राजè थान राजपğ
ͪवशेषांक
RAJASTHAN GAZETTE
Extraordinary
साͬधकार Ĥकाͧशत
Published by Authority
पौष 23, मंगलवार, शाके 1947- जनवरȣ 13, 2026
Pausa 23, Tuesday, Saka 1947- January 13, 2026
भाग 4 (ग)
उप-खÖ ड(II)
राÏ य सरकार तथा अÛ य राÏ य Ĥाͬधकाǐरयɉ Ùवारा जारȣ ͩकये गये काननी
ू
आदेश तथा
अͬधसचनाएं
ू
।
LABOUR DEPARTMENT
NOTIFICATION
Jaipur, January 12, 2026
S.O.151 .-Whereas, the draft of the Rajasthan Code on Social Security Rules, 2023
was published in Rajasthan Gazette Extraordinary Part 4 (ga) dated 11.05.2023 inviting
objections and suggestions from persons likely to be effected thereby;
And whereas,it is decided by the State Government to publish revised following draft
rules for information of all persons likely to be affected thereby;
Now therefore, the following draft of the Rajasthan Code on Social Security Rules,
2026, which the State Government proposes to make in exercise of the powers conferred by
section 154, 156 and 158 of the Code on Social Security, 2020 (Central Act No.36 of 2020)
are hereby published, as required by said sections for information of all persons likely to be
affected thereby and the notice is hereby given that the said draft rules will be taken into
consideration after the expiry of a period of forty-five days from the date on which the copies
of the Official Gazette in which the draft rules are published are made available to the public;
Any objections and suggestions, if any, may be addressed to the Labour
Commissioner, ShramBhawan, Shanti Nagar, Hasanpura, Jaipur-302006 or by email- lab-
[email protected].
The objections and suggestions, which may be received from any person with
respectto the said draft rules before expiry of the period specified above, will be considered
by the State Government.
DRAFT RULES
PART-I
PRELIMINARY
1. Short title, extent and commencement.- (1) These rules may be called the
Rajasthan Code on Social Security (Draft) Rules, 2026.
(2) They extend to the whole of Rajasthan.
(3) They shall come into force on the date of their final publication in the Official Gazette.
2. Definitions.- (1) In these rules, unless the subject or context otherwise requires,-
406 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(a) “appeal” means an appeal preferred under clause (b) of sub-section (7) of
section 37 or sub-section (8) of section 56or sub-section (3) of section 72 or
sub-section (1) of section 99 or sub-section (1) of section 105;
(b) "Appellate authority" means,-
(i) the State Government or the authority specified by the State
Government for the purpose of the Code; and
(ii) ESI Court constituted by the State Government for the purpose of
sub-section 7 of section 37;
(c) “authority” means the State Government or the authority specified by the
State Government under sub-section (3) of section 72;
(d) “average daily wages during a contribution period” under Chapter IV of
the Code in respect of an employee, means the aggregate amount of wages
payable to him during that period divided by the number of days for which
such wages were payable;
(e) “average daily wages during a wage period” under chapter IV of the Code
means,-
(i) in respect of an employee who is employed on time-rate basis, the
amount of wage which would have been payable to him for the
complete wage period had he worked on all the working days in that
wage period, divided by 26 if he is monthly rated, 13 if he is
fortnightly rated, 6 if he is weekly rated and 1 if he is daily rated;
(ii) in respect of an employee employed on any other basis, the amount
of wages earned during the complete wage period in the Contribution
period divided by the number of days in full or part for which he has
worked for wages in that wage period:
Provided that where an employee receives wages without working
on any day during such wage period, he shall be deemed to have
worked for 26, 13, 6 or 1 days or day if the wage period be a month, a
fortnight, a week or a day respectively.
Explanation: Where any night shift continues beyond midnight, the
period of the night shift after midnight shall be counted
for reckoning the day worked as part of the day
preceding;
(f) “benefit period” means the period not exceeding six consecutive months
corresponding to the contribution period, as may be specified in the
Regulations;
(g) “Board” means,-
(i) the Rajasthan Unorganised Workers Social Security Board constituted
under section 6, and
(ii) the Rajasthan Building and Other Construction Workers’ Welfare
Board constituted under section 7, as the case may be;
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 407
(h) “chairperson” means the Chairperson of the Rajasthan Building and Other
Constructions workers' Welfare Board, the Rajasthan Unorganised Workers
Social Security Board, the Standing Committee, the Medical Benefit
Committee or the Executive Committee, as the case may be;
(i) “Code” means the Code on Social Security, 2020 (Central Act No. 36 of
2020);
(j) “Court” means the Employee Insurance Court constituted under section 48 of
the Code;
(k) “electronically” means any information submitted by email or uploading
on the designated portal or digital payment in any mode for the purpose of
Code;
(l) “form” means a form appended to these rules;
(m) “fund” means the Building and Other Construction Workers Welfare Fund
as specified in section 108 and Social Security Fund, as specified in section
141, as the case may be;
(n) “Government” means Government of Rajasthan;
(o) “Government Securities” means Government Securities as defined in the
Government Securities Act, 2006 (Central Act No. 38 of 2006);
(p) “immovable property” includes land, benefits to arise out of land, things
attached to the earth, or permanently fastened to anything attached to the
earth;
(q) “movable property” means property of every description except
immovable property;
(r) “nomination" means nomination made under section 55 of the Code;
(s) “portal” mean official web portal of the Labour Department, Government of
Rajasthan, called by any name;
(t) “Registered Medical Practitioner” means a medical practitioner whose
name has been enrolled in a register maintained under any law for the time
being in force regulating the registration of practitioners of medicine;
(u) “register of women employees” means a register of women employees
maintained under these rules;
(v) “schedule” means the schedule of the Code;
(w) “section” means a section of the Code; and
(x) “specified” means specified by an order of the Central Government or the
State Government or any officer so authorised by such Government.
(2) Words and expressions not defined under these rules but defined or used under the Code
shall have the same meaning as assigned to them in the Code.
408 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
PART-II
SOCIAL SECURITY ORGANISATIONS
CHAPTER-I
RAJASTHAN UNORGANISED WORKERS SOCIAL SECURITY BOARD
3.Term of office of nominated members.- (1) A member, other than an ex-officio
member, shall, unless he resigns his office or dies or otherwise vacate his office at an earlier
date, hold office for a period not exceeding three years from the date of his nomination.
(2) A member nominated under sub-clause (i), (ii) and (iv) of clause (d) of sub-section (10) of
section 6 shall cease to be a member of the Board if he ceases to represent the category of
interest from which he was so nominated:
Provided that out of seven members nominated under sub-clause (i), one member
each from the Scheduled Caste, Scheduled Tribe, Minorities and Women shall be
represented.
(3) A member nominated under sub-clause (iii) of clause (d) of sub-section (10) of section 6
shall cease to be a member of the Board if he ceases to be a member of the Legislative
Assembly by which he was elected.
(4) A member shall be eligible for re-nomination.
4.Resignation.- (1) A member of the Board, not being an ex-officio member, may
resign his office by a letter in writing addressed to the Chairperson.
(2) The seat of such 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
electronically or otherwise, whichever is earlier.
(3) The power to accept the resignation of a member shall vest in the Chairperson who, on
accepting the resignation, shall report to the Board at its next meeting.
5. Vacation of office.- A member appointed under sub-clause (i), (ii) and (iv) of
clause (d) of sub-section (10) of section 6 shall be deemed to have vacated his office, if,–
(a) he is or has become disqualified as per sub-section (1) or sub-section (4) of
section 8 of the Code;
(b) he is absent from three consecutive meetings of the Board without leave of
absence from the Chairperson; or
(c) he is removed from the office by the State Government.
6. Manner of filling vacancies.- When a vacancy occurs or is likely to occur in the
membership of the Board, the Member Secretary shall submit a report to the State
Government and on receipt of such report, the State Government may, by notification,
nominate a person to fill the vacancy and the person so nominated shall hold office for the
remaining period of the term of office of the member in whose place he is nominated.
7.Allowances of members.- (1) The travelling allowance of an official or ex-officio
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 paid travelling allowance for attending the
meetings of the Board at such rates as are admissible to a Category ‘A’ officer of the State
Government and daily allowance shall be calculated at the maximum rate admissible to
Category ‘A’ officer of the State Government.
8.Meetings of the Board.- (1) The Board shall meet at such place and at such time as
may be decided by the Chairperson and it shall ordinarily meet at least once in a quarter.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 409
(2)The Chairperson shall preside over every meeting of the Board in which he is present and
in his absence he may nominate a member of the Board to preside over such meeting in his
place and in the absence of such nomination by the Chairperson, the members of the Board
present in such meeting may choose from amongst themselves a member to preside over the
meeting.
9.Quorum.- No business shall be transacted at any meeting of the Board unless six
members are present in that meeting which shall include at least one member of State
Legislative Assembly:
Provided that if at a meeting, less than six members are present, the Chairman may
adjourn the meeting to another date informing the members present and giving notice to the
other members that he proposes to dispose of the business at the adjourned meeting whether
there is required quorum or not, and it shall thereupon be lawful for him to dispose of the
business at the adjourned meeting irrespective of the number of members attending.
10.Notice of meeting and list of business.- (1) A notice of not less than fifteen days
from the date of issue, containing the date, time and place of every ordinary meeting of the
Board, together with a list of business proposed to be transacted approved by the Chairperson
shall be sent to every member of the Board, through e-mail or registered post or by special
messenger. A brief note on each item of the agenda shall be sent along with the agenda as
soon as thereafterpossible.
(2)In case when the Chairperson calls an emergency meeting of the Board for considering
any matter which in his opinion is urgent, a notice giving such reasonable time as he may
consider necessary shall be deemedsufficient.
(3) No business other than for which the meeting of the Board has been convened shall be
considered at the meeting except with the permission of the Chairperson of themeeting.
11.Transaction of Business.- Every matter which the Board is required to take into
consideration shall be considered at a meeting of the Board, or if the Chairperson so directs,
by sending the necessary papers to every member for his opinion, and the matter shall be
decided by a majority of votes of the members present and voting:
Provided that where there is no opinion of majority on a matter and the members of
the Board are equally divided, the Chairperson, or in his absence, the person presiding, shall
have a second or casting vote.
12.Minutes of meeting.- (1) The minutes of each meeting showing inter-alia the
names of the member present there, shall be forwarded to each member of the Board as soon
as possible and in any case not later than four weeks after themeeting.
(2)The records of the minutes of each meeting of the Board shall be signed by the Member
Secretary with the approval of theChairperson.
(3) The minutes of the meeting shall be confirmed with such modification considered
necessary at the next meeting.
(4) The minutes of a meeting of the Board shall be kept in a Minute Book and shall be signed
by the Chairperson of the meeting at which the proceedings areconfirmed.
13.Sub-Committees of the Board.- (1) The Board may appoint such sub-committees,
as it may deem fit for the proper discharge of its duties.
(2)Each sub-committee will be headed by the Chairperson of the Board or Member Secretary,
if so authorised by the Chairperson, and will have an equal number of unorganised workers,
employers and members of the Board representing the State Government.
(3) In the absence of the Chairperson, the members of the sub-committee present in such
meeting may choose from amongst themselves a member to preside over the meeting.
410 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(4) No work shall be performed at a meeting of the sub-committee unless at least one-third of
its members are present, of which there shall be one representing the members and at least
one unorganized worker.
(5) The term of any sub-committee, except the Sub-committee constituted for the short term,
shall be one year from the date of its constitution, however, the sub-committee shall continue
to function until a new sub-committee is appointed. But in any case, no sub-committee shall
function beyond the period of two years from the date of its original constitution.
(6) Recommendations of each sub-committee shall be placed before the Board for its
decision.
CHAPTER-II
RAJASTHAN BUILDING AND OTHER CONSTRUCTION WORKERS WELFARE
BOARD
14. Constitution of the Board.- (1) The Board shall consist of,-
(i)
The Minister in-charge of the Labour Department, Rajasthan shall be the ex-
officio Chairperson,
(ii)
not more than three persons representing building and other construction
workers appointed by the State Government,
(iii)
not more than three persons from among the employers of building and other
construction appointed by the State Government,
(iv)
not more than three members representing the State Government to be
appointed by the State Government representing Government Departments of
whom one shall be the Labour Commissioner and one shall be representative
of Finance Department and one shall be representative of Department engaged
in building or other construction work, and
(v)
a member nominated by the Central Government.
(2) At least one member of the Board among the members appointed under clauses (ii), (iii)
and (iv) of sub-rule (1) shall be a woman and the number of members appointed under
clauses (ii), (iii) and (iv) of sub-rule (1) shall be equal.
15. Term of office.- (1) The term of appointment of the Chairperson and other ex-
officio members of the Board shall be three years.
(2) A member appointed under clauses (ii) and (iii) of sub-rule (1) of rule 14 shall, unless he
resigns his office or dies or otherwise vacate his office at an earlier date, hold office for a
period for three years from the date of publication of the notification in the Rajasthan Gazette
appointing him as a member of the Board:
Provided that an outgoing member may continue in office till their successors are
appointed but in no case the members shall continue in office beyond a period of four years
from the date of their appointment.
16. Filling up of casual vacancy.- A non-official member appointed to fill a casual
vacancy shall hold office for the remaining period of the term of the member in whose place
he is appointed.
17. Resignation.- (1) A member appointed under clause (ii) and (iii) of sub-rule (1) of
rule 14 may resign his office by writing under his hand addressed to the State Government.
