COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

SL No. [1] Emp No Father/Husband Name

1 2 3 4 5

1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE

Name of the Employee[2]

Male / Female [3]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

PF No. [7]

Attendance (Please mention the date of suspension of employee, if any [9]

Esic 7(a) 1 2

6 7 9 10 11 12 13

Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P P

De

sig

na

tio

n/

De

pa

rtm

en

t [4

] Date of Joining [5]

Wage fixed

including VDA

[8]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

Attendance (Please mention the date of suspension of employee, if any [9]

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

W/O P P P P P P W/O P P P P P W/O P P P PP W/O P P P P P P W/O P P P P P W/O P P P

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]

No

. o

f p

ay

ab

le d

ay

s [

10

]

To

tal

OT

ho

ur

wo

rke

d [

11

] EARNED WAGES AND OTHER ALLOWANCES

21 22 23 24 25 26 27 28 29 30 31

Ba

sic

+D

A [

12

]

HR

A

[14

]

32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

P W/O P P P P P P P P P 31 0 6736 0P P W/O P P P P P P P P 31 0 6736 0

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Mar 15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS

Co

nv

ey

an

ce

[1

5]

Me

dic

al

All

ow

an

ce

[1

6]

Att

/ B

on

us

[1

7]

Sp

ec

ial

bo

nu

s [

18

]

OT

[1

9]

NF

H [

20

]

Ma

tern

ity

Be

ne

fit

[21

]

Oth

ers

[2

2]

S.

All

ow

an

ce

,if

an

y [

23

]

To

tal

[24

]

ES

I [2

5]

PF

[2

6]

47 48 49 50 51 52 53 54 55 56 57 58

0 0 292 0 0 0 0 0 0 7028 123 8080 0 292 0 0 0 0 0 0 7028 123 808

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Mar 15DEDUCTIONS

VP

F

PT

[2

7]

TD

S [

28

]

So

cie

ty [

29

]

Ins

ura

nc

e [

30

]/L

WF

Sa

l. A

dv

an

ce

[3

1]

Fin

es

[3

2]

Da

ma

ge

/ L

os

s [

33

]

Oth

ers

[3

4]

To

tal

[35

]

59 60 61 62 63 64 65 66 67 68 69

0 0 0 0 0 0 0 0 0 931 60970 0 0 0 0 0 0 0 0 931 6097

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE

KARNATAKA-560078

Net Payable

[36]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM TSI. No.

1

70 71

ChequeCheque

Mode of Payment Cash / Cheque No. [37]

Employee Signature /

Thumb Impression [38]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

Emp No Father/Husband Name

1 2 3 4 5

1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE

Total

SL No. [1]

Name of the Employee[2]

Male / Female [3]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

PF No. [7]

Attendance (Please mention the date of suspension of employee, if any [9]

Esic 7(a) 1 2

6 7 9 10 11 12 13

Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P W/O

De

sig

na

tio

n/

De

pa

rtm

en

t [4

] Date of Joining [5]

Wage fixed

including VDA

[8]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

Attendance (Please mention the date of suspension of employee, if any [9]

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

W/O P P P P P P W/O P P P P P P W/O PP P P P P P W/O P P P P P P W/O P P

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]

No

. o

f p

ay

ab

le d

ay

s [

10

]

To

tal

OT

ho

ur

wo

rke

d [

11

] EARNED WAGES AND OTHER ALLOWANCES

19 20 21 22 23 24 25 26 27 28

Ba

sic

+D

A [

12

]

30 31 32 33 34 35 36 37 38 39 40 41 42

P P P P P W/O P P P P 28 0 6736P P P P W/O P P P P P 28 0 6736

56 0

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Feb 15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS

HR

A

[14

]

Co

nv

ey

an

ce

[1

5]

Me

dic

al

All

ow

an

ce

[1

6]

Att

/ B

on

us

[1

7]

Sp

ec

ial

bo

nu

s [

18

]

OT

[1

9]

NF

H [

20

]

Ma

tern

ity

Be

ne

fit

[21

]

Oth

ers

[2

2]

S.

All

ow

an

ce

,if

an

y [

23

]

To

tal

[24

]

ES

I [2

5]

43 44 45 46 47 48 49 50 51 52 53 54

0 0 0 292 0 0 0 0 811 0 7839 1380 0 0 292 0 0 0 0 811 0 7839 1380 0 0 584 0 0 0 0 1622 0 15678 276

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Feb 15DEDUCTIONS

PF

[2

6]

VP

F

PT

[2

7]

TD

S [

28

]

So

cie

ty [

29

]

Ins

ura

nc

e [

30

]/L

WF

Sa

l. A

dv

an

ce

[3

1]

Fin

es

[3

2]

Da

ma

ge

/ L

os

s [

33

]

Oth

ers

[3

4]

To

tal

[35

]

55 56 57 58 59 60 61 62 63 64 65 66

808 0 0 0 0 0 0 0 0 0 946 6893808 0 0 0 0 0 0 0 0 0 946 6893

1616 0 0 0 0 0 0 0 0 0 1892 13786

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE

KARNATAKA-560078

Net Payable

[36]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM TSI. No.

