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FORM III

                             ANNUAL RETURN

( Prescribed under Rule 21(4) of the West Bengal Minimum Wages Rules , 1951 )
Return of the ending 31st December 20



1(a)         Name of the establishment and postal
             address
(b)          Name and residential address of the
             owner / contractor
(c)          Name and residential address of the
             Managing Agent / Director/ Partner in
             charge of the day to day affairs of the
             establishment owned by a company
             body corporate or Association
(d)          Name and residential address of the
             Management / Agent , if any
2.           Number of days worked during the
             year
*3.          Number of Mandays worked during
             the year
**4.         Average daily number of persons
             employed during the year
             (i) Adult
             ( ii ) Children
***5.        Total wages paid in cash
***6.        Total cash value of the wages paid in
             kinds
       7.   Deduction

                                               No. of cases     Total Amount
(a)         Fines                                      NIL             NIL
(b)         Deduction for damage or loss               NIL             NIL
( c)        Deduction for breach of contract           NIL             NIL




                                               [2]
8. Disbursement from fines                          Purpose        Amount

   (a )
   (b )
   (c )
   (d )
   (e )

   9. Balance of fine in hand at the end of the year




                                                                              Signature

                                                                           Designation
Date


   • This is the aggregate number of attendance during the year.
   ** The average daily number of persons employed during the year is obtained by
   dividing the aggregate number of attendances during the year by the number of
   working days.
   ***Cash value of the wages paid in kind should be obtained by taking the difference
   between the cost price paid by the employers and the actual price paid by the
   employees for suppliers of essential commodities given at concessional rate.
   Subs by Notification No. 695-L/.W/LW/IR-3564 dated 3 rd June, 1964.

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Form iii( annual return ) mw act

  • 1. FORM III ANNUAL RETURN ( Prescribed under Rule 21(4) of the West Bengal Minimum Wages Rules , 1951 ) Return of the ending 31st December 20 1(a) Name of the establishment and postal address (b) Name and residential address of the owner / contractor (c) Name and residential address of the Managing Agent / Director/ Partner in charge of the day to day affairs of the establishment owned by a company body corporate or Association (d) Name and residential address of the Management / Agent , if any 2. Number of days worked during the year *3. Number of Mandays worked during the year **4. Average daily number of persons employed during the year (i) Adult ( ii ) Children ***5. Total wages paid in cash ***6. Total cash value of the wages paid in kinds 7. Deduction No. of cases Total Amount (a) Fines NIL NIL (b) Deduction for damage or loss NIL NIL ( c) Deduction for breach of contract NIL NIL [2]
  • 2. 8. Disbursement from fines Purpose Amount (a ) (b ) (c ) (d ) (e ) 9. Balance of fine in hand at the end of the year Signature Designation Date • This is the aggregate number of attendance during the year. ** The average daily number of persons employed during the year is obtained by dividing the aggregate number of attendances during the year by the number of working days. ***Cash value of the wages paid in kind should be obtained by taking the difference between the cost price paid by the employers and the actual price paid by the employees for suppliers of essential commodities given at concessional rate. Subs by Notification No. 695-L/.W/LW/IR-3564 dated 3 rd June, 1964.