FORM E [See Section 4 (i) Proviso (b) (ii)] Monthly Register of muster roll-cum-wages required to be maintained by very small establishments Year.............Month. ........... Wage Period....... or (where different)..... Name of establishment __________________________________________ Name of employee ____________________ Father's Name _____________ Nature of Work ____________________ Rate of Wages ________________ Wage Period_______________________ Date of Employment ___________ Privilege Leave Signature of the employer Remarks of the employer Remuneration Due Leave due Leave availed Balance Basic Salary or wage Over Time Other Allowances, if any Total 10 11 12 13 14 15 16 17 18 Deductions Net Amount of Payment Date of Payment Signature or thumb impression of the employee Signature of Inspector with remarks, if any, and date Fines and deductions on account of damage or loss by neglect or default Other deductions Advance paid, if any Date Amount Total 19 20 21 22 23 24 25 26 27 Note: Columns 1 to 12 to be filled up on each working day and the remaining columns to be completed within seven days of the expiry of the wage period. Date: Place: Signature of the employee with full name in capitals