1

67 68

ChequeCheque

Mode of Payment Cash / Cheque No. [37]

Employee Signature /

Thumb Impression [38]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

1 Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 19582 Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,19633 Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 19744 Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

Emp No Father/Husband Name

1 2 3 4 5

1 Geetha T A 779303 Amasegowdae FEMALE2 Vishwanath S 779307 Siddagangaiah T MALE

SL No. [1]

Name of the Employee[2]

Male / Female [3]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

PF No. [7]

Attendance (Please mention the date of suspension of employee, if any [9]

Esic 7(a) 1 2

6 7 9 10 11 12 13

Trainee-K 2-Nov-14 BG/BNG/0035224/000/0637492 5038301252 7028 P PTrainee-K 31-Oct-14 BG/BNG/0035224/000/0637331 5038301236 7028 P P

De

sig

na

tio

n/

De

pa

rtm

en

t [4

] Date of Joining [5]

Wage fixed

including VDA

[8]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963Form XIII of Rule 75 and Forms XVI, XVII, XX, XXI, XXII & XXIII of Rule 78(1)(a)(i)(ii) & (iii) of the Contract Labour (Regulation & Abolition) (Karnataka) Rules, 1974Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981

Attendance (Please mention the date of suspension of employee, if any [9]

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

P P P P W/O P P P P P P W/O P P P P PP P P W/O P P P P P P W/O P P P P P P

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T[See Rule 24(9-b) of Karnataka Shops & Commercial Establishment Rules, 1963 in lieu of]

Form I and II of Rule 22(4); Form IV of Rule 28(2); Forms V & VII of Rule 29(1) & (5) of the Karnataka Minimum Wages (Karnataka) Rules, 1958Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

Form XIII of Rule 43 and Forms XVII, XVIII, XIX, XX, XXI, XXII of Rule 46(2)(a),© & (d) of Inter- State Migrant Workmen (Regulation of Employment and Condition of Service) (Karnataka) Rules, 1981Attendance (Please mention the date of suspension of employee, if any [9]

No

. o

f p

ay

ab

le d

ay

s [

10

]

To

tal

OT

ho

ur

wo

rke

d [

11

] EARNED WAGES AND OTHER ALLOWANCES

20 21 22 23 24 25 26 27 28 29 30 31

Ba

sic

+D

A [

12

]

31 32 33 34 35 36 37 38 39 40 41 42 43 44 45

P W/O P P P P P P W/O P P P 31 0 6736W/O P P P P P P W/O P P P P 31 0 6736

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Jan-15EARNED WAGES AND OTHER ALLOWANCES DEDUCTIONS

HR

A

[14

]

Co

nv

ey

an

ce

[1

5]

Me

dic

al

All

ow

an

ce

[1

6]

Att

/ B

on

us

[1

7]

Sp

ec

ial

bo

nu

s [

18

]

OT

[1

9]

NF

H [

20

]

Ma

tern

ity

Be

ne

fit

[21

]

Oth

ers

[2

2]

S.

All

ow

an

ce

,if

an

y [

23

]

To

tal

[24

]

ES

I [2

5]

46 47 48 49 50 51 52 53 54 55 56 57

0 0 0 292 0 0 0 0 0 0 7028 1230 0 0 292 0 0 0 0 0 0 7028 123

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, Koramangala, Bangalore-560095

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM T

Form I of Rule 3(1) of the Karnataka Payment of Wages (Karnataka) Rules,1963

MONTH / YEAR: Jan-15DEDUCTIONS

PF

[2

6]

VP

F

PT

[2

7]

TD

S [

28

]

So

cie

ty [

29

]

Ins

ura

nc

e [

30

]/L

WF

Sa

l. A

dv

an

ce

[3

1]

Fin

es

[3

2]

Da

ma

ge

/ L

os

s [

33

]

Oth

ers

[3

4]

To

tal

[35

]

58 59 60 61 62 63 64 65 66 67 68 69

808 0 0 0 0 0 0 0 0 0 931 6097808 0 0 0 0 0 0 0 0 0 931 6097

NAME AND ADDRESS OF THE ESTABLISHMENT: TeamLease Services Pvt. Ltd.,6th Floor, BMTC Commercial Complex, 80ft Road, NAME AND ADDRESS OF THE PRINCIPAL EMPLOYER:

BATA SHOE STORE #2 DEFENCE COLONY HESARAGHATTA MAIN ROAD BANGALORE

KARNATAKA-560078

Net Payable

[36]

COMBINED MUSTER ROLL CUM REGISTER OF WAGES

FORM TSI. No.

1

70 71

ChequeCheque

Mode of Payment Cash / Cheque No. [37]

Employee Signature /

Thumb Impression [38]