FORM No.

22
[Prescribed under sub-rule (3) of Rule 137]
HALF YEARLY RETURN

Period ending 30th June 2015

1. Name of Factory.
2. Name of Occupier
3. Name of Manager
I. District
II. Postal Address
III. Nature of industry
IV. Average No. of workers employed daily
(a) Male
(b) Female
4.

Adolescent
(a) Male
(b) Female

NIL
NIL

(a) Male
(b) Female

NIL
NIL

5.

Children

6.

Number of days worked during the half year ending 30th June, 2010-

Signature of Occupier

Signature of Manager

Date of Dispatch

Date of Dispatch

The average daily number should be calculated by dividing the aggregate number of
attendance on working days of the number of working days during the half year. In
recognizing attendance by temporary as well as permanent employees should be
counted and all employees should be included whether they are employed directly or
under contractor. Attendance on separate shift (e.g. night and days shift) should be
counted separately. Days in which the Factory was closed for whatever cause and
days on which the manufacturing process were not carrier in should be treated as
working days.