FORM XVII

1
[See Rule 78(1) (a) (i)]

Register of Wages
Name and address of the Contractor ……………………………………………………………………………………………………………………………….......................................
Name and address of Establishment in/under which contract is carried on …………………………………………………………………………………………………………
Name and location of work …………………………………………………………………………………………………………………………………………………………………………………..
Name and address of Principal Employer ………………………………………………………………………………………………………………………………………………………………
Sl. No. Uni
Designati No. Signature/ Initial of
in the t of Daily-rate Deductio
on/ of Net Thumb contracto
Sl. Name of registe wor of ns if any
Nature of days Amount of wages earned amount impression r or his
No. workmen r of k wages/pie (indicate
employm work paid of represent
workm don ce-rate nature)
ent ed workmen ative
en e

Dear Other cash

Bas
ness payments
ic Over
Allo (Nature of Total
wa time
wanc payments to
ges
e be indicated)
 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Wage Period: Monthly ………………………………………………………………………………………………………………………………………………………………………………………....

1 Substituted for the brackets, words, figures and letter “[See Rule 78(2) (a)]” by GSR 948, dated 12/7/1978, w.e.f. 22-7-1978.