(2) The resignation shall take effect from the date of its acceptance by the State Government.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 411
18. Vacation of office.- A member appointed under clauses (ii) and (iii) of sub-rule
(1) of rule 14shall be deemed to have vacated his office, if, –
(a)
he is declared to be of unsound mind or an undercharged insolvent by a
competent court, or
(b)
he is convicted of an offence which, in the opinion of the State Government,
involves moral turpitude; or
(c)
he is absent from three consecutive meetings of the Board without leave of
absence from the Chairperson; or
(d)
he ceases to represent the interest for representing which he was appointed; or
(e)
he removed by the State Government.
19. Meeting of the Board.- The Board shall ordinarily meet once in three month:
Provided that the Chairperson shall, within fifteen days of the receipt of a
requisition in writing from not less than one third of the members of the Board, call a special
meeting thereof.
20. Notice of meeting and list of business.- Notice intimating the date, time and
venue of every meeting together with a list of business to be transacted at the meeting shall
be sent by email or by registered post or by special messenger, to each member fifteen days
before the meeting:
Provided that when the Chairperson, calls a meeting for considering any matter which
in his opinion is of urgent nature, notice of not less than three days shall be deemed
sufficient.
21. Chairperson to preside at meetings.- (1) The Chairperson shall preside over all
the meetings of the Board in which he is present, and if, for any reason the Chairperson is
unable to attend the meeting any member nominated by the Chairperson in this behalf shall
preside over the meeting.
(2) When the Chairperson is absent and no member has been nominated the Chairperson
under sub-rule (1), the members present in such meting shall choose from amongst
themselves a member to preside over the meeting and the member so chosen shall exercise all
the powers of the Chairperson in conducting the meeting.
(3) No business shall be transacted at any meeting of the Board unless at least six members
are present.
22. Transaction of Business.- Every question considered at a meeting of the Board
shall be decided by a majority of the votes of the members present and voting and in the
event of equal votes, the Chairperson shall have and exercise a casting vote.
23. Minutes of the meeting.-(1) The minutes of each meeting showing inter-alia the
names of the member present there, shall be forwarded to each member of the Board as soon
as possible and in any case not later than four weeks after themeeting.
(2) The records of the minutes of each meeting of the Board shall be signed by the Member
Secretary with the approval of theChairperson.
(3) The minutes of the meeting shall be confirmed with such modification considered
necessary at the next meeting.
(4) The minutes of a meeting of the Board shall be kept in a Minute Book and shall be signed
by the Chairperson of the meeting at which the proceedings areconfirmed.
24. Fees and allowances.- (1) Every non-official member shall be paid a sitting fees
of five hundred rupees for attending a meeting of the Board. This fee shall not be applicable
for attending sub-committee meetings.
(2) The Chairperson shall be paid honorarium of four thousand rupees per mensem.
412 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(3) The travelling allowance of an official or ex-officio 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.
(4) The non-official members of the Board shall be paid travelling allowance for attending
the meetings of the Board at such rates as are admissible to a Category ‘A’ officer of the State
Government and daily allowance shall be calculated at the maximum rate admissible to
Category ‘A’ officer of the State Government.
25. Sub-committees of the Board.- (1) The Board may constitute such sub-
committees, as it may deem fit for the proper discharge of its duties.
(2) A sub-committee shall consist of the following persons, namely:-
(i)
Chairperson of the Board,
(ii)
One member representing the employers.
(iii)
One member representing the building workers, and
(iv)
One member representing the State Government.
(3) Every member of a sub-committee shall be allowed travelling allowance and daily
allowance as per sub-rule (3) and (4) of rule 24, as the case may be.
(4) The Chairperson of the Board shall be the Chairperson of the sub-committee also. If the
Chairperson is absent at any meeting the members, present in such meeting choose from
amongst themselves a member to preside over the meeting.
(5) No business shall be transacted at a meeting of the sub-committee unless at least three
members including Chairperson of the sub-committee are present, which shall include the
members representing employers and building workers.
(6) The term of the sub-committee, except the sub-committee constituted for the short term,
shall be one year from the date of its constitution:
Provided that the sub-committee shall continue in office until a new sub-committee is
constituted.
Provided further that in no case the sub-committee shall continue beyond a period of
two years from the date of its original constitution.
(7) The recommendation of sub-committee shall be placed before the Board for its decision.
26. Opening of District and Tehsil offices.- The Board may, with the approval of the
State Government, open district and tehsil level offices as it may consider desirable for the
purpose of efficient discharge of its functions under the Code.
27. Powers, duties and functions of the Board.- (1)Under sub-section 6 of section 7
of the Code, the Board shall be responsible for,-
(i)
all matters connected with the administration of the fund,
(ii) laying down policies for the deposits of the amount of the fund,
(iii)
submission of annual budget to Government for sanction,
(iv)
submission of annual report on the activities of the Board to the
Government,
(v)
proper maintenance of accounts,
(vi)
annual audit of account of the Board in accordance with the
provision of the Code,
(vii)
collection of the contribution to the fund and other charges,
(viii) launching of prosecution for and on behalf of the Board,
(ix)
speedy settlement of claims and sanction of advances and other
benefits,
(x)
proper and timely recovery of any amount due to the Board, and
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 413
(xi)
ensure the timely payment of contribution of ESI and PF, as the
case may be;
(2) The Board shall furnish information to Government on such matters as the Government
may refer to it, from time to time.
(3) The Board shall formulate scheme which provided in the Code and these rules, laying
down the procedure, formats and all other residual matters regarding each benefit or group of
benefits, inter alia specifying following, and with prior approval of the State Government,
notify the scheme;
(i)
Rates at which various benefits will granted,
(ii)
Eligibility criteria for admissibility of benefit,
(iii)
Application Procedure and Format,
(iv)
Procedure for sanctioning and competent authority to grant approval,
(v)
Procedure for disbursement, and
(vi)
Any other incidental matters.
28. Appointment of Secretary, other officers and employees.- (1)The Board may,
with the prior approval of the State Government, appoint an officer of the State Government
not below the rank of a Additional Labour Commissioner of the Labour Department as
Secretary of the Board.
(2) The Board may, with the prior approval of the State Government, appoint as many
officers and employees, as it consider necessary to assist the Board in the efficient discharge
of its function under the Code.
29. Administrative and financial powers of the Secretary.- (1) The Secretary of the
Board shall be the Chief Executive Officer of the Board.
(2) The Secretary shall, with the approval of the Chairperson, issue notice to convene
meetings of the Board and keep the record of minutes and shall take necessary steps for
carrying out the decision of the Board.
(3) The Secretary of the Board may, without reference to the Board, sanction expenditure and
contingencies, supplies and services and purchase of articles, refund for administering the
fund subject to the limit up to which he may be authorised to sanction expenditure on any
single item from time to time, by the Board.
(4) The Secretary may also exercise such other administrative and financial powers, other
than those specified in sub-rule (3) above, as may be delegated to him from time to time, by
the Board.
(5) The Board may, from time to time delegate, subject to such conditions as it may deem fit,
administrative and financial powers to any other officer under its control and supervision to
the extent considered necessary for its effective functioning.
30. Recruitment procedure and service conditions of officers and employees of
the Board.- (1) Classification, salary, pay scale, allowances, recruitment procedure and terms
and conditions of service of officers and employees of the Board may, with the prior
approval of the State Government, be determined by the Board.
(2) If in any case, any difficulty arises regarding interpretation or implementation, the matter
shall be referred to the State Government, whose decision shall be final thereon.
31. Amount in connection with premium for welfare schemes.- Notwithstanding
the welfare schemes mentioned in sub-section (6) of section 7 of the Code, the Board, with
prior approval of the State Government,shall also formulate following scheme(s) for the
beneficiaries, or such dependent,-
(i)
to pay such amount in connection with premium for Group Insurance Scheme
of the beneficiaries;
(ii)
educational schemes for the benefit of children of the beneficiaries; and
414 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(iii)
to meet such medical expenses for treatment of major ailments of a
beneficiary, or such dependent.
PART-III
EMPLOYEE INSURANCE COURT
CHAPTER-I
APPEAL COMPOSITION OF COURT, PLACE OF SITTING AND
PROCEDURE
32. Manner and time within which appeal may be filed.- The Insured Person or the
Corporation may file appeal under sub-section (7) of section 37 of the Code to the
Employees’ Insurance Court by presenting an application within ninety days of the date of
communication of the decision of the Medical Board 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 an application after the
period of ninety days, if it is satisfied that the appellant had sufficient reasons for not
presenting the application within the said period.
33. Composition of the Court and place of sitting.- (1) A court shall ordinarily
consist of one judge:
Provided that the Government may by notification in the official gazette appoint two
or more judges to a court for any particular proceedings of class of proceedings and for such
period as may be specified in the notification.
(2) Subject to the provision of rule 35, a court shall sit at such place or places and at such
time as the government may specify.
34. Distribution of business where there are more Courts than one.- Where more
than one Court is constituted for the same local area the Government may, by a general or
special order, distribute business among them.
35. Fixing of time of sitting etc.- Where there is one Court for two or more local
areas,-
(i) where one Court is constituted for two or more local areas the Court shall, subject
to the approval of the Government, appoint the time at which the court shall sit in
respect of each local area or in respect of any class of proceedings under the Code.
(ii) a notice of the time appointed under clause (i) shall be published in such manner
as the Government may, from time to time, direct.
(iii)
36. Procedure where there are more judges than one.- (1) Where more than one
Judge has been appointed to a Court, the Government shall specify their rank and precedence.
(2)The senior Judge for the time being shall, from time to time, make such arrangements, as
he thinks fit, for the distribution of business of the Court among the Judges thereof.
(3) When two or more Judges sitting together, differ on any question the opinion of the
majority of such Judges shall prevail, where there is no majority, the opinion of the senior
most Judge shall, unless the Government otherwise directs, prevail.
37. Abolition, etc., of a Court.- The Government may, by notification in the official
gazette, abolish any court or by a like notification alter the jurisdiction of any court.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 415
CHAPTER-II
CONDITIONS OF SERVICE OF JUDGES, OTHER OFFICER AND STAFF
38. Appointment, salaries, allowances, etc.- (1) The Government may appoint a
person qualified under section 48 of the Code to be judge of the court.
(2)A judge shall receive such salary and allowances as the Government may from time to
time determine.
(3) A judge shall receive dearness allowance, Compensatory city allowance, house rent
allowance and other allowances at such rate and conditions as are applicable to officer of the
Government of a corresponding rank stationed at the same place.
(4) A Judge shall be entitled to leave and leave salary under the leave rules which may from
time to time be applicable to other State Government servants of similar status and drawing
similar emoluments.
(5) A Judge shall be entitled to travelling allowances for journeys performed on official
business in accordance with the scale applicable to the class of officers to which in the
opinion of the Government such judge belongs.
(6) Other conditions of service of a Judge shall be such, as may be determined by the State
Government, from time to time.
(7) Notwithstanding, anything contained in sub-rule (2) to (6), the pay, allowances and other
conditions of service of a Judge, if he is a person already in the service of the State
Government shall be such as the State Government may by a general or special order, from
time to time, determine.
39. Appointment of other officers and subordinate staff.- (1) The State
Government may appoint such ministerial officers and other subordinate staff as may be
necessary for the exercise and, performance of the powers and duties conferred and imposed
on a Court by or under the Code.
(2) The ministerial officers and the subordinate staff of a Court shall exercise such powers
and discharge such duties as the Judge, or, if there are more judges than one, the senior judge,
may, subject to any order of the State Government, from time to time, direct.
(3) The ministerial officers and the subordinate staff of a Court shall be subject to such
conditions of service and draw such salaries and other emoluments and receive such benefits
as may be fixed by the State Government.
CHAPTER-III
ADMINISTRATIVE CONTROL AND SEAL
40. Administrative control.- All Courts shall be subject to the administrative control
and superintendence of the High Court, and shall,-
(i) keep such registers, books and accounts as the High court may, from time to time,
prescribe; and
(ii) comply with such requisitions as may be made by the High Court or the State
Government for submission of service records, returns and statements in such
forms and in such manner as the authority making the requisition directs.
41. Seal.- A Court shall keep a seal of such size, dimensions and design as the State
Government may direct.
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CHAPTER-IV
PROCEDURE AND EXECUTION OF ORDERS
42. Application.- (1) Every proceeding under section 49 shall be instituted by
presenting an application to the Court.
(2) Every such application shall be verified in the same manner as a pleading in a Civil Court
and shall be accompanied by two copies thereof.
(3) An application shall be presented in Form-I. It shall be duly stamped in accordance with
these rules, and shall contain the following particulars:-
(i)
the name of the Court in which the application is brought;
(ii) the full name including the father's name, description including age, occupation
and place of residence of the applicant;
(iii) the full name including the father's name, description including age, occupation
and place of residence of the opposite party so far as they can be ascertained;
(iv) where the applicant or the opposite party is a minor or a person of unsound mind
a statement to that effect and the full name, age, occupation and address of his or
her next friend or guardian;
(v)
the facts constituting the cause of action and the date when it arose;
(vi) the facts showing that the court has jurisdiction;
(vii) particulars giving the address within the jurisdiction of the Court at which
notice or summons may be served on the applicant; and
(viii) the relief which the applicant claims.
(4) The application may be rejected if it is not in accordance with sub-rule (3).
43. Production of documents.- (1)when any application is based upon a documents,
the document shall be appended to the application.
(2) Any other document which any party desires to tender in evidence shall be produced at or
before the first hearing.
(3) 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 permission of the Court, be admissible in evidence
on behalf of the party who should have produced it.
(4) All such documents shall be accompanied by an accurate list thereof prepared in the in
Form-II. Nothing in this rule shall apply to any documents which is produced for the purpose
of cross-examining witness or is handed to a witness to refresh his memory.
