-IX

[See rules 24(11) and 25(viii)]

NOTICE FOR PAYMENT OF GRATUITY

AS DETERMINED BY COMPETENT

AUTHORITY

(Strike out the words not applicable)

(Name and address of employer)

1. Whereas Shri/Smt./Kumari………………………………………..…………………………

an employee …………………………………………………………… (address)under you/a nominee(s)/legal

heir(s) of late ………………………………………………an employee under you, filed an application under

section 56 of the Code on Social Security, 2020, before me; or

Whereas a notice was given to you on …………………….requiring you to make payment of

Rs…………………… to Shri/Smt./Kumari………………………………as gratuity under the Code on Social

Security, 2020.

2. And whereas the application was heard in your presence on………..and after the hearing have

come to the finding that the said Shri/Smt./Kumari………………………………..….. is entitled

to a payment of Rs… as gratuity under the Code on Social Security, 2020; or

Whereas you/the applicant went in appeal before the appellate authority, who has decided that an amount

of Rs………………….. is due to be paid to Shri/Smt./Kumari

as gratuity due under the Code

on Social Security,

2020.

Now, therefore, I hereby direct you to pay the said sum of Rs............................................................... to

Shri/Smt./Kumari ............................................................ within thirty days of the receipt of this notice

with an intimation thereof to me.

Given under my hand and seal, this …………….day of……………….20………...

Competent Authority

under the Code on Social Security, 2020

Copy to:

1. The Applicant- He is advised to contact the employer for collecting payment.

(Strike out paragraphs if not applicable)

FORM-X

[See rule 26]

APPLICATION FOR RECOVERY OF GRATUITY

Before the Competent Authority under Chapter V of the Code

Application No.

Date

BETWEEN

(Name in full of the applicant with full address)

AND

(Name in full of the employer/Trust/Insurer concerned with full address)

1. The applicant is an employee of the above-mentioned employer/a nominee of

late………………….

an employee of the above mentioned employer/a legal heir of late .................................................. an

employee of the above-mentioned employer, and you were pleased to direct the said employer in your

notice dated the ………………………..under

sub-rule (11) or sub-rule

(12) of rule 35 of the Karnataka Social Security Rules, 2022 for payment of a sum of Rs…

gratuity payable under the Code on Social Security, 2020.

2. The applicant submits that the said employer failed to pay the said amount of gratuity to me as

directed by you although I approached him for payment.

3. The applicant therefore prays that a certificate may be issued under section 129 for recovery

of the said sum of Rs......................................................... due to me as gratuity in terms of your

direction.

Signature/Thumb-impression

of applicant

Place:

Date:

Note.—Strike out the words not applicable.

FORM-XI

[See rule 27 (3)]

APPLICATION FOR REGISTRATION OF AN ESTABLISHMENT UNDER

SUB-SECTION (3) OF SECTION 57

A. Establishment Details.

1. Retrieve details of Establishment through LIN/Registration Number:

2. Name of Establishment:

3. Location and Address of the Establishment:

4. Others details of Establishment:

a. Total Number of employees engaged directly in the establishment:

b. Total Number of the contract employees engaged:

c. Total Number of Inter-State Migrant workers employed:

5. Ownership Type/Sector:

6. Activity as per National Industrial Classification (NIC):

7. Details of Selected NIC Code:

8. Identification of the establishment e-sign/ digital sign of employer/ representative:

B. Details of Employer:-

1. Name & Address of Employer / Occupier / Owner/Agent/ Chief Executive-

2. Designation:

3. Father‘s/ Husband‘s Name of the Employer:

4. Email Address, Telephone& Mobile No:

C. Manager/ Agent Details

1. Full name & Address of Manager/ Agent or person responsible for supervision and control

of the Establishment;

2. Address of Manager/ Agent:

3. Email Address, Telephone& Mobile No :

D. Details of Approved Gratuity Fund/Insurance obtained for liability of payment

towards the Gratuity;

E. Others Details:-

Signature/ E-sign/digital sign of employer

Dated:-

Place:-

FORM–XII

[See rule 29 (1)]

COMPLAINT TO THE INSPECTOR-CUM-FACILITATOR

To,

The Inspector-cum-Facilitator

(Under The Code on Social Security, 2020)

Sir,

I…… (Name of woman) employed in…… (name and full address of the

establishment) or I…….............., (name), a person nominated under section 62 by or a legal

representative of…..........................…(name of woman) employed in…….(name and full address

of the establishment) having fulfilled the conditions laid down in the Code on Social Security ,

2020 and the Rules there under, am entitled to Rs……..........................being maternity benefit and/

or Rs….......................… being the medical bonus and/ or Rs…...........……. being wages for leave

due under section 65 but the same has been improperly withheld by the employer/discharged or

dismissed during or on account of her absence from work in accordance with the provisions of

this Chapter VI of Code on Social Security , 2020.

