FORM NO. 22(REVISED)

[PRESCRIBED UNDER RULE 99 (3)]

Half Yearly Return

Fields marked with "*" are mandatory

Section

(For the Period ending on 30th June,

Factory Details

Name of Factory : *

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Name of Occupier : *

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Name of Manager :

District *

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Sub DIvision

Full Postal Address

PIN C0de

E-Mail Address

Nature of Industry

Number of workers and particulars of employment

Number of days worked during the half yearly ending 30th june of current year

Number of mandays worked during the half yearly ending 30th June

( a ) Adults (Men)

( b ) Adults (Women)

(c)Adolescents (Male)

(d )Adolescents (Female)

( e ) Children (Boys)

( f ) Children (girls)

Average number of workers employed daily

( a ) Adults (Men)

( b ) Adults (Women)

(c) Adolescents (Male)

(d) Adolescents (Female)

( e ) Children (Boys)

( f ) Children (girls)

Declaration

I hereby declare that the above furnished details are true to best of my Knowledge and belief.

I Agree *

The average daily number should be calculated by dividing the aggregate number of attendance on working days by the number of working days during the half year. In reckoning attendance , attendance by temporary as well as permanent employees should be counted and all employees (including apprentice) should be counted and all employees should be included whether they are employed directly or under contractor. Attendance on separate shifts (e. g. night and day shifts) should be counted separately. Days on which the factory was closed, for whatever cause, and days on which the manufacturing processes were not carried on should not be treated as working days. However, if more than 50% of workers employed (on the previous days) attend to repair maintenance or other such work on closed days, such days should be treated as working days.

‘Partial attendance for less than half a shift of working days should be neglected and attendance of half a shift or more should be treated as full attendance’.