44. Register of proceedings.- All applications shall be entered in a Register in Form-
III called the register of proceedings. Such entries shall be serially numbered for every
calendar year according to the order in which the applications are presented.
45. Place of suing.- In cases not falling under rule 34,a proceeding against any person
shall be instituted in the Court within the local limits of whose jurisdiction,-
(i) the opposite party or each of the opposite parties where there are more than one, at
the time of commencement of the proceedings actually and ordinarily resides, or
carries on business, or personally works for gain, or
(ii) any of the opposite parties, where there are more than one, at the time of the
commencement of the proceeding, actually and voluntarily resides, or carries on
business, or personally works for gain provided that in such case either the leave
of the court is given, or the opposite parties who do not reside, or carry on
business or personally work for gain as aforesaid, acquiesce in such institution; or
(iii) the cause of action, wholly or in part, arose.
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46. Application presented to wrong Court.- (1) If on receiving an application it
appears to the Court that it should be presented to another Court, it shall return it to the
applicant after endorsing upon it the dates of the presentation and return, the reasons for
returning it and the designation of the Court to whom it should be presented.
(2) If it appears to the court at any stage subsequent to the presentation of an application, that
the application should have been presented to another Court, in the same State, it shall send
the application to the Court empowered to deal with it and shall inform the applicant and the
opposite party, if he has received a copy the application under rule 42.
(3) The Court to whom an application is transferred under sub-rule (2) may continue the
proceeding as if the previous proceeding or any part of it had been taken before it, if it is
satisfied that the interests of the parties will not thereby be prejudiced.
47. Issue of summons.- (1) On receiving an application the Court shall, within three
days thereof, cause to be sent to the party from whom the applicant claims relief, hereinafter
referred to as the 'opposite party', a summons in Form-IV or Form-V, as the case may be, to
appear and answer the application in a day, not later than fifteen days from the day of issue of
such summons, to be specified therein:
Provided that no such summons shall be issued when the opposite party has appeared
at the presentation of the application and admitted the applicant's claim.
(2) A copy of the application shall also be sent along with the summons under sub-rule (1).
48. Service of summons or notice.- (1) A summon or notice may, on payment of the
required fee, be sent by the Court by whom it is issued either by registered post or in such
other manner as the Court thinks fit.
(2) Where the Court is satisfied that there is reason to believe that the opposite party is
avoiding service or that for any reason the summons or the notice cannot be served in the
ordinary way, the court shall order the summons or the notice to be served by affixing a copy
thereof in some conspicuous place in the Court-house, and also upon some conspicuous part
of the house in which the opposite party is known to have last resided or carried on business
or personally worked for gain or in such other manner as the Court thinks fit and it shall be
effectual as if it had been made on the opposite party personally.
(3) Where a summons or notice is served under sub-rule (2), the Court shall fix such time for
the appearance of the opposite party as the circumstances of the case may require.
49. Additional matters in the summons.- The Court shall determine at the time of
issuing the summons, whether it shall be for the settlement of the issues only and /or for the
final disposal of the application and the summons shall contain a direction accordingly. The
Court may also call upon the parties to produce upon that date any evidence which they wish
to render.
50. Proceedings involving disablement question.- If in any proceeding before the
Court is disablement questions, as defined in the section 37 of the Code, arises and the
decisions of a Medical Board or a Medical Appeal Tribunal has not been obtained on the
same and the decision of such questions is necessary for determination of the claim or
question before the court that court shall direct the Corporation to have the question decided
as laid down in section 37 and shall thereafter proceed with the determination of the claim or
question before it in accordance with section 49.
51. Written statement.- (1)The opposite party may, and, if so required by the Court,
shall, at or before the first hearing or within such time as the Court may permit, present a
written statement of his defence along with the documents on which he relies and an accurate
list thereof in Form-II.
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(2)Every such written statement shall be verified in the same manner as a pleading in a Civil
Court and shall be accompanied by two copies thereof.
(3) In any written statement submitted under sub-rule (1) the opposite party shall deal
specifically with each allegation of fact alleged by the applicant, of which he admits or does
not admit or denied the truth. The written statement must also contain all matters which show
that the application is not maintainable and all such grounds of defence as, if not raised,
would be likely to take the application as for instance, fraud, undue influence or coercion
release, payment, performance of facts showing illegality of the transaction.
52. Failure to present written statement called for by the Court.- Where any party
from whom a written statement is required fails to present the same within the time
prescribed by the Court may, pronounce judgment against him or make such order in relation
to the proceeding as it thinks fit.
53. Framing of issues.- (1) at the first hearing of the application, after the summons
has been issued, the Court shall, after considering the application and the written statement, if
any, or after such examination of the parties or any person or any document as may appear
necessary, ascertain upon what material proposition of fact or of law the parties are at
variance, and shall thereupon proceed to frame and record the issues upon which the right
decision appears to depend.
(2) In recording the issues, the Court shall distinguish between those issue which in its
opinion concern points of fact and those which concern points of law.
(3) The Court may, in like manner, at any time before passing its final order add to, strike out
from, or in any way amend, the issues on such terms as it may think fit.
54. Order where parties are not at issue.- Where at any hearing of the case it
appears that the parties are not at issue on any question of law or of fact the Court may at
once pronounce its final order.
55. Appearance of parties and consequences of non-appearance.- (1) On the day
fixed in the summons for the opposite party to appear and answer the parties shall be in
attendance at the Court in person or by their respective legal practitioners or any other person
authorised under section 51 and the application shall then be heard unless the hearing is
adjourned by the Court.
(2) When neither party appears when the application is called on for hearing, the Court may
make an order that the application be dismissed.
(3) Where the opposite party appears and the applicant does not appear when the application
is called on for hearing, the Court shall make an order that the application be dismissed
unless the opposite party admits the claim or part thereof in which case the court shall make
an order against the opposite party upon such admission and where party only of the claim
has been admitted it shall dismiss the case so far as it relates to the remainder.
(4) Where the applicant appears and the opposite party after receiving the Summons fails, to
appear, when the application is called on for hearing the Court may proceed ex-parte.
(5) Where the application is wholly or partly dismissed under sub-rule (2) or (3), the
applicant may within thirty days of such dismissal apply in Form-VI for an order to set the
dismissal aside and the Court shall, if it is satisfied that he was prevented from appearing
when the proceeding was called on for hearing due to any sufficient cause make an order
setting aside the dismissal upon such terms as to costs or otherwise as it thinks fit and may
proceed with the case or appoint a day for proceeding with the same:
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Provided that no order under this sub-rule shall be made in respect of an application
which is dismissed under sub-rule (3) unless notice of the application has been served in
Form-VII on the opposite party.
(6) In any application in which an ex-parte order has been passed against the opposite party,
he may within thirty days from the date of such order apply in Form-VI to the Court which
passed the order, to set it aside and, if the Court is satisfied that he was prevented from
appearing when the proceedings was called on for hearing due to any sufficient cause, it may
after serving notice thereof to the applicant in Form-VII make an order setting aside the order
upon such terms as to costs or otherwise as it thinks fit and may proceed with the hearing of
the case or appoint a day for proceeding with the same.
56. Summoning of witness.- (1) At any time after framing of the issues the Court
may call upon the parties to produce their evidence in support of the issues.
(2) The Court may, on the application of either party issue a summons in Form-VIII to any
witness directing him to attend or to produce any document.
(3) The Court may, before summoning any witness on application under sub-rule (2), require
that his reasonable expenses to be incurred in attending the Court be deposited with it.
57. Grant of time and adjournment of hearing.- (1) The Court may, if sufficient
cause is shown, at any stage of the application, grant time to the parties or to any of them, and
may, from time to time, adjourn the hearing of the application.
(2) In every such adjournment the Court shall fix a day not exceeding fifteen days from the
date on which such adjournment is made for the further hearing of the application and may
make such order as it thinks fit with respect to the costs occasioned by the adjournment:
Provided that when the hearing of the evidence has once begun the hearing of the
application shall be continued from day to day until all the witnesses in attendance have been
examined, unless the Court finds the adjournment of the hearing beyond the following day to
be necessary for reasons to be recorded.
58. Right to begin proceeding.- The applicant has the rights to begin unless the
opposite party admits the facts alleged by the applicant and contends that either in point of
law or on some additional facts alleged by the opposite party, the application is not entitled to
the relief which he seeks, in which case the opposite party has the right to begin.
59. Statement and production of evidence.- (1) On the day fixed for the hearing of
the application or on any other day to which the hearing is adjourned the party having the
right to begin shall state his case and produce his case and produce his evidence in support of
the issues which he is bound to prove.
(2) The other party shall then state his case and produce his evidence, if any, and may then
address the Court generally on the whole case.
(3) The Party beginning may then reply generally on the whole case.
(4) Notwithstanding anything contained in this rule the Court may order that the production
of evidence or the address to the Court may be in any order which it may deem fit.
60. Method of recording evidence.- The evidence of each witness shall be taken
down in writing by the Judge or where there is more than one Judge by the junior Judge, or at
the dictation of any such Judge in the open Court in the language of the Court, not ordinarily
in the form of question and answer but in that of a narrative and, when completed, shall be
read over or translated, where necessary, in the presence of such Judge, to the witness, and
such Judge shall if necessary, correct the same, and shall sign it.
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61. Recall of a witness.- The Court may at any stage of a proceeding recall any
witness who has been examined and may subject to the law of evidence for the time being in
force put such question to him as the Court thinks fit.
62. Inspection by Court.- The Court may at any stage of a proceeding inspect any
property or thing concerning which any question may arise.
63. Pronouncement of order.- The Court, after the application has been heard, shall
pronounce its final order in open Court, either at once or on some future day, of which due
notice shall be given to the parties.
64. Signing of order.- The final order shall be dated and signed in open Court at the
time of pronouncing it and, when once signed, shall not afterwards be altered or added to,
save in the case of clerical or arithmetical mistake arising from accidental slip or omission.
65. Statement of decision on each issue.- In cases in which issues have been framed
the Court shall state its finding or decision, with the reason there for, upon each separate
issue, unless the finding upon any one or more of the issues is sufficient for the decision of
the case.
66. Compromise of suit.- Where it is proved to the satisfaction of the Court that a
case had been adjusted wholly or in partly by any lawful agreement or compromise, or where
the opposite party satisfies the applicant in respect of the whole or any part of the subject
matter of the case, the Court shall order such agreement, compromise or satisfaction to be
recorded, and shall pass final order in accordance therewith so far as it relates to the case.
67. Finality of Order.- Save as provided in section 52 the order of a Court shall be
final and binding upon the parties.
68. Costs.- (1) The costs and incidental to the application shall be in the discretion of
the Court, and the Court shall have full power to determine by whom or out of what property
and to what extent such costs are to be paid, and to give all necessary direction for the
purposes aforesaid. The fact that the Court has no jurisdiction to try the case shall be no bar
to the exercise of such powers.
(2) Where the Court directs that any cost shall not follow the event, the Court shall state its
reasons in writing.
69. Contents of the decree.- (1) A decree in Form-IX shall be prepared in conformity
with the order made by the Court it shall contain the number of the application, the names
and descriptions of the parties, and particulars of the claim, and shall specify clearly the relief
granted or other determination of the proceeding.
(2) The decree shall also state the amount of costs incurred in the proceeding and by whom
and in what proportion such costs are to be paid.
(3) The Court may direct that the cost payable to one party by the other shall be set off
against any sum which is admitted or found to be due from the former to the latter.
70. Certified copies of order, decree etc. to be furnished.- (1) Certified copies of
the final order, decree or any other order or matter on record shall be furnished to the parties
on application to the Court and at their expenses.
(2) If any party requires copies of any order, decree or any other matter on record made by or
furnished to the Court, as the case may be, to be supplied to him within forty-eight hours of
the submission of an application thereof to the Court, he shall pay an additional fee of two
rupees for each such copy.
(3) If any party applied for copies of any order, decree or any other matter on record made by
of furnished to the court, as the case may be, after the expire of twelve months from the date
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of such making or furnishing as the case may be, he shall pay an additional searching fee of
two rupees.
71. Execution.- (1) Any person in whose favour an order has been passed shall,
within one year from the date of the order, apply in Form-X to the Court which made the
order for its execution.
(2) On such, application being made, the court shall send the same together with the
necessary record to a Civil Court, of competent jurisdiction, for its execution and such civil
court shall have the same power in executing such order as, if it had been passed by it.
72. Communication of fact of execution or otherwise.- The Civil Court to which a
decree is sent for execution shall certify to the Court which passed it the fact of such
execution or where that Court fails to execute the same and the circumstances attending such
failure.
73. Fees.- (1) The fee payable on an application in respect of any matter referred to in
section 49 shall be tenrupees.
(2) The fee payable in respect of any other application except a written statement called for
by the Court under these rules shall be five rupees:
Provided that the fee for an application for obtaining a copy or translation of any
document on record or statement, order to decree presented to or made before or by the
Court, as the case may be, shall be two rupees.
(3)The fee for copies of any document on record, or statement or order or decree shall be
such as may, from time to time be determined by the Government.
(4) The fee for any authorisation for the appearance of any person under section 51 on behalf
of any of the parties in a case shall be ten rupees.
(5)The fee for filling certified copies of any document in a Court shall be five rupees.
(6)All fees referred to in this rule shall be collected by means of Court-fee stamps used in
ordinary Courts and no document which ought to bear stamps under these rules shall be of
any validity unless and unless and until it is properly stamped:
Provided that where any such document is through mistake or inadvertence received,
filed or used in a Court without being properly stamped, the Court may, if it thinks fit, order
that such document be stamped as it may direct and on such document being stamped
accordingly the same and every proceeding relating thereto shall be as valid as it had been
properly stamped in the first instance.