You are therefore requested, to direct the employer to pay the amount to me/ to set aside the

discharge or dismissal done by the employer.

Date:

Signature or thumb impression of the

Woman/nominee/legal representative

Signature of an Attester in case of the

woman/nominee/legal representative is unable to sign an

and affixes thumb impression

Full address of the women/nominee/legal

representative

FORM XIII

[See rule 13(2)]

APPEAL UNDER SECTION 72

To,

The Authority

(Appointed under the Code)

……………………………………………………. (Address)

Sir/Madam,

I………… the undersigned, woman employee of (name

and

full

address

the

establishment)

* Feel aggrieved by the order of Inspector-cum-Facilitator under sub section (2 ) of Section 72 for

the reasons attached hereto, prefer this appeal under sub-section (2) of section 68 and request

that the said employer be ordered to pay the above mentioned amount to me. A copy of the

order of Inspector-cum-Facilitator in this behalf is enclosed or,

* Shri…………., Inspector-cum-Facilitator, having directed under the sub-section (2) of section

72 to pay the maternity benefit or other amount being….......(Nature of amount) to

which………(Name of woman) is said to be entitled / to set aside my discharge or dismissal

during or on account of absence from work in accordance with the provision of this Chapter V

of the Code on Social Security ,2020

* (Strike out the unnecessary portion).

I prefer this appeal under sub-section (3) of section 72 . In view of the facts mentioned in the

memorandum attached hereto and the documents filed herewith it is submitted that the women

is not entitled to the maternity benefit or the said amount and hence the order of the Inspector-

cum- Facilitator in the copy of which is enclosed , may be set aside.

(Strike out the unnecessary portion).

Date:

Signature/Thumb impression of the women/aggrieved person

Signature of an attester in case the woman is not able

to sign and affixes thumb impression Full address of

the nominee/ legal representative

FORM – XIV

[See rule 37]

NOTICE BOOK UNDER SECTION 82(4)

Name of the Establishment…………………………………………………

Nature of business………………………………………………………….

Date of opening…………………………………………………………….

Registration no (if any)…………………………………………………….

Name of the employer/occupier……………………………………………

Wheth

accide

resulte

death/

total

disabl

ement/

partial

disabl

ement/

tempo

rary

disabl

ement

Amo

unt of

Com

pensa

tion

paid

empl

oyee

or his

depe

ndent

ount

mpe

nsat

ion

dep

osit

com

pete

auth

orit

Dat

e of

dep

osit

com

pens

atio

rks

FORM XV

[See Rule 35]

STATEMENT OF FATAL ACCIDENTS

To,

Competent Authority,

...............................

Sir,

1. I hereby submit the following statement of an accident which occurred in (date), at (here enter

details of premises) and which resulted in the death of the employee/employees of whom

particulars are given in the statement annexed.

2. The circumstances relating to the death of the employee/employees were as under: -

a. Time of accident.

b. Place where the accident occurred.

c. Manner in which deceased was/were employed at the time.

d. Cause of the accident.

e. Any other relevant particulars.

3. I am responsible for payment of compensation.

4. Details of employee …………………………..

a. Name of the employee …………….

b. Age of the employee ………………..

c. Wages of the employee ………………

5. The establishment is not responsible for payment of compensation due to reasons mentioned

below......................................................................................

(Signature and designation of person making the statement)

FORM-XVI-A

[See rule 23 (1)]

MEMORANDUM OF AGREEMENT

It is hereby submitted that on the …………. Day of ……..20 , personal injury was caused

to………. Residing at ………… by accident arising out of and in the course of employment

in ......................................................................................................................................................

The said injury has resulted in temporary disablement to the said employee whereby it is

e stimated that he will be prevented from earning more than his previous/any wages for a

period of …………. Months, The said employee

has been in receipt of half- monthly

payments which have continued from the…….. day of ……….20 , until the ………. Day

………20

amounting

Rs .....................................................................................................................................................

all. The said employee’s monthly wages are estimated at Rs……..

The employee is over the age of 15 years/will reach the age of 15 years on…………

It is further submitted that………. The employer of the said employee has agreed to pay, and the

said employee has agreed to accept the sum of Rs…. in full settlement of all and every claim under

the Code. In respect of all disablement of a temporary nature arising out of the said accident

whether now or hereafter to become manifest, it is therefore requested that this memorandum

be duly recorded.

Date………………

Signature of employer………

Witness……………………

Signature of employee………

Witness……………..

