FORM K

[See sub-rule (1) of rule 16]

The Tamil Nadu Maternity Benefit Rules, 1967
Annual Return
Return for the year ending 31st December' 2021

M/S. CONNECT INDIA E COMMERCE SERVICES PVT LTD,

(1) Name of the establishment with the postal address NO:360 THANGAM COMPLEX,NANJUNDAPURAM
ROAD,COIMBATORE – 641036

MISS. SAPNA PARVATHI

M/S. CONNECT INDIA E COMMERCE SERVICES PVT LTD,
(2) Name of the employer with his postal address
NO- 3, JRS NAGAR, CUSTOMS ROAD, CHAVADI NATTAPATTU
CUDDALORE-607006

MISS. SAPNA PARVATHI

M/S. CONNECT INDIA E COMMERCE SERVICES PVT LTD,
(3) Name of the Manager with his postal address
NO- 3, JRS NAGAR, CUSTOMS ROAD, CHAVADI NATTAPATTU
CUDDALORE-607006

Aggregate number of women permanently or temporarily

(4) 0
employed during the year
Number of women who worked for a period of not less than
(5) one hundred and sixty days in the twelve months NIL
immediately preceding the date of delivery

(6) Number of women who gave notice under section 6 NIL

Number of women who were granted permission to absent

(7) NIL
on receipt of notice of confinement
(8) Claims for maternity benefit paid NIL

(9) Claims for maternity benefit rejected NIL NIL

(10) Claims for medical bonus paid (section 8) NIL NIL
(11) Claims for medical bonus rejected NIL NIL
(12) Cases in which leave for miscarriage was granted NIL NIL
Cases in which leave for miscarriage was applied for but was
(13) NIL NIL
rejected
Cases in which additional leave for illness under section 10
(14) NIL NIL
was granted
Cases in which additional leave for illness under section 10
(15) NIL NIL
was applied for but was rejected
Cases in which payment was made to persons other than the
(16) NIL NIL
woman concerned

Women deprived of maternity benefit and/or medical bonus

(17) NIL NIL
under proviso to sub-section (2) of section 12

Cases in which payment was made on the order of the

(18) NIL NIL
Appellate Authority or Inspector
Number of cases where prenatal confinement and postnatal
(19) care was provided by the management free of charge NIL
(Section 8)
(20) Number of women who died NIL
(a) before delivery NIL
(b) after delivery NIL

(21) Number of woman discharged or dismissed while working NIL

Date:
For CONNECT INDIA E COMMERCE SERVICES PVT LTD,

Authorised Signatory