(7) No document requiring a stamp under this rule shall be acted upon in any proceeding in a
Court until the stamp has been cancelled.
74. Payment of Costs of services of summons, etc.- (1) The cost of service of
summons or notices or the expenses of the witnesses in any case or the fee payable in respect
of any matter not referred to in the preceding rule shall be such amount as may be specified in
each case by the Court and such amount or any other sum of money payable under these rules
shall be paid in such manner and within such time as it may specify therefore.
(2) Any amount which is left over after meeting the expenses, if any, for which it was
intended shall be returned by the Court to the party by whom or on whose behalf the amount
was originally paid into the Court.
(3) The Court shall maintain proper accounts of the amount received and disbursed under
sub-rule (1).
(4) The Court may, whenever it thinks fit, receive and register proceedings instituted under
the Code and applications made under these rules, by persons who are paupers, and may issue
summons or notice on behalf of such persons, without payment or on a part payment of the
fees and costs mentioned in these rules.
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CHAPTER-V
MISCELLANEOUS
75. Provisions in the code of Civil Procedure, 1908 etc. to apply.- In respect of
matters relating to procedure or admission of evidence for which no specific provision is
made in these rules, the provisions of the Code of Civil Procedure, 1908 (Central Act No. V
of 1908), including the rules made thereunder and the BharatiyaSakshyaAdhiniyam, 2023
(Central Act No.47 of 2023), shall so far as may be apply to proceedings under the Act.
76. Proceeding of Employees' Insurance Courts.- (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 any 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 records connected with that matter.
(4) The State 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 State
Government of that State.
(5) The Court to which any matter is transferred under sub-rule (3) or sub-rule (4) shall
continue the proceedings as if they had been originally instituted in it.
PART-IV
GRATUITY
77. 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.- In the case
of nominee, or an heir, who is minor, the competent authority shall invest the gratuity amount
deposited with him for the benefit of such minor in term deposit with the State Bank of India
or a 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 (Central Act No. 5 of 1970) or a corresponding new
bank specified in the First Schedule of the Banking Companies (Acquisition
and Transfer of Undertakings) Act, 1980 (Central Act No. 40 of 1980).
78. Nomination.- (1) A nomination shall be in Form-XI and submitted in duplicate by
the employee either by personal service, after taking proper receipt or by registered post
acknowledgement due or electronically to the employer,-
(a) in the case of an employee who is already in employment for a year or more on
the date of commencement of these rules but not submitted the nomination,
ordinarily within ninety days from such date; and
(b) in the case of an employee who completes one year of service after the date of
commencement of these rules, ordinarily within thirty days of the completion of
one year of service:
Provided that nomination in Form-XI 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.
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(2) Within thirty days of the receipt of nomination in Form-XI 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-XI
duly attested either by the employer or an officer authorised in this behalf by him, as a token
of recording of the nomination by the employer and the other copy of the nomination shall be
recorded.
(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, duplicate in Form-XI 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-XI to the employer in the manner
specified in sub-rule (1), and thereafter the provisions of sub-rule (2) shall apply mutatis
mutandis.
(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 and shall be
submitted by the employee electronically or by registered post acknowledgement due.
(6) A nomination, fresh nomination or notice of modification of nomination shall take effect
from the date of receipt thereof by the employer.
79. Application for Gratuity.- (1)An employee who is eligible for payment of
gratuity under the Code, or any person authorised, in writing, to act on his behalf, shall apply,
ordinarily within thirty days from the date the gratuity became payable, in Form-XIIto the
employer:
Provided that where the date of superannuation or retirement of an employee is known,
the employee may apply to the employer before thirty days of the date of superannuation or
retirement.
Provided further that an employee on fixed term employment shall be eligible for
gratuity, if he renders service under the contract for a period of one year and he shall be paid
gratuity at the rate of fifteen days’ wages, based on the rate of wages last drawn by him, for
every completed year of service or part thereof in excess of six months.
(2) A nominee of an employee who is eligible for payment of gratuity under the second
proviso to sub-section (1) of section 53 shall apply, ordinarily within thirty days from the date
of gratuity became payable to him, in Form-XIIto the employer:
Provided that an application in plain paper with relevant particulars shall also be
accepted. The employer may obtain such other particulars as may be deemed necessary by
him.
(3) A legal heir of an employee who is eligible for payment of gratuity under the second
proviso to sub-section (1) of section 53 shall apply, ordinarily within one year from the date
of gratuity became payable to him, in Form-XII to the employer.
(4) Where gratuity becomes payable under the Code before the commencement of these rules,
the periods of limitation specified in sub-rule (1), (2) and (3)shall be deemed to be operative
from the date of such commencement.
(5) 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 his claim, and no claim for gratuity under the Code shall be invalid
merely because the claimant failed to present his application within the specified period. Any
dispute in this regard shall be referred to the competent authority for his decision.
(6) An application under this rule shall be presented to the employer either by electronically
or personal service or by registered post acknowledgement due.
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80. Notice for payment of gratuity.- (1) Within fifteen days of the receipt of an
application under rule 79 for payment of gratuity, the employer shall,-
(i)
if the claim is found admissible on verification, issue a notice in Form-XIII 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-XIII 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; or
(iii) in the case of denial of gratuity a copy of the notice shall be endorsed to the
competent authority.
(2) In case payment of gratuity is due to be made in the employer's office, the date fixed for
the purpose in the notice in Form-XIII under clause (i) of sub-rule (1) 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.
(3) 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 sub-rule (1) 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.
(4) A notice in Form-XIII shall be served on the applicant either by personal service after
taking receipt or by registered post with acknowledgement due or electronically.
(5) A notice under sub-section (2) of section 56 shall be in Form-XIII.
81. Mode of payment of gratuity.- 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:
Provided that intimation about the details of payment shall also be given by the
employer to the competent authority of the area.
82. Application to competent authority for direction under clause (b) of sub-
section (5) of section 56.- (1)If an employer,-
(i)
refuses to accept a nomination under rule 78 or to entertain an
application sought to be filed under rule 79, or
(ii)
issues a notice under clause (1) of sub-rule (1) of rule 80 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 79 fails to issue notice as
required under rule 80 within the time specified therein, the claimant
employee, nominee or legal heir, as the case may be, may, within one
hundred eighty days of the occurrence of the cause for the application,
apply in Form-XIV 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 under this sub-rule, on sufficient cause being shown by the
applicant, after the expiry of the specified period.
(2) Application under clause (i) of sub-rule (1) rule 82 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.
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83.Procedure for dealing with application for direction.- (1)On receipt of an
application under rule 82 the competent authority shall, by issuing a notice in Form-XV, 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 may dismiss the application:
Provided that an order 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.
84.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.
85.Administration of oath.- The competent authority may authorise a clerk of his
office to administer oaths for the purpose of making affidavits.
86. 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-XV either to give evidence or
to produce documents or for both purposes on a specified date, time and place.
87. Service of summons or notice.- (1) Subject to the provisions of sub-rule (2) 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 (Central Act No. V of 1908).
(2)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.
88.Maintenance of records of cases by the competent authority.- (1)The
competent authority shall record the particulars of each case under section 56 and at the time
of passing orders shall sign and date the particulars so recorded.
426 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(2) 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.
(3) 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.
89.Direction for payment of gratuity.- If a finding is recorded under sub-rule (4)
ofrule 83 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-XVI 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.
90.Appeal.- (1)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.
(2) 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.
(3) 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.
(4) On receipt of the copy of Memorandum of appeal, the competent authority shall forward
records of the case to the appellate authority.
(5) 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.
(6) 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.
(7) 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.
(8) 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-XVIspecifying 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.
91. Application for recovery of gratuity.- Where an employer fails to pay the
gratuity due under the Code in accordance with the notice by the competent authority under
rule 89 or 90, as the case may be, 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-XVII for recovery thereof under section 129 of the Code.
92. Qualifications and experience of the officer appointed as the competent
authority under sub-section (1) of section 58.- The State Government may, by notification,
appoint any officer to be a competent authority, having such qualifications and experience as
may be specified, from time to time.
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PART-V
MATERNITY BENEFIT
93. Complaint and Appeal under section 72.- (1)A complaint under sub-section (1)
of section 72 shall be made in writing in Form-XVIII.
(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.
(3)An appeal against the decision of the Inspector-cum-Facilitator under sub-section (2) of
section 72 shall lie to the Competent Authority, as may be notified by the State Government,
from time to time.
(4) The aggrieved person shall prefer an appeal in writing to the Competent Authority in
Form-XIX and file other supporting documents.
(5) 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.
(6) Taking into account the documents, the evidence produced before him and the facts
presented to him or ascertained by him, the Competent Authority shall give his decision.
94. Duties and powers of the Competent Authority and Inspector-cum-
Facilitator under Chapter VI of theCode.- (1)The Competent Authority shall be
responsible for the administration of these rules their respective areasnotified.
(2) Every Inspector-cum-Facilitator shall discharge his duties within the area assigned to him
by the State Government and shall act under the supervision and control of the
CompetentAuthority.
(3) Every Inspector-cum-Facilitator shall at each inspection of an establishmentensure,-
(i)
whether due action has been taken on every notice given under section62;
(ii) whether the Register of women employees prescribed under rule 122 is
correctlymaintained;
(iii) whether there have been any cases of discharge or dismissal or notices of
discharge or dismissal in contravention of the provisions of section 68 since
the lastinspection;
(iv) whether the provisions of sub-section (1) of section 59, sub-sections (5) and
(6) of section 62, section 64, sub-sections (1), (2) and (3) of section 65 ,
sections 66, 67, 69 and 71 have been complied with and whether amounts due
have been paid within the prescribedtime;
(v)
whether there have been any cases of deprival of maternity benefit or medical
bonus in contravention of sub-section (2) of section 68;and
(vi) how far the irregularities pointed out at previous inspections have been
remedied and how far orders previously issued have been compliedwith.
(4) Where an Inspector-cum-Facilitator observes irregularities against the Code or these
Rules, he shall issue orders in writing to the employer asking the latter to rectify the
428 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
irregularities within a specified period and to report compliance to the Inspector-cum-
Facilitator.
95. Abstract.- The abstract of the provisions of the Chapter V of the Code and the
rules frame thereunder required to be exhibited under section 71 in such manner as the
Competent Authority mayrequire.
PART-VI
EMPLOYEE’S COMPENSATION
96. The amount to be deposited towards the expenditure of the funeral of the
employee with the competent authority by the employer under sub-section (7) of section
76.- If the injury of the employee result in his death, the employer shall, in addition to the
compensation under sub-section (1), deposit with the competent authority a sum of fifteen
thousand rupees, or such higher amount as may be notified by the State Government or the
Central Government from time to time,for the payment of the same to the eldest surviving
dependent of the employee towards the expenditure of the funeral of such employee or where
the employee did not have a dependent or was not living with his dependent at the time of his
death, to the person who actually incurred such expenditure.
97. 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 of the code may be made without being accompanied by a
certificate of a medical practitioner,-
(i)
by the employer, on the ground that since the right to compensation was
determined the employee’s wages have increased;
(ii) by the employer, on the ground that since the right to compensation was
determined the employee’s wages have diminished;
(iii) by the employee, on the ground that the employer, having commenced to pay
compensation, has ceased to pay the same notwithstanding the fact that there
has been no change in his condition such as to warrant such cessation;
(iv) either by the employer or by the employee, on the ground that the
determination of compensation was obtained by fraud or under influence
other improper means;
(v) either by the employer or by the employee on the ground that in the
determination of compensation there is a mistake or error apparent on the face
of the record.
98. Procedure for review.- If, on examining an application for review by an
employer in which the reduction or discontinuance of half-monthly payments is sought it
appears to the Competent Authority that there is reasonable grounds for believing that the
employer has a right to such reduction to discontinuance, he may at any time issue an order
after giving the employee likely to be affected thereby an opportunity of being heard for
withholding the half monthly payments in whole or in part pending his decision on the
application.
99. Procedure on application for commutation.- (1) Where application is made to
the Competent Authority under section 80 of the Code for redemption of a right to receive
half-monthly payments by the payment of a lump-sum, the Competent Authority shall form
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 429
an estimated of the probable duration of the disablement, and shall not a sum equivalent to
the total of half-monthly payments will would be payable for the period during which he
estimated the disablement will continue, less one-half per cent, of that total for each month
comprised in that period:
Provided that fractions of a rupee included in the sum so computed shall be
disregarded.
(2) When, in any case to which sub-rule (1) applies, the Competent Authority is unable to
form an approximate estimate of the probable duration of the disablement, he may from time
to lime postpone a decision on the application for a period not exceeding two months at any
one time.
100. Class of employers and the form of notice book under sub-section (4) of
section 82.- The State Government may, by making a general or specific order for the
purpose of sub-section (4) of section 82 of the Code, require that any class of employers,
shall maintain at their premises at which employees are employed, a notice book, in Form-
XX, which shall be readily accessible at all reasonable times to any injured employee
employed on the premises and to any person acting bonafide on his behalf.
101. The frequent interval for medical examination under the proviso to sub-
section (1) of section 84.- (1)An employee who is required by sub-section (1) of section 84
to submit himself for medical examination shall be bound to do so in accordance with the
rules contained in this part and not otherwise.
(2)When such employee is present at the employer's premises and the employer offers to
have him examined free of charge by a qualified medical practitioner who is so present, the
workman shall submit himself for examination forthwith.