Note:- An application to register an agreement can be presented under the signature of one

party, provided that the other party has agreed to the terms. But both signatures should be

appended whenever possible.

……………………………………………………………………………………..

Receipt (to be filled in when the money has actually been paid)

accordance

with

the

above

agreement,

have

this

day received the sum of

……………………

Date… ............. 20

Signature or thumb-impression of employee

The money has been paid and this receipt signed in my presence.

Witness…………………………………………………………………………………………

Note:- This form may be varied to suit special case, e.g., injury by occupational disease,

agreement when employee is under legal disability etc.

FORM XVI-B

[See rule 36 (1)]

MEMORANDUM OF AGREEMENT

It is hereby submitted that on the …………. day at ……… 20, personal injury was caused

to ……. residing at

……by accident arising out of and in the course of his employment

in………. The said injury has resulted in permanent disablement to the said workman of the

following nature, namely …. The said employee’s monthly wages are estimated at Rs…….

The employee is over the age of 15 years/will reach the age of 15 years on……….The said

employee has, prior to the date of this agreement, received the following payments, namely: -

Rs…………….

on……………….

Rs………………. on……………….

Rs…………….

on……………….

Rs ……………… on……………….

Rs…………….

on……………….

Rs………………. on……………….

It is further submitted that……. The employer of the said employee, has agreed to pay, and the

said employee has agreed to accept the sum of Rs……. in full, settlement of all and

every claim under the Employees Compensation Code. In respect of the disablement stated

above and all disablement now manifest. It is therefore requested that this memorandum be

duly recorded.

Date………………

Signature of employer………

Witness……………………

Signature of employee………

Witness……………..

Note.-An application to register an agreement can be presented under the signature of one party

provided that the other party has agreed to the terms. But both signatures should be appended,

whenever possible.

Receipt (to be filled in when the money has actually been paid)

accordance

with

above

agreement,

have

this

day received the sum of

Rs…………………………………………….

Date ……………..

Signature or thumb-impression of the employee

The money has been paid and this receipt signed in my presence.

Witness……………..

Note.- This form may be varied to suit special cases, e.g., injury by occupational disease,

agreement when workman is under legal disability, etc.

FORM XVI-C

[See rule 36 (1)]

MEMORANDUM OF AGREEMENT

It is hereby submitted that on the ….. day of ……20 , personal injury was caused to …….. residing

at …… by accident arising out of and in the course of employment in …… The said injury has

resulted in temporary disablement of the workman, who is at present in receipt of

……..wages amounting to Rs… per

month/on wages. The said employee’s monthly wages prior to the accident are estimated at Rs

……. The employee is subject to a legal disability by reason of ……..

It is further submitted that …… the employer of the employee has agreed to accept half-monthly

payments at the rate of Rs……. for the period of the said temporary disablement.

This agreement is subject to the conditions that the amount of half-monthly payment may be

varied in accordance with the provisions of the Employees Compensation Code on account of

an alteration in the earning of the said employee during disablement. It is further stipulated that

all rights of commutation under Section 89 of the said Code are unaffected by this agreement. It

is therefore requested that this memorandum be duly recorded.

Date………………

Signature of employer………

Witness……………………

Signature of employee………

Witness……………..

Note.-An application to register an agreement can be presented under the signature of one party

provided that the other party has agreed to terms.

Receipt (to be filled in when the money as actually been paid)

In accordance with the above agreement, I have this day received the sum of Rs

………………………………………

Date ……………..

Signature or thumb-impression of the employee

The money has been paid and the receipt signed in my presence.

Witness…………………….

Note.- This form may be varied to suit special cases, e.g. injury by occupational disease,

etc.

FORM XVII-A

[See rule 38 (1) (i)]

APPLICATION FOR COMPENSATION BY WORKMAN

The Competent Authority for Workmen’s Compensation.

………………………………………………………………………………………………

…………………………………………………………………………………..

Residing

at…………………………………………………………………………………………...

…………………………………………………………………………………………….

Applicant

Versus

………………………………………………………………………………………………

……………………………………………………………………………………………

………………………………………………………………………………….. Residing

at…………………………………………………………………………………………...

………………………………………………….………………………………………….

Opposite Party

It is hereby submitted that-

(1) The Applicant, a workman employed by the opposite party on the

…………..day of ………………19……………………..received personal injury

by accident arising out of and in the course of his employment.

The cause of the injury was (here insert briefly in ordinary language the cause of

the injury)……………………………………………

(2) The applicant sustained the following injuries, namely……………………….

(3) The monthly wages of the applicant amounted to Rs…… the applicant is

over/under the age of

15 years…….

(4) *(a) Notice of the accident was served on the ………………day of

…………………………

(b) Notice was served as soon as practicable.

