Rule Form XV Form XV
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORMDefined in rule 2(b): FORM means FORMS annexed in Annexure VII to these rules -- XV (See Rule 72(1)(iii)) REGISTER FOR WAGES, OVERTIME AND DEDUCTIONS (The register may also be maintained electronically capturing, inter-alia the following details)
Name of Establishment:
Name of the Employer/owner:
PAN/TAN of the Employer
Registration Number of the establishment (Labour Identification Number (LIN) shall be the Registration Number of the Establishment)
Wage Period from dd/mm/yyyy to dd/mm/yyyy
(Monthly/Fortnightly/Weekly/Daily/Piece Rated)
1. Serial Number
2. Employee CodeDefined in rule 2(a): Code means the Occupational Safety, Health and Working Conditions Code, 2020 (37 of 2020) Number
3. Name of the employee
4. Designation
5 Department
6 Duration of Payment of wages (Monthly/Fortnightly/Weekly/Piece
rated)
7 Wage Period from- to
8 Total number of days worked during the wage period
9 Total overtime hours worked or overtime production in case of piece
workers
Rate of Wage
10 a)Basic
11 b)DA
12 c)Other allowance
Amount of wages earned
13 Basic 14 DA 15 Allownaces 16 Overtime 17 Total wages earned
Deductions 18 EPF 19 ESIC 20 Society 21 Income Tax 22 Insurance 23 Advances 24 Recovery of Fine 25 Recovery on amount of damages/losses 26 Total deductions 27 Others 28 Net Payment 29 Date of Payment 30 Receipt by employee/Bank Transaction ID 31 Nature of acts and omissions for which fine imposed with date 32 Amount of fine imposed 33 Damage or loss caused to the employer by neglect or default of the
employee 34 Signature of Employer/Employer Representative* *Note: Required in case register is maintained physically