(3)In other cases the employer may,-
(i) send the medical practitioner to the place where the employee is residing for
the time being, in which case the workman shall submit himself for medical
examination on being requested to do so by the medical practitioner; or
(ii) send an offer to the employee in writing to have him examined free of charge
by a medical practitioner, in which case the employee shall submit himself for
medical examination at the employer's premises or at such other place in the
vicinity as is specified in such offer and at such time as is so specified:
Provided that,-
(a) the time so specified shall not, save with the express consent of the
employee, be between the hours of 7 p.m. and 7 a.m.; and
(b) in case where the employee’s condition renders it impossible or
inadvisable that he should leave the place where he is residing for
the time being, he shall not be required to submit himself for
medical examination save at such place.
(4)An employee 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.
(5)If a workman whose right to compensation has been suspended under sub-section (2) or
sub-section (3) of section 84 of the Code subsequently offers himself for medical
examination, his examination shall take place on the employer's premises or at such other
place in the vicinity as may be fixed by the employer, and at a time to be fixed by the
employer not being, save with the express consent of the employee more than 72 hours after
the workman has so offered himself.
430 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(6) No woman shall without her consent be medically examined by a male practitioner, save
in the presence of another woman and no woman shall be required to be medically examined
by a male practitioner if she deposits a sum sufficient to cover the expenses of examination
by a female practitioner.
102. The statement to be submitted by the employer.- The statements, required to
be submitted under sub-section (1) of section 88, shall be,-
(i) the notice to be sent by a Competent Authority under sub-section (1) of section
88 of the Code shall be in Form-XXI and shall be accompanied by a blank copy
of Form-XXI;
(ii) the statement to be submitted by an employer under section 88 shall be inForm-
XXII; and
(iii) the report in respect of an accident under sub-section (1) of section 88 may be
sent to the authority to which the notice of such accident is required to be given.
103. Form of Memorandum.- Memorandum of an agreement to be sent to the
Competent Authority under sub-section (1) of section 89 shall, unless the Competent
Authority otherwise directs, be in duplicate and shall be in as close conformity as the
circumstances of the case admit with Form-XXIII or Form-XXIV or Form-XXV, as the case
may be.
104. Procedure where Competent Authority does not consider that he should
refuse to record memorandum.- (1) On receiving a memorandum of agreement, the
Competent Authority shall, unless he considers that there are grounds for refusing to record
the memorandum, fix a date for recording the same, and shall issue a notice in writing in
Form- XXVI to the parties concerned that in default of objections he proposes to record the
memorandum on the date so fixed:
Provided that the notice may be communicated orally to any parties who are present
at the time when notice in writing would otherwise issue.
(2) On the date so fixed, the Competent Authority shall record the memorandum unless, after
hearing any of the parties who appear and desire to be heard, he considers that it ought not to
be recorded:
Provided that the issue of a notice under sub-rule (1) shall not be deemed to prevent
the Competent Authority from refusing to record the memorandum on the date so fixed even
if no objection be made by any party concerned.
(3) If on such date, the Competent Authority decides that the memorandum ought not to be
recorded, he shall inform the parties present of his decision and of the reasons therefore, and
if any party desiring the memorandum to be recorded is not present, he shall send information
to that party in Form-XXVII.
105. Procedure where Competent Authority considers he should refuse to record
memorandum.- (1)If, on receiving a memorandum of agreement, the Competent Authority
considers that there are grounds for refusing to record the same, he shall fix a date for hearing
the party or parties desiring the memorandum to be recorded, and shall inform such party or
parties and, if he thinks fit, any other party concerned, of the date so fixed and of the grounds
on which he considers that the memorandum should not be recorded.
(2) If the parties to be informed are not present, a written notice shall he sent to them in
Form- XXVIII or Form-XXIX, as the case may be, and the date fixed in such notice shall be
not less than seven days after the date of the issue of the same.
(3) If, on the date fixed under sub-rule (1) the party or parties desiring the memorandum to be
recorded show adequate cause for proceeding to the record of the same, the Competent
Authority may, if information has already been given to all the parties concerned, recorded
the agreement. If information has not been given to all such parties, he shall proceed in
accordance with rule 103.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 431
(4)If, on the date so fixed, the Competent Authority refuses to record the memorandum, he
shall send notice inForm-XXVII to any party who did not receive information under sub-rule
(1).
(5) If, in any case, the Competent Authority refuses to record a memorandum of agreement,
he shall briefly record his reasons for such refusal.
(6) If, the Competent Authority refuses to record a memorandum of agreement, he shall not
pass any order directing the payment of any sum or amount over and above the sum specified
in the agreement, unless opportunity has been given to the party liable to pay such sum to
show-cause why it should not be paid.
(7) Where the agreement is for the redemption of half monthly payments by the payment of
lump-sum, and the Competent Authority considers that the memorandum of' agreement
should not be recorded by reason of the inadequacy of the amount of such sum as fixed in the
agreement, he shall record his estimate of the probable duration of the disablement of the
workman.
106. Registration of memorandum accepted for record. - In recording a
memorandum of agreement, the Competent Authority shall cause the same to be entered in a
register in Form- XXX and shall cause an endorsement to be entered under his signature on a
copy of the memorandum to be retained by him in the following terms, namely :-
"This memorandum of agreement bearing serial No........of.......20.........
in the register has been recorded this day.......of........20.......
Signature of Competent Authority"
107. Appointment of Competent Authority.- The State Government may, by
notification, appoint any person as a Competent Authority, having qualifications referred to
in sub-section (1) of section 91.
108. Manner of the notice under sub-section (1) and the manner of transmitting
money under sub-section (3) of section 92.- (1)A Competent Authority transferring any
matter to another Competent Authority for report in accordance with sub-section (2) of
section 92 shall, along with the documents referred to in that sub-section, transmit to such
other Competent Authority a concise statement, in the form of questions for answer, of the
matter on which report is required.
(2) A Competent Authority to whom a case is so transferred for report shall not be required to
report on any question of law.
(3) Money transmitted by one Competent Authority to another in accordance with sub-section
(2) of section 92 shall be transmitted either by remittance transfer receipt, or by money order,
or by messenger, as the Competent Authority transmitting the money may direct.
109. Manner in which matters of claim or settlementmay be dealt with by or
before a competent authority.- (1) Save as otherwise provided in these rules, the procedure
to be followed by Competent Authorities in the disposal of cases under the Act or these rules
and by the parties in such cases shall be regulated in accordance with the rules contained in
this part.
(2) Any application of the nature referred to in section 93 may be sent to the Competent
Authority by registered post or may be presented to him or to any of his subordinate
authorised by him in this behalf and, if so sent or presented, shall unless the Competent
Authority otherwise directs, be made in duplicate in From-XXXI, From-XXXII or From-
XXXIII, as the casemaybeand shall be signed and verified by the applicant in the manner
prescribed by Order VI Rule 15 of the Code of Civil Procedure 1908 (Central Act No. V of
1908).
(3) When the application for relief is based upon a document, the document shall be
appended to the application and any other document which the applicant desires to tender in
432 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
evidence shall be produced at or before the first hearing. Any document which is not
produced along with application or before the first hearing shall not, without the sanction of
the Competent Authority, be received in evidence on behalf of the applicant. Nothing in this
rule applies to any document which is produced for the purposes of cross-examining a
witness or is handed to a witness to refresh his memory.
(4)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 and 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 (10), accordingly.
(5) The Competent Authority to whom an application is transferred under sub-rule (4) may
continue the proceedings as if the previous proceedings or any part of them had been taken
before him, if he is satisfied that the interest of the parties will not thereby be prejudiced.
(6) On receiving the application of the nature referred to in section 92 or section 93, the
Competent Authority may examine the applicant and his witness, if any, on oath and the
substance of any examination made shall be recorded in the manner provided for the
recording of evidence in section 97.
(7) The Competent Authority may, after considering application and the result of any
examination of the applicant under the sub-rule (6) summarily dismiss the application if, for
reasons to be recorded, he is of opinion that there are no sufficient grounds for proceeding
thereon.
(8) The dismissal of the application under sub-rule (7) shall not itself preclude the applicant
from presenting a fresh application for the settlement of the same matter.
(9) If the application is not dismissed under sub-rule (7), 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.
(10) If the Competent Authority does not dismiss the application under the sub-rule (7) or (9),
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 date on which he will
dispose of the application and may call upon the parties to produce upon that date any
evidence which they may wish to tender.
(11) The opposite party may, and if so required by the Competent Authority, shall, at or
before the first hearing or within such time as the Competent Authority may permit, file a
written statement dealing with the claim raised in the application, and any such written
statement shall form part of the record and 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.
(12) After considering the written statement and the result of any examination of the parties,
the Competent Authority shall ascertain upon what material propositions of fact or of 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. 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.
(13) 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
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 433
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.
(14)The Competent Authority shall maintain under his hand a brief diary of the proceedings
on an application.
(15) If the Competent Authority finds it impossible to dispose of an application at one
hearing he shall record the reasons which necessitates a postponement.
(16)The Competent Authority in passing orders, shall record concisely a judgment, and his
finding on each of the issues framed and his reasons for such finding. 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
a clerical or arithmetical mistake arising from any accidental slip or omission.
(17)If an application is presented by any party to the proceedings for the citation of witnesses,
the Competent Authority shall on payment of expenses and fees, issue summons for the
appearance of such witnesses, unless he considers that their appearance is not necessary for
the just decision of the case.
(18)If the Competent Authority is satisfied that the applicant is unable by reason of poverty to
pay the prescribed fees, he may remit any or all of such fees. If the case is decided in favour
of the applicant, the prescribed fees which had they not been remitted, would have been due
to be paid, may be added to the costs of the case and recovered in as the Competent Authority
in its order regarding costs may direct.
110. Local Inspection.- (1)A Competent Authority before whom any proceeding
relating to an injury by accident is pending may at any lime enter the place where the
workman was injured, or where the workman ordinarily performed his work, for the purpose
of making a local inspection or of 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.
(2) 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 representative notice of his intention to conduct such inspection, unless in his
opinion the urgency of the case renders the giving of such notice impracticable. 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 (2) of section 88, or to the
representatives of any such person. Any party, or the representative of any party, may
accompany the Competent Authority at a local inspection.
(3) The Competent Authority, after making 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 fees, shall supply any party with a copy
thereof. The memorandum shall form part of the record.
(4) 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 relating to such case, whether such person has been or is to called as a
witness in the case or not, and whether any or all of the parties are present or not. No oath
shall be administered to a person examined under this sub-rule.
(5) Statements made by persons examined under sub-rule (4), 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 utilised by the Competent Authority for the purpose of
arriving at a decision in the case.
434 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
(6) If a witness who has been examined under sub-rule (4), makes in evidence any material
statement contradicting any statement made by him in such examination and reduced 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 witness.
(7) Any statement or part of a statement which is furnished to the parties under sub-rule (6)
shall be incorporated in the record.
111. Settlement by Agreement.- Where a case is settled by agreement between the
parties, the Competent Authority may incorporate in the record any statement made under
sub-rule (4) of rule 110 and may utilize such statement for the purpose of justifying his
acceptance of, or refusal to accept, the agreement reached.
112. Agreement to abide by Competent Authority's decision.- If a party states in
writing his willingness to abide by the decision of the Competent Authority, the Competent
Authority shall inquire whether the other party is willing to abide by his decision and if the
other party agrees to abide by the Competent Authority's decision, the fact of his agreement
shall be recorded in writing and signed by him but if the other party does not agree to abide
by the Competent Authority's decision, the first party shall not remain under an obligation so
to abide.
113. Procedure where indemnity claimed under sub-section (2) of section 85.- (1)
Where the opposite party claims that if compensation is recovered from him he will be
entitled under sub-section (2) of section 85 to be indemnified by a person not being a party lo
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-XXXIV.
(2) If any person served with a notice under sub-rule (1), 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; and in default of so appearing he shall be deemed to admit the validity of
any award made against the opposite party and to admit its own liability to indemnify the
opposite party 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 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.
(3) If any person served with a notice under sub-rule (1), whether or not he desires to contest
the applicant's claim 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-rule (1), 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-XXXV.
(4) If any person served with a notice under sub-rule (3) desires to contest the applicant's
claim for compensation, or the claim under sub-rule (3) to be indemnified he shall appear
before the Competent Authority on the date fixed in the notice in Form-XXXV 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 original opposite party or the person served with a notice under sub-
rule (1) and to admit his own liability to indemnify the party against whom such award is
made for any compensation recovered from him:
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 435
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.
(5) In any proceeding in which a notice has been served on any person under sub-rule (1) or
sub-rule (3), 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.
114. Procedure in connected cases.- (1)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 issue is
concerned, be heard simultaneously.
(2) Where action is taken under sub-rule (1), 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 records of any such other case, the extent to which the evidence so
recorded 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.
115. Certain provisions of Code of Civil Procedure, 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 namely, those contained in Order V rule 9 to
13 and 15 to 30, Order IX. Order XII rule 3 to 10, Order XVI rule 2 to 21, Order XVII, Order
XVIII rule 1 and 2 shall apply to proceedings before Competent Authorities, in so far 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 substantive 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.
116. Provisions regarding signature of forms.- Any form, other than a receipt for
compensation, which is by these rules required to be 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.
117. Apportionment of compensation among dependents.- The provisions of this
part except those contained in sub-rule (10) and (11) of rule 109 and rule 113 shall, as far as
may be, apply in the case of any proceedings relating to the apportionment of compensation
among dependents of a deceased workman.
118. The manner of authentication of memorandum under section 97.- The
competent authority shall make a brief memorandum of the substance of the evidence of
every witness as the examination of the witness proceeds, and such memorandum shall be
authenticated under the hand of the competent authority.