……………..

(5) The applicant is accordingly entitled to receive:---

(a) half

monthly

payment

Rs.

………………………

from

the

………………….day

of……………………19…………….to

………………………

(b) a lump sum payment of Rs……………….

(6) The applicant has taken the following steps to secure a settlement by agreement,

namely………………. But it was proved impossible to settle the questions

in dispute because………………………

*You are therefore requested to determine the following questions in dispute namely:-

(a) Whether the applicant is a workman within the meaning of the Act.

(b) Whether accident arose out of and in the course of the applicant’s

employment.

amount.

(d) Whether the opposite party is liable to pay such compensation as is due.

(e) etc, (as required)

Date…………………………………

Applicant

FORM XVII-B

[See rule 38 (1) (i)]

APPLICATION FOR ORDER TO DEPOSIT COMPENSATION

The Competent Authority for Workmen’s Compensation.

………………………………………………………………………………………………

……………………………………………………………………………………………

………………………………………………………………………………….. Residing

at…………………………………………………………………………………………...

…………………………………………………………………………………………….

Applicant

Versus

………………………………………………………………………………………………

……………………………………………………………………………………………

………………………………………………………………………………….. Residing

at…………………………………………………………………………………………...

………………………………………………….………………………………………….

Opposite Party

It is hereby submitted that-

1. I …………………………..a workman employed by (a contractor with the

opposite party) on the …………………………day of……………………..arising

out of and in the course of his employment

resulting

his

death

the ……………………date of

19.

The cause of the injury was (here insert briefly in ordinary language the cause of the

injury)……………………………………………………..

2. The

applicant(s)

is/are

dependant(s)

the deceased workman being his

………………………………

3. The monthly wages of the deceased amount Rs………………………….the

deceases was over/under the age of 15 years at the time of his death.

4. (a) Notice of the accident was served on the ………….day of 19

(b)

Notice was served as soon as practicable.

(c)

Notice of the accident was not served (in due time ) by reason of

…………………………….

5. The deceased before his death received as compensation the total sum of

Rs……………………………………………

The applicant(s) is/are accordingly entitled to receive a lumpsum payment of

Rs……………….

7. The applicant(s) has/have requested the opposite party to deposit compensation

and the latter has refused/omitted to do so.

*You are therefore requested to determine the following questions in dispute namely:-

(a)

Whether the deceased was a workman within the meaning of the Act.

(b)

Whether the accident arose out of and in the course of the deceased’s

employment.

(c)

Whether the amount of compensation claimed is due, or any part of the

amount.

(d)

Whether the opposite party is liable to pay such compensation as is

due.

(e)

Whether the applicant’(s) is/are dependant(s) of the deceased.

(f)

How the compensation, when deposited should be distributed.

(g)

Etc………………(as required).

Date…………………..19

Applicant

FORM XVIII-A

[See rule 38 (20) (i)]

NOTICE

Whereas a claim for compensation has been made by

applicant

against

and

the

said

has claimed that you are liable under Section 85 (2) of the Code to indemnify him against any

compensation which he may be liable to pay in respect of the aforesaid claim,

you are hereby informed

that

you

may

appear

before

and contest the claim for compensation made by the said applicant or the claim for indemnity made

by the opposite party. In default of your appearance, you will be deemed to admit the validity of any award

made against the opposite party and your liability to indemnify the opposite party for any compensation

recovered from him.

Dated:

Competent Authority

FORM XVIII-B

[See rule 38 (20) (iii)(iv)]

NOTICE

Whereas

claim

for

compensation

has

been made

by………………………………

applicant, against……………………..and the said has claimed that

is liable under Section

85 (2) of the Code, to indemnify him against any claim and where as the said

notice served has claimed that you

stand to him in the relation of a contractor from whom the

applicant could have recovered compensation you are hereby informed that you may appear before me on

and contest the claim for compensation made by the said applicant or the claim for indemnity made

by the opposite party . In default of your appearance you will be deemed to admit the validity of any award

made against the opposite party

your liability to indemnify the opposite party

for any compensation recovered

from him.

Date

Competent Authority

FORM-XIX

[See rule 41(5)]

Annual Report

Karnataka Building and Other Construction Workers Welfare Board/

Karnataka Unorganized Workers Social Security Board

Annual Report for the year…………………………….

Board:

1. Full registered address:

2. Date of constitution:

3. Name of Chairperson:

4. Member of the Board:

5. Regional offices with address (if any):

6. No. of staff of the Board with grade-wise (including regional offices):

II.

Membership:

(i)

No. of beneficiaries registered with the Board:

(ii)

No. of registered employers:

(iii)

No. of beneficiaries registered during the audit period:

III.

