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State of Goa - Section
Section 29 in The Goa Labour Welfare Fund Rules, 1990
29. [ Authority. [Inserted by the Amendment Rules, 1991 published in the Official Gazette, Series I No. 29, dated 18-9-1991.]
- The Commissioner of Labour shall be the authority for the purpose of deciding any question as to whether or not any of the provisions of the Act apply to an establishment or to an employee therein.]Form-A(See Rule 4)Statement of Employees and Employer's Contribution as On 30th June/31st December| 1. | Name of the Establishment | : |
| 2. | Name of the Employer | : |
| 3. | Class of Establishment (i.e. whether a factory or motor omnibusservice, motor transport undertaking a shop commercialestablishment, residential hotel, restaurant, eating house,theatre or other place of public amusement or entertainment) | : |
| 4. | Address of the Establishment | : |
| 5. | Total number of employees whose names stand on theestablishment register as on 30th June/31st December | : |
| 6. | (A) Employees contribution at the rate of Rs. 0.50 per employeedrawing salary upto Rs. 1,600/- per month | : |
| (B) Employer's contribution Re. 1/- per employee drawing salaryupto Rs. 1,600/- per month | : | |
| 7. | Total of Sub-Entries (A) + (B) above of Entry 6 | : |
| 8. | Whether the contribution has already been paid to theSecretary, if so whether by cheque, money order or cash anddetails thereof | : |
| Class of Establishment | Number of Establishment | Amount of employer's contribution received bythe Secretary | |
| 1 | 2 | 3 | |
| 1. Factories | |||
| 2. Motor Omnibus Services | |||
| 3. Shops | |||
| 4. Commercial establishments | |||
| 5. Residential hotels | |||
| 6. Restaurants | |||
| 7. Eating houses | |||
| 8. Theatres | |||
| 9. Other places of public amusement or entertainment. |
| Date of Receipt | Serial No. of Receipt | Details of the Receipts | P. O. Deposit | ||||||
| Particulars of Receipts | Receipt No. | Bank Deposit | Cash | Bank | Provisional Receipts | Other Deposits | R. B. F. | ||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Opening Balance | Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | |||
| EXPENDITURE | |||||||||
| Date of Expenditure | Serial No. or Sub-Voucher | ||||||||
| Particulars of expenditure | Voucher No. | Bank Deposit | Cash | Bank | Provisional Receipts | Other Deposit | R. B. F. | ||
| 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
| Total expenditure | Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | |||
| Total Receipts .......................................... | Total Expenditure ....................................... |
| Closing Balance ......................................... | |
| Grand Total ............................................. | Grand Total ................................................ |
| Date | D.A.R. | R. No. | Name of establishment or person | Unpaid accumulations | ||||
| Fines | Unpaid accumulations | Deposit | N. S. Certificates | Donations | ||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
| Loans from State Government | Grant in aid | Deposit | Refund Board's contribution | |||||
| Government | Other Institution | Earnest Money | Tailoring Class | Library and information centre | Other Deposit | R.B.F. | ||
| 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 |
| Entry fees | Miscellaneous receipts | Electricity | ||||||
| R. E. C. | Loss of books | N. S. and H. C. Fees | Sale of old newspapers | Tailoring class | and other recoveries from staff | Miscellaneous Receipt | ||
| 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 |
| Miscellaneous receipts | Interest on Bank Deposit | Interest on Government Securities | Total | Initials | ||||
| Rent and Taxes | Sales of Annual Reports | Advertisement charges | Sale of unserviceable articles | Clerk | Supdt. | |||
| 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 |
| Serial No. | Voucher No. | Date | Bill No. | Officers | Leave Salary Provision | ||
| Pay | Allow. | Pay | Allow. | ||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Supervisory-cum-Administrative Staff | Programme for Administrative Staff | Community necessities and educational staff | Total | ||||
| Pay | Allow. | Pay | Allow. | Pay | Allow. | Pay | Allow. |
| 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 |
| T. A. for staff | T. A. for members of the Board | Leave Travel Concession | Total of each Voucher | Initials | ||
| On tour | On transfer | Clerk | Supdt. | |||
| 17 | 18 | 19 | 20 | 21 | 22 | 23 |
| Serial | Voucher No. | Bill No. | Date | Place | Community necessity | ||
| Creche | Nursery School | ||||||
| N. R. | R. | ||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Tailoring classes | R. E. S. | Home Industries | Subsidiary occupations for women | Sewing Machines | Reading Rooms Centres | |
| N. R. | R. | |||||
| 9 | 10 | 11 | 12 | 13 | 14 | 15 |
| Libraries Centres | Workers Education | Entertainment and other | ||||