436 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
PART-VII
FINANCE AND ACCOUNTS
119. 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.-(1) Subject to the provisions of sub-rule (3) and such conditions as
may, from time to time, be laid down by the Board, the Member Secretary or the Secretary,
as the case may be, may, for the purposes of the Code, acquire on behalf of the Board
movable or immovableproperty:
Provided that sanction of the State Government shall be required for the exchange of
any immovable property, for the taking of any property on lease for a term exceeding thirty
sixmonths, or for the acceptance of any gift or be quest of property burdened an obligation.
(2) Subject to the provisions of sub-rule (3) and such conditions as may be laid down by the
Board from time to time, the Member Secretary or the Secretary, as the case may be, may,-
(i)
dispose of, by sale or exchange, any movable property belonging to the Board, the
value of which does not exceed rupees ten lakhin each case, or grant for any term
not exceeding twelve months a lease of any immovable property belonging to
theBoard.
(ii) with the sanction of the State Government, lease, sell or otherwise dispose of any
movable or immovable property belonging to theCorporation.
(3)The Board may enter into and perform all such contracts as it may consider necessary or
expedient for carrying out its duties under theCode. Every contract made under or for any
purpose of the Code shall be made on behalf of the Board by the Member Secretary or the
Secretary, as the case may be:
Provided that the sanction of the State Government shall be obtained in respect of any
contract involving an expenditure exceeding rupees fifty lakh.
(4) Every contract entered into by any person as provided in sub-rule (3) shall be entered into
in such manner and form as would bind him if it were made on his own behalf and may in
like manner and form be varied or discharged:
Provided that the common or official seal, as the case may be, of the Board shall be
affixed to every contract for amounts exceeding rupees five lakh.
(5)The Board may, in pursuance of a resolution passed at a meeting of the Board, and with
the prior approval of the State Government, raise loans for the purposes of the Code. In
particular and without prejudice to the generality of the foregoing power, the Board may raise
loans,-
(i) for the acquisition of land and/or the raising of buildings thereon;or
(ii) to repay a loan raised under this sub-rule;or
(iii) for any other purpose approved by the StateGovernment.
(6) All loans under sub-rule (5) shall be obtained,-
(i) from the State Government on such rates of interest and such terms as to the time
and method of repayment as the State Government may specify;or
(ii) with the approval of the State Government from such bank or banks specified in
sub-rule (8),-
(a) where a loan is obtained from such bank or banks the Board may, with the
approval of the State Government, grant mortgages of all or any of the
property vested in it for securing the repayment of the sums so advanced,
withinterest.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 437
(b) all payments due from the Board for interest on and repayment of loans shall
be made in such manner and at such times as may have been agreedupon:
Provided that the Board may apply any sums, which can be so applied,
in repayment of any amount due in respect of the principal of any loan
although the repayment of the same may not be due.
(c) no expenditure incurred out of a loan shall be charged by the Board to capital,
except with the previous sanction or under the direction of the State
Government.
(d) the Corporation shall submit to the State Government an annual statement by
the thirtieth of April each year showing the loans raised and repayments made
during the precedingyear.
(7) The Board may, as soon as, after the coming into force of these rules constitute a fund to
be called the Rajasthan Social Security Fund in accordance with the provisions of the Code
and these rules. The fund shall vest in and be administered by the Board.
(8)All moneys belonging to the Board may be invested in Nationalised Bank(s) or in
securities referred to in clause (a) to (d) of section 20 of the Indian Trust Act, 1882 (Central
Act No. 2 of 1882)
(9) In pursuance of sub-section (3) of section 120 of the Code, the Board may raise loan or
receive fund in advance form the State Government and shall repay such loan or return such
advance, as the case may be, in accordance with terms and condition as may be specified by
the State Government.
120. Conditions and manner of writing off irrecoverable dues under section 121.-
Where the Board is of the opinion that any amount of contribution, cess, interest and damages
due to the Board has become irrecoverable, the Board or any other officer authorised by it in
this behalf, with prior approval of the State Government, may sanction the writing off of the
said amount, subject to the following conditions, namely:-
(i)
establishment has been closed for more than five years and the whereabouts of
the employer cannot be ascertained, despite all possible efforts;
(ii) decree obtained by the Board could not be executed successfully for want of
sufficient assets of the defaulting employer; or
(iii) claim for amount due is not fully met by,-
(a) the Official Liquidator in the event of factory/establishment having gone
into liquidation; or
(b) the Competent Authority of payments in the event of unit being
nationalised or taken over by the Government.
PART-VIII
AUTHORITIES, ASSESSMENT, COMPLIANCE AND RECOVERY
121. Other powers of Inspector cum-facilitator under clause (e) of sub-section (6)
of section 122.- The Inspector cum-facilitator may exercise powers referred to in rule 94 and
such others powers which may be specified by the State Government for efficient discharge
of duties by Inspector cum-facilitator, from time to time.
122. Form and manner formaintenance of records and registers and other
particulars and details under clause (a), manner and form for display of notices at the
work places of the employees under clause (b) and the manner and period of filing
returns to the officers or authority under clause (d) of section 123.- (1)The employer of
every establishment in which women are employed shall prepare and maintain a register of
438 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
women employees in Form-XXXVIelectronically or in hard copy and shall enter therein
particulars of all women workers in the establishment. Further, it shall always be available for
inspection under notified inspection scheme for the Inspector-cum-Facilitator.
(2) The employer shall enter in the register of women employees such other particulars as
may be required for any other purpose of the Code.
(3) Records as perthe provisions Chapter V of the Code and the rules framed thereunder shall
be preserved for a period of two years from the date of their preparation.
(4) The employer to which the provisions of Chapter V of the Code applies, on or before the
1st day of February in each year, upload a unified annual return in Form-XXXVII online on
the web portal of the State Government in the Labour Department, giving information as to
the particulars specified, in respect of the preceding year:
Provided that during inspection, the Inspector-cum-Facilitator may require the
production of accounts, books, register and other documents maintained in electronic form or
otherwise.
Explanation: For the purposes 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 No. 21 of 2000).
(5) 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 in the Labour Department, a further unified return in Form-
XXXVII referred to in sub-rule (4) in respect of the period between the end of the preceding
year and the date of the sale, abandonment or discontinuance.
PART-IX
COMPOUNDING OF OFFEENCES
123.
Compounding
of
offences.-
(1)
The
officer
authorised
by
the
StateGovernmentby notification, for thepurposes of compounding of offences under sub-
section (1) of section 138 shall issueelectronically a compounding notice in Form-
XXXVIIIfor the offences which are compoundableunder section 138.
(2) The person so noticed under sub-section(1) may apply in Part III of the Form-
XXXVIIItothe officer electronically and deposit the entire compounding amount by
electronic transfer orotherwise, within fifteen days of the receipt of the notice.
(3) The Compounding Officer shall issue a composition certificate in Part IV of Form-
XXXVIIIwithin ten days of receipt of the composition amount, to such person from whom
such amounthas been received in satisfaction of the composition notice.
(4) If a person so noticed fails to deposit the composition amount within the time specified
bythe Compounding Officer, the prosecution shall be instituted before the Competent
Courtagainst such person for the offences in respect of which the compounding notice was
issued.
(5) For the compounding of an offence after the institution of prosecution in a Competent
Courtin respect thereof, the provisions of sub-section (6) of section 138 shall apply.
PART-X
MISCELLANEOUS
124. Such other sources of funding and the manner of administering and
expending of the Fund under sub-section (5) of section 141.- (1)All the following funds
received shall be credited to separate account(s) and called State Social Security Fund and all
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 439
expenses towards the scheme(s) under sub-section (2) of section 109 for the unorganised
workers shall be met out of this fund,-
(a) under sub-section (1) of section 110 of the Code on Social Security, 2020 (Central
Act No. 36 of 2020),
(b) under sub-section (5) of section 141 of the Code on Social Security, 2020 (Central
Act No.36 of 2020),
(c) under sub-section (1) of section 115 of the Occupational Safety, Health and
Working Conditions Code, 2020 (Central Act No.37 of 2020),
(d) corporate social responsibility fund within the meaning of the Companies Act,
2013 (Central Act No.18 of 2013), and
(e) any other source as may be specified in the scheme(s) by the State Government,
from time to time.
(2) The State Government may identify the source(s) for initial funding or replenishing of
State Social Security Fund, from time to time.
(3) The fund shall be administered by the State Government through a department designated
by the State Government in the manner, as notified by the State Government.
(4) Directions of the State Government, if any, shall be complied by the agency designated by
the State Government.
(5) The statement of accounts of State Social Security Fund shall be maintained by the
agency, in the form(s) and manner as specified by the State Government and shall be
submitted to the State Government, from time to time.
125. Repeal and savings.- (1) On and from the date of commencement of these
rules,-
(i)
The Rajasthan Employees’ Insurance Court Rules, 1959;
(ii) The Rajasthan Employees’ State Insurance (Medical Benefit Services
System) Rules, 1955;
(iii) The Rajasthan Workmen’s Compensation Rules, 1960;
(iv) The Rajasthan Workmen’s Compensation (Occupational Diseases) Rules,
1965;
(v) Rajasthan Maternity Benefit Rules, 1967;
(vi) The Rajasthan Payment of Gratuity Rules, 1973; and
(vii) The Rajasthan Un-organised Workers’ Social Security Rules, 2011, are
hereby repealed.
(2) The repeal of the rules specified in sub-rule (1) shall not,-
(i) revive anything not in force or existing at the time of such repeal; or
(ii) affect the previous operation of any rules so repealed and orders or anything
duly done or suffered thereunder; or
(iii) affect any right, privilege, obligation, or liability acquired, accrued or
incurred under the rules so repealed or orders issued under such repealed
rules:
(iv) affect any investigation, inquiry, verification, adjudication and any other
legal proceedings or recovery of arrears or remedy in respect of any such
rights, privilege, obligation, liability, forfeiture or punishment, as aforesaid,
and any such investigation, inquiry, verification proceedings, adjudication
and other legal proceeding or recovery of arrears or remedy may be
instituted, continued or enforced, and any penalty, fine, interest, forfeiture or
440 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
punishment may be levied or imposed as if these rules had not been so
repealed; or
(v) affect any proceedings including that relating to an appeal, revision, review
or reference, instituted before, on or after the commencement of these rules
and such proceedings shall be continued under the said repealed rules as if
these rules had not come into force and the said rules had not been repealed.
(3) The mention of the particular matters referred to in sub-rules (2) above shall not be held
to prejudice or affect the general application of provisions of the General Clauses Act, 1897
(Central Act No. 10 of 1897) with regard to the effect of repeal.
Form-I
(See sub-rule (3) of rule 42)
In the Employees’ Insurance Court at ………………
A B (add description and residence)……………………………… Applicant
Against
C D (add description and residence) …………………………….. Opposite party,
Other particulars of the application specified in rule……...
Date …………………….
Signature of the 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 of the applicant
----------------
Form-II
(Seesub-rule (4) of rule 43 and sub-rule (1) of rule 51)
List of document produced by applicant/Opposite party
(Title) e.g., Description, Subject, Name of the Court, No. etc.
S.
No.
Description of
Document(s)
Date, if any, which the
document bears
Signature of party or pleader or
any authorized representative.
(1)
(2)
(3)
(4)
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 441
Form-III
(See rule 44)
Register of Proceedings
Employees’ Insurance Court at …………..
Register of Proceedings in the year 20………
Date of
presentation
of application
No. of
Proceedings
Name
Description
Place of residence
1
2
3
4
5
Name
Opposite party
Description
Place of
residence
Particulars
Claim
Amount or
value if any
When the
cause of
action
accrued
6
7
8
9
10
11
Day for the
parties to
appear
Appearance
Applicant
Opposite
party
Date
Final Order
For whom
For what, of
amount
12
13
14
15
16
17
Appeal Execution
Other
Date
of
decision
of
appeal,
If any
Judgment
of appeal
Date of
applica-
tion
Againts
whom
For
what &
amount
of
money
Amount
of cost
Date
of
order
trans-
fering to
another
Civil
Court of
…..at
Re
mark if
any
18
19
20
21
22
23
24
25
442 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-IV
(See sub-rule (1) of rule 47)
Summons for disposal of proceedings
(Title)
To
…………………………
(Name, description and place of residence).
Whereas ………………….has instituted proceeding against you for ……………..
You are hereby summoned to appear in this Court in person or by authorized agents duty
instructed and able to answer all material questions relating to the case, or who shall be
accompanied by some person able to answer all such questions at ……… O’clock in the
…………noon on the …………. Day of …………..20.., to answer the claim, and the day
fixed for your appearance is appointed for the final disposal of the proceedings, you must be
prepared to produce on that day all the witnesses, upon whose evidence and all the
documents upon which you intend to rely in support of your defence.
Take notice, that, in default of your appearance on the before mentioned the case will
be heard and determined in your absence.
Given under my hand and the seal of the Court, this …………. Day of ………….20...
Court
NOTICE –
1. Should you apprehend your witnesses will not attend of their own accord, you can
have a summons from this Court to compel the attendance of any witness, and the
production of any document that you have a right to call on the witness to produce, on
applying to the Court and on depositing the necessary expenses.
2. If you admit the claim, you should pay the money into Court together with the cost of
the proceedings, to avoid execution of the, which may be passed against your person
or property or both.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 443
Form-V
(See sub-rule (1) of rule 47)
Summons for Settlement of issues
To
(Name, description and place of residence).
Whereas …………………. has instituted proceeding against you for ……………..
You are hereby summoned to appear in this Court in person or by authorized agents duty
instructed and able to answer all material questions relating to the proceedings, or who shall
be accompanied by some person able to answer such questions at ……… O’clock in the
………… noon on the …………. day of …………..19, to answer the claim, and you are
directed to produce on that day all the documents upon which you intend to rely in support of
your defense.