Meetings:

State the number of meetings held with dates during the year and names of the members

remaining absent:

IV.

Audit:

(i)

Date of the last audit:

(ii)

Have any irregularities been mentioned in the previous audit?

If so, state the position regarding compliance thereof.

Internal audit:

(a) Is there a formal internal audit system in operation?

(b) Any special areas which are taken up by the internal auditor? If yes, list them

Whether the internal auditor

Is from the panel of auditors?

(d) State whether there is proper co-ordination between the Government auditor and the

internal auditor;

(e) Whether recommendations made by the internal auditor have been complied withby the

Board, if no, specify them:

VI.

Bank balance and securities:

(a) Does the bank balance shown in bank Statements/pass book tally with the bank book?

If not, whether any reconciliation statement is prepared? Attach statement

(b) Whether confirmation of balance are obtained From all the banks?

VII.

Securities

(a) Verify securities physically and see whether

They are in the name of the Board:

(b) Are dividends and /or interests being duly Collected and whether provision of accrued

Interest is as calculated correctly?

(d) If investment register kept and written upto date?

(e) Whether the aggregate amount as per the register tallies with the ledger? If not what is the

quantum of difference?

(f) Amount not received upon maturity:

(g)

VIII. Moveable and immovable property

(a) Are relevant registers maintained upto date?

(b) Verify properly physically and obtain list. Do the balance tally with balance sheet features?

are min the Name of the Board

(d) Is the property duty insured whether necessary?

If so, give details.

(e) Depreciation:

(i)

Is due depreciation charges?

(ii)

State the rates of depreciation charged on various assets.

IX.

Receipts during the year under report:

(1) Amount of grants/loans received from the Central Govt.

(2) Amount of contribution received from the beneficiaries

(3) Amount of cess received

(4) Amount of registration fees received from the beneficiaries

(5) Any other source

Expenditure during the year under report:

(1) Financial assistance provided to the beneficiaries

Give the details scheme-wise

(2) Administrative expenditure including salary

(3) Expenditure on other heads specify the heads

XI.

Activities:

(1) State the various activities of the Board:

(2) Proposals for the future scheme:

(3)

XII.

General:

1. Litigations:

(a) No. of court cases against Board:

(b) No. of course cases filed by the Board:

2. Inspections:

(a) Whether any inspection has been carried

Out by the any Central/State Govt. authority

(b) Orders/directions issued, if any

3. Proposals:

4. Pending proposals, if any, with the Government.

FORM XX

[See rules 43 (1)]

REGISTER OF WAGES AND DEDUCTION

Employee cod e

Employee name

Na me of father

Se x

Date of Birth

Address

Photo

Identification Mark

Designation

Cat egory (H

Designation code/

grade as in

Government

Date of joining

Education

Qualification

Date of Exit

Rea son for Exit

Mo bile

Number

E-

Ban k Na me

IFS C Cod e

Ban k Account

Number

Day s of

attendance

Los s of pay

day s

Number of

weekly off

grant

Number of

Leave granted

Basic

HR A

City

Compensation

allowances

Gross Monthly

Wages

Overtime wages

Leave Wages

National and

Festival holidays

Arrear Paid

Bonus

Maternity

Benefit

Other

Allowances

Advance

Total Amount

EPF

ESI

Welfare Fund

Professional Tax

Tax Deduction

Source

Deduction of

Fine

Deduction for

Loss and

Other

Deduction

Total Deduction

Net wages

paid

Date of payment

Re marks

EPF

ESI

Elect ion ID

Aadhar No

Loan Payment

Loan Recovery

Signature/

Thumb

FORM XXI

[See rule 43(1) (v)(vi)(vii)]

MUSTER ROLL

Name of establishment……………………….

Place …..………………..…..

Sl.

Name

Father’s/

Husband’s

Name

Sex

Date of

entry

service

Designation/

Category

Total

Number of

hours work

performed

Total

number of

days work

performed

Total

number

workers

FORM XXII

[See rule 43(1)(viii)(ix)]

REGISTER OF EMPLOYEES

Name of the Establishment

Name of Employer

LIN

Sl No.

Employee

Code

Name

Gender

Father’s/

Spouse

Name

Date of

Birth

Nationality

Education

Qualification

Date of

joining

Designation

Category (HS/S/S

S/US)

Type of Employment

Mobile Number

UAN

PAN

E S I C

LW F

AAD HAAR

Bank A/ c

Number

Bank

Branch

(IFSC)

Present

Address

Permanent

Date of

Exit

Reason

for

Exit

Mark of

Identificat

ion

Photo

Specimen

Signature/

Thumb

Remarks

FORM XXIII

[See rule 43(1)(x))]

REGISTER OF DANGEROUS OCCURRENCES, ACCIDENTS, INJURIES

Name and address of the Establishment:

Name of the Employer / Contractor:

No.

