Download Form of Annual Return

*FORM III [Rule 21(4) ] Annual Return Return for the year ending the 31st December .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 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 estt. Owned by a company, body corporate or Association .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (d) Name and residential address of the Manager/Agent, if any .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Number of days worked during the year .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. **3.. Number of man days worked during the year .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. +4. Average daily number of persons employed during the year .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (i) Adults .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (ii) Children .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .5. Total wages paid in cash .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .6. Total cash value of the wages paid in kind .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Deduction :­ No. of Cases Total Rs. Ps. Fines. Deduction for damage or loss. Deduction for breach of contract. 8. Disbursement from fines. Purpose Amount Rs. Ps. (a) (b) (c) (d) 9. Balance of fine fund in hand at the end of the year .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Signature .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Designation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. *Form substituted vide G. N., E. and L. D., No. KH/SH-314-MWA/1963-20856-T, dated 12th April, 1965. **This is the aggregate Number of attention during the year. +The average daily number of persons employed during the year is obtained by dividing the aggregate number of attendance during the year by the number of working days. C Cash value of the wages paid in kind should be obtained by taking the difference between the cost price paid by the employer and the actual price paid by the employee for supplies of essential commodities at concessional rates.