Take notice that, in default of your appearance on the day before mentioned the case
will be heard and determined in your absence.
Given under my hand and the seal of the Court, this …………. day of ………….20.
Court
Notice-
1. Should you apprehend your witnesses will not attend of their own accord, you can
have a summons from this Court to compel the attendance of any witness, and the
production of any document that you have a right to call on the witness to produce, on
applying to the Court and on depositing the necessary expenses.
2. If you admit the claim, you should pay the money into the Court together with the
cost of the suit, to avoid execution of the decree, which may be passed against your
person or property or both.
444 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-VI
(See sub-rule (5) and (6) of rule 55)
(Title)
Subject-Application for setting aside the Ex parte order
The ………………. above named states as follows:-
(The ground of application should be stated)
Date …………………….
Signature of the applicant
…………………….
(Verification by the Applicant)
The statement of facts contained in the application is, to the best of may knowledge
and belief, true and correct.
Date …………..
Place ……………
Signature
…………………..
Form-VII
(See sub-rule (5) and (6) of rule 55)
General Form
(Title)
To
Whereas the above named ………… has made application to this
…………………. You are herby warned to appear in the Court in person or by a pleader duly
instructed at ……….. O’ clock in the…………… noon, on the ………….Day of
………20…., to show cause against the application failing wherein, the said application will
be heard and determined ex-parte.
Given under my hand and the seal of the Court this ……….. day of ……20….
COURT
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 445
Form-VIII
(See sub-rule (2) of rule 56)
Summons to witness
(Title)
Whereas your attendance is required to……….on behalf of the ……………….in the
above proceedings, you are hear by required (personally) to appear before this Court o the
…………. Day of ……………. 20 at O’clock in the ………. Noon, and to bring will you (or
to send to this ………. Court)……………
A sum of Rs……………. Being your travelling and the other expenses and
subsistence allowance for one day, is deposited with this Court and will be tendered to you on
the day you appear before the Court. If you fail to comply with this order without lawful
excuse, you will be subject to the consequence of non-attendance laid down in rule 12 of
order XVI of the Code of Civil Procedure, 1908 (Central Act No. V of 1908).
Given under my hand and the deal of the Court, this day of 20……….
COURT
Notice-
1. If you are summoned only to produce a document and not to give evidence, you shall
be deemed to have complied with the summons if you cause such document to be
produced in this Court on the day and hour aforesaid.
2. If you are detained beyond the day aforesaid, a sum of Rs ……..will be tendered to
you for each day’s attendance beyond the day specified.
Form-IX
(See sub-rule (1) of rule 69)
Decree in case
Claim for
(Title)
This case coming on this day of final disposal before ……… in the presence of
…………..for the applicant and of …………..for the opposite party, it is ordered and decreed
the …………..and that the sum of Rs ……….be paid by the …………..to the
…………….on account of the costs of this suit, with interest thereon at the rate of
……..percent. per annum from this date to the date of realisation.
Given under my hand and the deal of the Court, this …......... day of ……….. 20….
COURT
Costs of Suit
Rs.
Rs.
Stamp for application
Stamp for power
Stamp for power
Stamp for written statement
Stamp for exhibits
Pleader’s fee
Pleader’s fee
Subsistence for witness
Subsistence for witnesses
Service of summons and Notices
Competent Authority’s fee
Competent Authority’s fee
Service of summons and Notices
Total …………………..
Total …………………..
446 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-X
(See sub-rule (1) of rule 71)
Application for the Execution of Decree
In the Court of ………………………………………………………………decree
holder, hereby applies for execution of the decree herein below set forth.
Number
of Proceedings
Name of Parties Date of decree
Whether
any
appeal
preferred from
decree
Payment
of
adjustment
made, if any
1
2
3
4
5
Pervious
application, if any,
with date and result
Amount with interest due
upon the decree or other
relief
granted
thereby
together with particulars of
any cross decree
Amount
of
costs, if any,
awarded
Against
whom
to be executed
6
7
8
9
Mode in which the assistance of the Court is required
10
(When attachment and sale of movable property is sought)
I pray that the total amount of Rs………… (together with interest on the principal sum up
to the date of payment) and the cost of taking out this execution be realized by attachment
and sale of the opposite party’s movable property as per annexed list and paid to me.
(When attachment and sale of immovable property is sought)
I pray that the total amount of Rs………… (together with interest on principal sum up to
date of payment) and the cost of taking out this execution be realised by attachment and sale
of the opposite party’s immovable property specified at the foot of this application and paid
to me
I ………….declare that what it stated herein is true to the best of my knowledge and belief.
Date, the …………… day of 20...
Signature ……………..
Decree holder
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 447
Form-XI
(See sub-rule(1), (2), (3) and (4) of rule 78)
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 …………………(mention 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).
Or
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)
S.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
1.
2.
3.
So on
448 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
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:
Village…………………. Thana……..……………… Sub-division……………………….
Post-Office………………………… Pin-Code………… District…………………
State……………………………
E-mail
ID…………………………………Mobile
Number……………………
Place:
Date:
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
Date
Signature of the employer/Officer authorised
Designation
Name and address of the establishment or
rubber stamp thereof.
Acknowledgement by the Employee
Received the duplicate copy of nomination in Form-XI filed by me and duly certified by the
employer.
Date: ………………….
Signature of the Employee
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 449
Form-XII
(See sub-rule (1), (2) and (3) of rule 79)
Application for Gratuity by an Employee/Nominee/Legal Heir
(Strike out the words not applicable)
To,……………………………………………………………………………
(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), beg 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;
(c) death of aforesaid employee of your establishment while in service/superannuation
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.
1. 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
or
2. 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
3. Department/Branch/Section where last employed
4. Post held by employee.
5. Date of appointment.
6. Date and cause of termination of service
7. Date of Death
450 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
8. Total period of service of the employee
9. Total wages last drawn by the employee.
10. Total gratuity payable to the employee/ share of gratuity claimed by a nominee/legal heir.
11. Payment may please be made by crossed bank cheque/credit in my bank account no…...
Yours faithfully,
Signature/Thumb-impression of the
applicant/employee/nominee/legal heir.
Place:
Date:
Form-XIII
(See sub-rule (1), (2), (4) and (5) of rule 80)
Notice for Payment/Rejecting claim of Gratuity
(Strike out the words not applicable)
To,………………………………………………………………………………………………
…………………………
(Name and address of the applicant employee/nominee/legal heir)
You are hereby informed that
(a) *as required under sub-clause (ii) of sub-rule (1) of rule 80 that your claim for payments
of gratuity as indicated on your application in Form-XII under the said rules is not admissible
for the reasons stated below:
Reasons(Here specify the reasons); or
(b) *as required under sub-clause (i) of sub-rule (1) of rule 80that a sum of Rs.
………..(Rupees…………………) is payable to you as gratuity/as your share of gratuity in
terms of nomination made by ………………..on …………………and……………recorded
in this …………………as a legal heir of………………….an employee of this establishment.
2.*Please call at ……………………..on………………………… (Here specify
place)……………………..(date) at……………….(time) for collecting your payment
of gratuity crossed cheque.
3. Amount payable shall be sent to you through demand draft or shall be credited in your
bank account as desired by you.
4. Brief statement of calculation
(a) Date of appointment.
(b) Date of termination/superannuation/resignation/ disablement/death.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 451
(c) Total
period
of
service
of
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 paragraph, if not applicable
Place:
Date:
Signature of the Employer/authorised officer
Name or description of establishment or
Rubber stamp thereof.
Copy to: The Competent Authority in case of denial of gratuity.
Copy also to: Office of DG Labour Bureau, Ministry of Labour and Employment,
Chandigarh.
Form-XIV
(See sub- rule (1) of rule 82 )
Application for Direction
Before the Competent Authority for Chapter V under the Code on Social Security, 2020
Application No.
Date
BETWEEN
(Name in full of the applicant with full address)
AND
(Name in full of the employer concerned with full address)
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………………………… 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 Rajasthan
Code on Social Security Rules, 2021 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-
452 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
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.
Date:
Signature/Thumb impression of the applicant.
ANNEXURE
1. Name in full of applicant with full address
2.
Basis
of
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
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 453
Form-XV
(See rule 86)
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 (1) of rule 83alleging 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/ defense.
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.
List of documents-
1.
2.
3. so on
Given under my hand and seal, this …………..day of …………..20…..
Competent Authority
under the Code on Social Security, 2020
Note:
1. Strike out the words and paragraphs not applicable.
2. The portion not applicable to be deleted.
3. The summons shall be issued in duplicate. The duplicate is to
be signed and returned by the person served before the date
fixed.
4. In case the summons is issued only for producing a document
and not to give evidence it will be sufficient compliance to the
summons if the documents are caused to be produced before
the Competent Authority on the day and hour fixed for the
purpose.
454 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XVI
(See rule 89 and sub-rule (8) of 90)
Notice for Payment of Gratuity as Determined by Competent/Appellate Authority
(Strike out the words not applicable)
To,
(Name and address of employer)
1.
Whereas
Shri/Smt./Kumari……………………………………
of
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
offs…………………..
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.
2. The Appellate Authority if applicable.
Note.- (Strike out paragraphs, if not applicable)
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 455
Form-XVII
(See rule 91)
Application for Recovery of Gratuity
Before the Competent Authority for Chapter V under the Code on Social Security, 2020
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 rule 91 for payment of a sum of
Rs………………….. as 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 of the
Code 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.
456 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XVIII
(See sub-rule (1) of 93)
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 72 of the Code on Social
Security, 2020 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 thereunder, 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 Chapter VI of the 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.
Signature or thumb impression of the Woman/
nominee/ legal representative
Date…………
Signature of an Attester in case the woman/
nominee/legal representative is
unable to sign and affixes thumb impression.
Full address of the women/nominee/legal representative.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 457
Form-XIX
(See sub-rule (4) of 93)
Appeal
To,
The Authority,
(Appointed under the Code on Social Security, 2020)
……………………………………………(Address)
Sir,
I………, the undersigned, woman employee of……… (name and full address of 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 cum Facilitator in this behalf is enclosed; or
*Shri……, Inspector-cum-Facilitator, having directed under 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 discharger dismissal during or on
account of absence from work in accordance with the provisions of this Chapter V of the
Code on Social Security, 2020 *(Strike out 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 other documents filed herewith it is submitted that
the woman 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 unnecessary portion.
Signature or thumb impression of the Women/Aggrieved person
Date………
…………………………………………………………………..
Signature of an Attester in case the woman is
not able to sign and affixes thumb impression.
Full address of the nominee/legal representative
458 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XX
(See rule 100)
Notice Book of Accidents
[To be filled up by or on behalf of workman]
Date and time of accident
…………………………………………………………………………………………
Date and time of notice
…………………………………………………………………………………………….
Name of person injured
……………………………………………………………………………………………
Address………………………………………………………………
Mobile No………………………………
Cause of injury………………………………………………………………………………….
Signature or thumb-impression of person giving notice
Mobile No………………………….
[To be filled up by the employer or his agent]
Rate of wages of injured employee …………………………………………………………
Place of accident ………………………………………………………………………………
Nature of injuries…………………………………………………………………………
Names of eye-witnesses………………………………………………………………………
Note of circumstances…………………………………………………………………………
…………………………………………………………………………………………………
Form XXI
(See clause (i) of sub-rule (1) of 102)
Whereas I have received information that (1) ............. a workman employed by you in
(2)...........has died, as the result of an accident arising out of and in the course of employment.
I hereby require you in accordance with sub section (1) of Section 88 of Code on Social
Security,2020 to submit to me within 30 days of the receipt of this notice the enclosed form
with the particulars required in paragraphs 1 and 2 and the particulars required in either
paragraph 3 or paragraph 4 duly filled in. In the event of your admitting liability to pay
compensation, the necessary deposits must, under sub section (1) of Section 88 of the Code.
be made within 30 days of the receipt of this notice.
.....................................
Competent Authority for Employees’ Compensation
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 459
Form-XXII
(See clause (ii) of sub-rule (1) of 102)
1. In reply to your notice, dated the......................20...., which was received by me on the
........ 20......., it is submitted that (1) ...... residing at/workmen over/under 15 years of
age and I employed in (2).........met with an accident on the..........20......, as a result of
which he died on the.......20.......The monthly wages of the deceased amounted to
Rs............
2. The circumstances in which the deceased met his death were as follows :-
.....................................................................
.....................................................................
3. I admit liability to pay as compensation on account of the deceased's death the amount
of Rs……………. which was/will be deposited with you on or before the 20....
4. I disclaim liability to pay compensation on account of the deceased's death on the
following grounds :-
(1) Insert name of workman...............
(2) Insert name of establishment.................
...............
Signature of Employer or his agent
Form-XXIII
(See rule 103)
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 workman whereby it is
estimated that he will be prevented for earning more than of his previous wages for a period
of.............month. The said workman has been in receipt of half-monthly payment which has
continued
from
the.............day
of..........20.................until
the..........day
of.............20............................amounting to Rs...............in all.
The said workmen's monthly wages are estimated at Rs........ The Workman 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 workman has agreed to pay, and the said workman has agreed to accept the sum of
Rs....... in full settlement of all and every claim under the Social Security Code 2020, 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..........20...
460 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Signature of employer
Witness .............................
Signature of Workman
Witness........................
Note - An application to register an agreement can be presented under 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)
In accordance with the above agreement, I have this day received the sum of Rs..........
Date...............20....
Signature of Workman
The money has been paid and this receipt is signed in my presence.
Witness.............
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 461
Form-XXIV
(See rule 103)
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 his
employment in ............. The said injury has resulted in permanent disablement to the said
workman of the following nature, namely,…………………………………. The said
workman's monthly wages are estimated at Rs..........