Date &

time of

accident

Date

information

authorities

Name of

employee

injured/

deceased

Nature of

injury

permanent

temporary

Amount

compensation

and monthly

wages

Lump sum /

half monthly

Date of

disposal &

mode of

payment:

cheque

/Demand

Draft/Bank

transfer

Remarks

FORM XXIV

[See rule 43(1)(xi)]

REGISTER OF CESS

Name and address of the Establishment:

Name of the Employer:

Date of

commencemen

t of

construction

Type of

construction

Residential/

Commercial

Date of

proposed

completio

n of

constructi

Estimated

cost of

construction

Advan

cess

oun

pai

Mode

and

date of

payme

n t

Balance

cess

amoun

t to be

paid

Tot

ces

pai

Fil

FORM XXV

[See rule 43(1)(xii)]

REGISTER OF VACANCIES

Name and address of the Establishment:

Name of the Employer:

Sl. No

Total Number of employees

Persons

recruited

up to 31st

March.

..... year

Occupation

al details of

employees

recruited

Number of unfilled vacancies/

posts

Regular

Contractual Fixed term

Skill/

Essential Desirable

employment

Qualification/

technical/

experience

prescribed

FORM-XXVI

[See rule 44(1)]

REGISTER OF WOMEN EMPLOYEES

Name of establishment

Serial Number.

Name of woman and her father's (or, if married, husband's) name.

Date of appointment.

Nature of work.

Dates with month and year in which she is employed, laid off and not employed.

Month

No. of days

employed

No. of days laid

off

No. of days

not

employed

Remark

Date on which the woman gives notice under section62.

Date of discharge / dismissal, if any.

Date of production of proof of pregnancy under section 62.

Date of birth of child.

10. Date of production of proof of delivery/miscarriage Medical Termination of pregnancy /

tubectomy operation /death /adoption of child.

11. Date of production of proof of illness referred to in section 66.

12. Date with the amount of maternity benefit paid in advance of expected delivery.

13. Date with the amount of subsequent payment of maternity benefit.

14. Date with the amount of bon us, if paid, under section64.

15. Date with the amount of wages paid on account of leave under section 66(1) & 6b (3).

16. Date with the amount of wages paid on account of leave under Section66(2) and period of leave

granted.

17. Name of the person nominated by the woman under section62.

18. If the woman dies, the date of her death, the name of the person to whom maternity benefits

and/or other amount was paid, the amount thereof, and the date of payment.

19. If the woman dies and the child survives, the name of the person to whom the amount of

maternity benefit was paid on behalf of the child and the period for which it was paid.

20. Signature of the employer of the establishment authenticating the entries in the register of women

employees.

21. Remarks column for the use of the Inspector-cum-Facilitator

FORM XXVII

[See rule 46(1)(2))]

UNIFIED ANNUAL RETURN

A. General Part:

(a) Name of the establishment……………………………………………………………

Address of the establishment:

House No./Flat No. …………………………….Street No./Plot No…………………………………

Town …………………. District …………………….State …………………… pin code ………

(b) Name of the employer …………………………………………………………………………..

Address of the employer:

House No./Flat No. ……………………………. Street No./Plot No. ……………………………..

Town………………….District…………………….State……………………… pin code………..

E-mail ID……………………………Telephone Number………………………..

Mobile number………………..

……………………………………………………………………………………………………… Address:

House No./Flat No…………………………….Street No./Plot No…………………………………

Town………………….District…………………….State……………………… pin code………..

E-mail ID……………………………Telephone Number………………………..

Mobile number………………………

B. Employer’s Registration/Licence number under the Codes mentioned in column (2) of the

table below:

Sl.

No.

Name

Registration

If yes (Registration No.)

The Code on Occupational Safety

Health and working condition code

2020.

The Code on Social Security 2020.

Any other Law for the time being in

force.

C. Details of Employer, Contractor and Contract Labour:

Name of the employer in the case of a contractor’s

establishment.

Date of commencement of the establishment.

Number of Contractors engaged in the establishment

during the year.

Total Number of days during the year on which Contract

Labour was employed.

Total number of man-days worked by Contract Labour

during the year.

Name of the Manager or Agent (in case of mines).

Address

E-mail ID

Telephone Number

Mobile Number

D. Working hours and weekly rest day:

Number of days worked during the year.

Number of maydays worked during the

year.

Daily hours of work.

Weekly day of rest.

E. Maximum number of persons employed in any day during the year:

Males

Females

Adolescents

(between the

age of 14 to

18 years.)

