Rule Form II Form II
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORM-II [See sub rule (1) of rule 49]
[SINGLE APPLICATION UNDER SUB-SECTION (5) OF SECTION 45]
BEFORE THE AUTHORITYDefined in rule 2(d): authority means the authority appointed by the Central Government under sub section (1) of section 45 APPOINTED UNDER SUB SECTIONDefined in rule 2(r): section means a section of the Code (1) OF SECTION 45 OF THE CODEDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) ON
WAGES, 2019 (29 OF 2019)
FOR............. AREA......... Application No
........................................................................................... of 20......
Between ABC and (State the number).........other................................................................................Applicant
(Through employees concerned or registered trade unionDefined in rule 2(q): registered trade union means a trade union registered under the Industrial Relations Code, 2020 (35 of 2020) or Inspector-cum-FacilitatorDefined in rule 2(n): Inspector cum Facilitator means a person appointed by the Central Government, under sub section (1) of section 51
Address...........................................................................................
And XYZ..........................................................................................................
Address........................... The
application states as follows:
(1) The applicant(s) whose name(s) appear in the attached schedule was/were/has/have been employed from ...............to........ as..................(category) in ............................................................................... (establishment) Shri/M/s.........engaged in .............(nature of work) which is/are covered by the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) on Wages, 2019.
(2) The opponent(s) is/are the employer(s) within the meaning of section 2(l) of the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) on Wages, 2019.
(3) (a)The applicant(s) has/ have been paid wages at less than the minimum rates of wages fixed for their category (categories) of employment(s) under the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) by Rs.... ..............Per dayDefined in rule 2(i): day means a period of twenty four hours beginning at mid night for the period(s) from...........................to......... ...................
(b) The applicant(s) has/ have not been paid wages at Rs ................................. Per dayDefined in rule 2(i): day means a period of twenty four hours beginning at mid night for the weekly days of rest from ............................to...
(c) The applicant(s) has/ have not been paid wages at overtime rate(s) for the period from.......................to....
(d) The applicant(s) has/have not been paid wages for period from ..................to.......... (e)Deductions have been made which are in contravention of the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019), from the wage(s) of the applicant(s) as per details specified in the annexure appended with this application.
(f) The applicant(s) has/have not been paid minimum bonus for the accounting year .................
(4) The applicant(s) estimate(s) the value of relief sought by him/ them on each amount as under:
(a) Rs.......
(b) Rs.......
(c) Rs....... Total Rs.......
(5) The applicant(s), therefore, pray(s) that a direction may be issued under section 45(2) of the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) on Wages, 2019 for;
(a) payment of the difference between the wages payable under the CodeDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) and the wages actually paid,
(b) payment of remuneration for the days of rest
(c) payment of wages at the overtime rates,
(d) compensation amounting to Rs...........................
(6) The applicant(s) do hereby solemnly declare(s) that the facts stated in this application are true to the best of his/their knowledge, belief and information.
Dated
Signatire of thumb-impression of the Emplyed person(s) of official of a
registerd trade union duly authorized or inspector-cum-Faciliator
Note:The applicant(s), if required, may append annexures containing details, with this application.