The workman is over the age of 15 years/will reach the age of 15 years on..........
Rs............on............Rs......................on...........................
It is further submitted that ............ the employer of the said workman, has agreed to pay, and
the said workman has agreed to accept the sum of Rs........... in lull settlement of all and every
claim under the Social Security Code 2020 , in respect of the disablement stated above and all
disablement now manifest. It is, therefore, requested that this memorandum be duly recorded.
Date...........20....
Signature
of
employer..........
Witness.......................
Signature
of
Workman..........
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]
In accordance with the above agreement, I have this day received the sum of Rs............
Date.......20...
.......
Workman
The money has been paid and this receipt is signed in my presence.
.......
Witness
462 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XXV
(See rule 103)
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 workman, who is at present
in receipt of wages amounting to Rs............ per month no wages. The said workman's
monthly wages prior to the accident are estimated at Rs.......
The workman is subject to a legal disability by reason of........
It is further submitted that ..... the employer of the workman has agreed to pay and on behalf
of the said workman has agreed to accept half-monthly payments at the rate of for the period
of the said temporary disablement. This agreement is subject to the condition that the amount
of the half-monthly payments may be varied in accordance with the provisions of the said
code on account of an alteration in the earnings of the said workman during disablement. It is
further stipulated that all rights of commutation under sub-section (3) of section 93 of the said
Code are unaffected by this agreement. It is, therefore, requested that this memorandum be
duly recorded.
Date-………. 20...
Signature
of
employer.......
Witness.......................
Signature
of
Workman..........
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]
In accordance with the above agreement, I have this day received the sum of Rs..........
Date..................20.......
.........................
Workman
The money has been paid and this receipt is signed in my presence.
.........................
Witness
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 463
Form-XXVI
(See sun-rule (1) of rule 104)
Whereas an agreement to pay compensation is said to have been reached between .......... and
................whereas...................... has/have applied for registration of the agreement under
Section 89(1) of the , 2020, notice is hereby given that the said agreement will be taken into
consideration on ............ 20... and that any objections to the registration of the said agreement
should be made on that date. In the absence of valid objections it is my intention lo proceed
to the registration of the agreement.
.........................
Competent Authority.
Form-XXVII
(See sub-rule(3) of rule 104 and sub-rule(4) of rule 105 )
Take notice that registration of the agreement to pay compensation said to have been reached
between you...........and............on the ............................... 20.... has been refused for the
following reasons :-
................................................................................
................................................................................
................................................................................
................................................................................
Date...............20...
.............
Competent Authority
Form-XXVIII
(See sub-rule(2) of rule 105)
Whereas an agreement to pay compensation is said to have been reached
between................and..............and whereas.............has/have applied for registration of the
agreement under sub-section (1) of section 89 of theCode on Social Security, 2020, and
whereas it appears to me that the said agreement ought not to be registered for the following
reasons, namely :-
................................................................................
................................................................................
an opportunity will be afforded to you of showing cause on why the said agreement should be
registered. If no adequate cause is shown on that date registration of the agreement will be
refused.
Date.............20...
.............
Competent Authority
464 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XXIX
(See sub-rule(2) of rule 105)
Whereas an agreement to pay compensation is said to have been reached between.............
and....... and whereas ..... has/have applied for registration of the agreement under sub-section
(1) of section 89of the Code on Social Security, 2020, and whereas it appears to me that the
said agreement ought not to be registered for the following reasons, namely :-
................................................................................
................................................................................
an
opportunity
will
be
afforded
to
the
said............for
showing
cause
on....................20..............why the said agreement should be registered. Any representation
which you have to make with regard to the said agreement should be made on that date. II
adequate cause is then shown, the agreement may be registered.
Date...........20....
.........
Competent Authority
Form-XXX
(See rule 106)
Register of Agreements for the Years, 20.....
Serial No.
Date of
agreement
Date of registration
Employer Workman
Initials of
Competent
Authority
Reference to orders
rectifying the register
Form-XXXI
(See sub-rule(2) of rule 109)
Application for Compensation by Workmen
To,
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 (a contractor with) the opposite party on the
............ day of ...........20..... received personal injury by accident arising out of and in the
course of his employment.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 465
The cause of the injury was (here insert briefly in ordinary languages the cause of the
injury).................
(2) The applicant sustained the following injuries, namely :-
(3) The monthly wages of the applicant amount 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..............
(c) Notice of the accident was not served (on due time) by reason of.........
(5) The applicant is accordingly entitled to receive-
(a) Hall-monthly payments of Rs................... from the................day of 20.... 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 has proved impossible to settle the question in dispute because.........
*Your are therefore, requested to determine the following questions in dispute, namely :-
(a) Whether the applicant is a workman within the meaning of the Code...............
(b) Whether the accident arose out of or in the course of the applicant's
employment...............
(c) Whether the amount of compensation claimed in due, or any part of that
amount..................
(d) Whether the opposite party is liable to pay such compensation as is due............
(e) etc., (as required).........
Date.................20.........
...............................
Applicant
*Strike out of the clauses which are not applicable.
466 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XXXII
(See sub-rule(2) of rule 109)
Application for order to Deposit Compensation
To,
The Competent Authority for Workmen's Compensation
......................................
......................................
............Residing at................ Applicant
versus
............Residing at........... Opposite party.
It is hereby submitted that:-
(1) ..............a workman employed by (a contractor with) the opposite party on the ............ day
of.............. 20............ received personal injury by accident arising out of and in the course of
the employment resulting in his death on the................ day of ..........20.... The cause of the
injury was (here insert briefly in ordinary language the cause of the injury)..........
(2) The applicant(s) is/are dependent(s) of the deceased workman being his........
(3) The majority wages of the deceased amount to Rs.................
The deceased was under/over the age of 15 years at the time of his death.
(4) (a) Notice of the accident was served on the...........day of....
(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.............................
(6) The applicant(s) is/are accordingly entitled to receive a lump-sum payment of
Rs................................
You are, therefore, requested to award to the applicant the said compensation or any other
compensation to which he may be entitled.
Date...............20..........
...............................
Applicant
*Strike out the clauses which are not applicable.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 467
Form XXXIII
(See sub-rule(2) of rule 109)
Application for Commutation
To,
The Competent Authority for Workmen's Compensation
......................................
......................................
............Residing at................ Applicant
versus
............Residing at........... Opposite party.
It is hereby submitted that :-
(1) The applicant/opposite party has been in receipt of half-monthly payments
from..............to................in respect of temporary disablement by accident arising out of and
in the course of his employment.
(2) The applicant is desirous that the right to receive half-monthly payments should be
redeemed.
(3) (a) The opposite party is unwilling to agree to the redemption of the right to receive half-
monthly payments.
(b) The parties have been unable to agree regarding the sum for which the right to receive
half-monthly payments should be redeemed.
You are therefore requested to pass orders:-
(a) directing that the right to receive half-monthly payments should be redeemed.
(b) fixing a sum for the redemption of the right to receive half-monthly payments.
Date..................20....
….......
Applicant
Form-XXXIV
(See sub-rule (1) of rule 113)
Notice
Whereas a claim for compensation has been made by...............applicant, against...............and
the said ...........has claim that you are liable under sub-section (3) and (4) of section 93 of the
, Code on Social Security, 2020, 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 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 would be deemed to admit the validity of any award made against the
opposite party and your liability to indemnity the opposite party for any compensation
recovered from him.
date............20.....................
Competent Authority
468 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
Form-XXXV
(See sub-rule(3)and (4) of rule 113)
Notice
Whereas a claim for compensation has been made by...........applicant, against and the
said.................has claimed, that......is liable under Section 93 (3)(4)of the , 2020, to indemnity
him against any compensation which he may be liable to pay in respect of the aforesaid
claim, and whereas the said..........on notice served has claimed that you..........stated 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 lo admit the
validity of any award made against the opposite party.
.........and your liability to indemnity the opposite party.............for any compensation
recovered from him:-
Date...........20....
............
Competent Authority
FORM-XXXVI
(See sub-rule(1) of rule 122)
REGISTER OF WOMEN EMPLOYEES
Name of establishment
1. Serial Number.
2. Name of woman and her father's (or, if married, husband's) name.
3. Date of appointment.
4. Nature of work.
5. 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
1
2
3
4
5
6. Date on which the woman gives notice under section 62.
7. Date of discharge/dismissal, if any.
8. Date of production of proof of pregnancy under section 62.
9. 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 65.
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 469
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 bonus, if paid, under section 64.
15. Date with the amount of wages paid on account of leave under section 65(1) & 65(3).
16. Date with the amount of wages paid on account of leave under section 65(2) and
period of leave granted.
17. Name of the person nominated by the woman under section 62.
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-XXXVII
(See sub-rule(4) and (5) of rule 122)
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……
(c) Name of the manager or person responsible for supervision and control of
establishment
…………………………………………………………………………………………………
Address:
House No./Flat No………………….Street No./Plot No……………………………
Town…………….District……………….State…………………….pin code………
E-mail ID…………………Telephone Number…………………..Mobile number…
470 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
B. Employer’s Registration/License number under the Codes mentioned in column
(2) of the table below:
S.
No.
Name
Registration
If yes
(Registration No.)
(1)
(2)
(3)
(4)
01.
The Code on Occupational Safety Health and
working condition code 2020.
02.
The Code on Social Security, 2020.
03.
Any other Law for the time being in force.
C. Details of Employer, Contractor and Contract Labour:
01.
Name of the employer in the case of a contractor’s
establishment.
02.
Date of commencement of the establishment.
03.
Number of Contractors engaged in the establishment during the
year.
04.
Total Number of days during the year on which Contract
Labour was employed.
05.
Total number of man-days worked by Contract Labour during
the year.
06.
Name of the Manager or Agent (in case of mines).
07.
Address House No./Flat No. Street/Plot No. Town
District State Pin Code
E-mail ID Telephone Number Moblie Number
D. Working hours and weekly rest day:
01.
Number of days worked during the year.
02.
Number of mandays worked during the year.
03.
Daily hours of work.
04.
Weekly day of rest.
E. Maximum number of persons employed in any day during the year:
Sl. No.
Males
Females Adolescents (between
the age of 14 to 18
years.)
Children (below 14
years of age.)
Total
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 471
F. Wage rates (Category Wise):
No. of workers
Regular
Contract
Category
Rates
of
Wages Male Female Children Adolescent Male Female Children Adolescent
HighlySkilled
Skilled
Semiskilled
Unskilled
G. (a) Details of Payments:
Gross wages paid
Deductions
Net wages paid
In cash
In kind
Fines
Deductions for
damage or loss
Others
In cash
In kind
(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:
01.
Date of opening of establishment
02.
Date of closing, if closed
03.
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
472 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
01.
Total number of female employees in the establishment
02.
Total number of days of leave granted
03.
Number of 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 Laws applicable to my establishment.
Place Date Signature
FORM-XXXVIII
(See sub-rule(1),(2) and (3) of rule 123)
Notice to the Employer who committed an offence for the first time for compounding of
offence under sub-section (1) of section 138 of the Code on Social Security, 2020
Notice No……………
Date:
On the basis of records and documents produced before me, the undersigned has reasons to
believe that you, being the employer of the establishment…………….. (Registration
No………….), have committed offence for the violation of provision of the Code or the
Schemes or the Rules or the Regulations framed thereunder as per the details given below:-
PART-I
1.
Name of the Person:
2.
Name and Address of the Establishment :
3.
Registration No of the Establishment:
4.
Particulars of the offence:
5.
Provisions of the Code/Scheme/Rules/Regulations
under which the offence is committed:
6.
Compounding amount required to be paid towards
composition of the offence:
7.
Name and Details of Account for depositing the
Amount specified in Column 6:
PART-II
In view of the above, you have an option to pay the above-mentioned amount within
fifteen days from the date of issue of this notice and return the application duly filled in Part –
III of this notice.
In case the said amount is not paid within the specified time, necessary action for
filing of prosecution shall be initiated without giving any further opportunity in this regard.
(Signature of the Compounding Officer)
Date:
Place:
भाग 4(ग) राजè थान राज-पğ, जनवरȣ 13, 2026 473
PART-III
[See sub-rule (2) of rule 123]
Application under sub-section (4) of section 138 for compounding of offence
Ref: Notice No…………..
Date:
The undersigned has deposited the entire amount as specified in Column 6 of Part-I and the
details of payment are given below with a request to compound the offences mentioned in
Part-I.
1. Details of the compounding amount deposited (Copy of electronically generated receipt to
be attached):
2. Details of the prosecution, if filed for the violation of above-mentioned offences may be
given:
3. Whether the offence is first offence or the applicant had committed any other offence prior
to this offence, if committed, then, full details of the offence:
4. Any other information which the applicant desires to provide:
Signature of the applicant
(Name and Designation)
Dated:
Place:
474 राजè थान राज-पğ, जनवरȣ 13, 2026 भाग 4(ग)
PART-IV
Composition Certificate
[See sub-rule (3) of rule 123]
Ref: Notice No…………..
Date:
This is to certify that the offence under sub-section ……….of section 133 of the Code in
respect of which Notice No…………… Dated………was issued to Sh. ………….
(Applicant), the employer of ……………. (Name and Registration Number of
establishment), has been compounded on account of remission of full amount of Rs ………..
(Rupees _________________) towards the composition of offences to the satisfaction of the
said notice.
Date:
Place:
(Signature)
Name and Designation of the Officer
[F(14)(13)(42)S.S.Code/shram/vidhi/2021/00011]
By order of the Governor,
Om Prakash Saharan,
Joint Secretary to the Government.
_____________
Government Central Press, Jaipur.