Children

(below

years of age)

Total

F. Wage rates (Category Wise):

Category

Rates

Wages

No. of Workers

Regular

Contract

Male

Female

Children

Adolescent

Male

Female Children

Adolescent

Highly

Skilled

Semi-

skilled

Unskilled

G. (a) Details of Payments:

Gross wages paid

Deductions

Net wages paid

In cash

In kind

Fines

Deductions

Others

In cash

In kind

for damage

or loss

(b) Number of workers who were granted leave with wages during the year:

Sl. No.

During the year

Number of workers

Granted leave with

wages

H. Details of various welfare amenities provided under the statutory schemes:

Sl. No.

Nature of various welfare amenities provided

Statutory (specify the statute)

I. Maternity Benefit under the Code on Social Security, 2020:

(a) Details of establishment, medical and para-medical staff:

Date of opening of establishment

Date of closing, if closed

Name of Medical Officer

03 (i)

Qualification of Medical Officer

03 (ii)

Is Medical Officer at (the mines or circus) ?

03 (iii)

If a part time, how often does he/she pay visit to

establishment?

03 (iv)

Is there any Hospital?

03 (v)

If so, how many beds are provided?

03 (vi)

Is there a lady Doctor?

03 (vii)

If so, what is her qualification?

03 (viii)

Is there a qualified mid-wife?

03 (ix)

Has any crèche been provided?

(b) Leave Granted under the Code on Social Security, 2020:

Total number of female employees in the establishment

Total number days of leave granted

Number

employees

granted

maternity

leave/benefited by ESI

Declaration

It is to certify that the above information is true and correct and also I certify that I have complied with the all

provisions of Labour Codes applicable to my establishment.

Place

Date

Signature

FORM-XXVIII

[See rule 49(1)]

APPLICATION FOR COMPOUNDING OF OFFENCES

1. Name of applicant ………………………………………………………..

2. Father’s / Husband’s name of the applicant…………………………………………………….….

3. Address of the applicant ……………. ………………………………………….

4. Mobile number/email

5. Name , address, Mobile no, and email of Complainant

6. whether any case pending before any authority or Court in the same matter

If Yes, Particulars .......................................................

•

Particulars

the

offences…………………………………………………………………

……………………………………………………………………..

Provisions of the Code/Scheme/Rules/Regulations under which the offence is committed:

•

Maximum

fine

provided

for

the

offence

under

the

Code………………………………………………………………….

• Whether the offence is first offence or the applicant had committed any other offence prior to the offence,

had

committed,

then,

full

detail

the

offence

…………………………………………………………………………………

……………………………………………………………………………………………………………

…………………………………………………………………………………………………………

•

Any

other

information

which

the

applicant

desires

provide

…………………………………………………………………………………

……………………………………………………………………..

I, pray for the compounding of offences as stated above.

Dated:

Applicant (Name and signature)

FORM-XXIX

[See rule 50(3)(B)]

FORM FOR REPORTING VACANCIES TO CAREER CENTRES

(Separate forms to be used for each type of posts)

Particulars of the employer:

Name:

Address with pin code:

Telephone No. :

Mobile No.:

Email address :

Name &Type of Establishment:

(Central Government, State Government,

PSU, Autonomous, Private, etc)

Registration No of establishment under

Code: Economic activity details:

Particulars of the indenting

Officer: Name:

Designation:

Telephone No.

: Mobile No.:

Email address

Particulars of vacancy(ies):

(a) Designation/nomenclature of the vacancy(ies)

to be filled

(b) Description of duties of the post (job

role/functional role)

(educational, technical, experience)

Essential

Desirable/Preferable

(i) Educational Qualifications

(ii) Technical Qualifications

(iii) Skills

(iv) Experience

(d) Age Limits, if any

( Age as on last date of application)

(e) Preferences (such as Ex-servicemen, persons with

disabilities, women, etc) if any

(f) duration of employment

(i) 3-6 months

Number of Posts

(ii) 6-12 months

(iii) 12 months and more

Whether there is any obligation for arrangement for giving reservation/ preference to any category of persons

such as Scheduled Caste(SC), Scheduled Tribe(ST), Economically Weaker Sections(EWS), Other Backward

Classes(OBC), Ex- serviceman and persons with disabilities (pwd) , etc, in filling up the vacancies: Yes/No

( if yes, give the number of vacancies to be filled by such categories of persons as detailed below)

Category

Number of vacancies to be filled

(a) Scheduled Caste

(b) Scheduled Tribe

(d) EWS

(e) Ex-Serviceman

(f) Persons with disabilities (pwd)

(g) women

(h) Others(specify)

Tota

*By Priority candidates

*(Applicable for

Central Government

vacancies)

Pay and Allowances:

For Government vacancies:

Mention pay level/pay scale of

the post with basic pay/pay per

month with other details if any

For others: Mention minimum

total emoluments

per month with other details, if any.