| Music and Socials etc. | National Special Days | Dramas and Drama Festivals | Exhibition | |||
| 16 | 17 | 18 | 19 | 20 | 21 | 22 |
| Recreation | Games and Sports | ||||||
| Visual Instruction Cinema Show | Scouts and Guides | Excursions and Tours | Matches | ||||
| Conveyance and refreshment | Entry Fees | First Aid | Prizes | ||||
| 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 |
| OFFICE/CENTRE ...................... FOR THEMONTH OF ....................... 19 | ||||||
| Facilities for conducting programme | ||||||
| Games materials | Repairs to play Appn. and play grounds | N.R. | Annual Sports, Sports and Miscellaneous | Furniture | Electricity and lighting | |
| N.R. | R. | |||||
| 31 | 32 | 33 | 34 | 35 | 36 | 37 |
| Rent, rates and taxes | Postage Exchange and Bank Commission | Printing and Stationery | Vehicles | ||
| N.R. | R. | N.R. | R. | ||
| 38 | 39 | 40 | 41 | 42 | 43 |
| SPECIAL ITEMS | ||||||
| Other miscellaneous | ||||||
| Replacement of radios and musical instruments | Other Miscellaneous | Home Nursing | Conveyance | Daily wages | Maintenance of Buildings and Repairs | |
| 44 | 45 | 46 | 47 | 48 | 49 | 50 |
| Repairs | Administrative contingency | Provident Fund Contribution | Gratuity Payment | Loans and Advances | ||
| 51 | 52 | 53 | 54 | 55 | 56 | 57 |
| Investigation of claims | Legal | Grant-in-aid | Total | Initials Clerk/Supdt. | ||
| 58 | 59 | 60 | 61 | 62 | 63 | 64 |
| Serial No. | Voucher No. | Date | Bill No. | |
| 1 | 2 | 3 | 4 | |
| Central Office, Bombay ... ... ... ... ... ... ... ... | ||||
| Divisional Office, . ... ... ... ... ... ... ... ... ... ... | ||||
| Development Zone Office, ... ... ... ... ... ... ... ... | ||||
| Development Zone Office, ... ... ... ... ... ... ... ... | ||||
| Circle Office, ... ... ... ... ... ... ... ... ... ... ...... | ||||
| .............................................................. | ||||
| .............................................................. | ||||
| .............................................................. | ||||
| .............................................................. | ||||
| .............................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments ............... | } | DebitCredit |
| Progressive expenditure upto ........................ |
| Officer | Leave Salary Provision | Supervisory-cum-administrative staff | Programme administrative staff | ||||
| Pay | Allow. | Pay | Allow. | Pay | Allow. | Pay | Allow. |
| 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| Community necessities and educational staff | Total | |||
| Pay | Allow. | Pay | Allow. | |
| 13 | 14 | 15 | 16 | |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments ............... | } | DebitCredit |
| Progressive expenditure upto ........................ |
| T. A. for staff | T. A. for members of the Board | Leave Travel Concession | Total each Voucher | Initials | ||
| On tour | On transfer | Clerk | Supdt. | |||
| 17 | 18 | 19 | 20 | 21 | 22 | 23 |
| Serial No. | Voucher No. | Bill No. | Date | Place | |
| 1 | 2 | 3 | 4 | 5 | |
| Central Office,...........................................Divisional Office,...............Development Zone Office,..............Development Zone Office,............Circle Office,....................................................................................................................................................................................................................................................................................... |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Community necessity | Tailoring Classes | R. E. S. | Home Industries | Subsidiary Occupation Women | Sewing Machines | Reading Rooms at Centres | |||
| Creche | Nursery School | N. R. | R. | ||||||
| N. R. | R. | ||||||||
| 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
| Libraries at Centres | Workers Education | |
| 16 | 17 | |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Music and socials etc. | National | Dramas and drama festivals | Exhibition | Visual Instruction Cinema show | Scouts and guides | Excursions and tours | |
| 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 |
| Games and Sports | ||||
| Matches | First Aid | Prizes | ||
| Conveyance and refreshment | Entry fees | |||
| 26 | 27 | 28 | 29 | 30 |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Games material | Repairs to play appn. and play grounds | N. R. | Annual Sports and Misc. | Furniture | Electricity and lighting | |
| N. R. | R. | |||||
| 31 | 32 | 33 | 34 | 35 | 36 | 37 |
| Rent, rates and taxes | Postage Exchange and Bank Commission | |
| 38 | 39 | |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Printing and Stationery | Vehicles | ||
| N. R. | R. | N. R. | R. |
| 40 | 41 | 42 | 43 |
| Other | ||
| Replacement of radios and musical instruments | Other Miscellaneous | |
