FORM B

STATEMENT OF EMPLOYEES' AND EMPLOYERS' CONTRIBUTION FOR THE SIX MONTHS ENDING ON THE 30TH JUNE AND THE 31ST DECEMBER, RESPECTIVELY

[See Rule 3(5)]
  CLass of Establishment Number of establishment Amount of employers' contribution recevied by the Welfare Commissioner
  1 2 3
 

Rs.
1. Factries    
2. Motor Omni Bus Service    
3. Shops    
4. Commercial Establishments    
5. Residencial Hotel    
6. Restaurants    
7. Eating Houses    
8. Theatres    
9. Other places of Public amusement or entertainment ________________________________________
       
TOTAL ___________________________________

 

Signature of the Welfare Commissioner
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Last Updated : 23 Mar,2014