Place of work (Name of the

town/village and district, pin code

etc.

in which it is situated)

Mode of Application(email,

online, in writing, etc) and Last

date for receipt

of applications.

Particulars of officer to whom the

applications be sent/candidates

should approach(Mention Name,

designation, email id, address ,

telephone No., website address in

case

of online)

Mode of Recruitment

{Through Career Centre, Placement

Agency , self-management, any

other

mode(specify) }

Would like to prefer submission of

list of eligible candidates registered

with

Career Centre

Any other relevant information

Name, address, email id of the

Career Centre

Date of receipt of Vacancies

NIC Code of the establishment/

NCO Code of the post

Unique Vacancy ID(number)

Signature, Name& Designation of Authorised Signatory

of Career Centre with seal & date

NOTE:

1. Career Centre to which the vacancies are reported, would provide a unique vacancy reporting

number for the vacancy reported and convey it to the employer in writing, through email or

digitally or through any other such media immediately but in any case not later than 3 working

days from the date of receipt of reporting of vacancies.

2. An employer, if advertises that vacancy in any media or makes recruitment through any agency

or any other mode, may invariably quote that unique vacancy reporting number in that

advertisement or recruitment process.

3. Any change in the particulars already furnished to the Career Centre, shall be reported in writing

or through valid official email or digitally(including through a portal) as the case may be, to the

appropriate Career Centre.

Yearly Return to be submitted to the Career Centre (Regional) for the Year ended................

*As per provisions of Code on Social Security, 2020(Chapter XIII) and Rules made there under,

FORM-XXX

[See rule 51(6)]

FORM EIR (EMPLOYMENT INFORMATION RETURN)

Name &Address of the

Employer

Whether – Head Office

Branch Office

Type of Establishment

(Public/ Private Sector)

Nature of business/

Principal activity

Establishment

Registration No. under

the Code

1. (a) EMPLOYMENT

Total number of manpower of establishment including working proprietors/partners//contingent paid

and contractual workers, out-sourced workers excluding part-time workers and apprentices.

(The figures should include every person whose wage or salary is paid).

Category

On the last working day of the

previous Year

On the last working day of the Year under

report

MEN

WOMEN

Other

(Transgender)

TOTAL :

PWD (persons

with disabilities)

out of above total

2. Number of vacancies* occurred and reported to Career Centre during the year and the number of

vacancies filled during the year

Occurred

Reported

Filled

Source (Career Centre/ NCS

Portal/ Govt. Recruiting

Agencies/ Private Placement

Organisations/ others)

Career Centre

(Regional)

Central Centre

(Central)

3. MANPOWER SHORTAGES:

Vacancies/posts remained unfilled because of shortage of suitable applicants.

Name of the occupation

designation of the post

Number of unfilled vacancies/posts

Skill/ qualifications

(educational / technical/

experience)

prescribed

Essential

Desirable

(Please list any other occupations also for which this establishment had any difficulty in obtaining

suitable applicants recently.)

4. Estimated Manpower Requirement by Occupational Classification during the next calendar

year (Please give below the number of employees in each occupation separately).

Occupation

Number of employees

Please give as far as possible approximate number of vacancies in each occupation

you are likely to fill during the next financial year due to retirement/ expansion or

re-organization.

Description

Men

Women

Others

(transgender)

Total

PWD

(persons with

disabilities out

of total)

Total

* In the column (description) -Use exact terms such as Engineer (Mechanical), Assistant Director

(Metallurgist); Research Officer (Economist); Supervisor (Tailoring), Inspector (Sanitary),

Superintendent (Office), Manager(Sales), Manager (Accounts), Executive (Marketing), Data Entry

Operator .................................................................................................................................... so on.

Signature, Name & Designation of

Authorised Signatory of establishment/ employer with seal & date

The Career Centre,

...................................

Note:- 1. This return is to be rendered to the Career Centre (Regional) within 30 days after the end of

the financial year concerned by establishments/employers vide their obligation under the Code on

Social Security, 2020 (Chapter XIII-Employment Information and Monitoring).

2. The main purpose in obtaining the information from employers is to know (i) the

vacancies/employment opportunities available; (ii) type of personnel who are in short supply; and (iii)

future job opportunities for providing vocational guidance to the jobseekers and connecting them with

the employers. This is helpful in ascertaining the skill needs also. Employers too will be able to call

on the Career Centres for getting suitable candidates as per their requirements.

[

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THAMMAIAH

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Date: 2026.01.29 17:20:28 +05'30'