| 44 | 45 | |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Miscellaneous | Maintenance of building and repairs | Repairs | |||
| Home Nursing | Conveyance | Daily wages | |||
| 46 | 47 | 48 | 49 | 50 | 51 |
| Administrative Contingency | Provident Fund Contribution | Gratuity Payment | |||
| 52 | 53 | 54 | 55 | 56 | |
| Central Office,............................................Divisional Office,........................................Development Zone Office,.............................Development Zone Office,............................Circle Office,............................................................................................................................................................................................................................................................................................................................................................. |
| Expenditure during the month of ..................... | ||
| Add.: Previous Progressive Expenditure upto ....... | ||
| Adjustments | } | Debit |
| Credit | ||
| Progressive expenditure upto ........................ |
| Loans and Advances | Investigation Claims | Legal fees | Grant-in-aid | Total | Initials | ||
| 57 | 58 | 59 | 60 | 61 | 62 | 63 | 64 |
| Serial No. | Name of student | Deposit | Rates of fees | April | May | June | July | August |
| Rs. | Rs. | |||||||
| September | October | November | December | January | February | March | Examination fees | Total amount of fees paid |
| Rs. | Rs. | |||||||
| Serial No. | Particulars of students | Year of deposit | Receipts | |||
| Name | Address | D.A.R. | Receipt No. and date | Amount | ||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Initials | Withdrawals | Initials | |
| Voucher No. | Amount | ||
| 8 | 9 | 10 | 11 |
| Dr. | |||||
| Date | Voucher | Particulars | Reference No. | Amount | Initials |
| Cr. | ||||||
| Date | Particulars | Reference No. | DAR No. | Amount | Initials | |
| Date | Particulars | Name of the persons | Payment made from amounts received during quarter | L. F. | V. No. | Amount |
| Receipts | ||||
| Date | Particulars | Receipt No. | L. F. | Amount |
| Period and Particulars (wage period) | Reference of notice if issued | Amount received | Receipt No. and date | |
| Unpaid accumulations | Interest | |||
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total | ||||
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total | ||||
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total |
| Factory or establishment andpublication of notice file No. .......................Factory Address.............................Registered office | |||
| 1st year | |||
| Notice board | Newspaper | Notice board | Newspaper |
| Period and Particulars (wage period) | 2nd year | |||
| Notice board | Newspaper | Notice board | Newspaper | |
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total | ||||
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total | ||||
| First Quarter ending 31st March, 19 | ||||
| Second Quarter ending 30th June, 19 | ||||
| Third Quarter ending 30th September, 19 | ||||
| Fourth Quarter ending 31st December, 19 | ||||
| Bonus for the year declared on | ||||
| Total |
| 3rd year | Reference to Report to Inspector | Inspector Report No. and date | Remarks | |
| Notice Board | Newspaper | |||
| Serial No. | Name of the claimant | Refund order No. and date | Voucher No. and date | Payment of unpaid accumulation from receipt | |||||
| As on | Quarter ending | Quarter ending | Quarter ending | Quarter ending | Quarter ending | ||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Amount received | |||||||||
| Date of first publication |
| Serial No. | Name of the claimant | Payment of unpaid accumulation from receipt | Remarks | ||||||
| Quarter ending | Quarter ending | Quarter ending | Quarter ending | Quarter ending | Quarter ending | Quarter ending | |||
| 1 | 2 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 |
| Amount received | |||||||||
| Date of first publication: |
| Serial No. | Name of employees | Ticket and Badge No. | Amounts payable during the month | ||||
| Occupation | Basic wages | Overtime | Dearness allowance and other allowances | Bonus | |||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Amount deducted during the month | Basic wages | Amount actually paid during the month | Bonus | ||
| Fines | other deductions | overtime | Dearness allowance and other allowances | ||
| 9 | 10 | 11 | 12 | 13 | 14 |
| Balance due to the employees | |||
| Basic wages | Overtime | Dearness allowances and other allowances | Bonus |
| 15 | 16 | 17 | 18 |
| Quarter ending 31st March | Quarter ending 30th June | Quarter ending 30th September | Quarter ending 31st December | ||
| 1. | Total realization under fines | ||||
| 2. | Total amount becoming unpaid accumulations of | ||||
| (i) Basic wage | |||||
| (ii) Overtime | |||||
| (iii) Dearness allowances and other allowances | |||||
| Total of (1), (2) |