Appendix 'XI' Form - XII (See rule 78 (2) (d)) Register of Fines Name and address of the contractor : Nature & Location of Work : Name & address of Establishment under which Contract is carried on : Name and address of Principal Employer : Designation / Act / Omission / Father’s Sl Name of Date of Nature of for which fine Husband’s no Workman offence Employment imposed name 1 2 3 4 5 6 Whether Name of person in Wage Amount workman whose presence Date on period & of fine showed employees which fine Remarks Wages imposed cause against explanation was realised payable fine heard 7 8 9 10 11 12
Appendix 'XI' Form - XII (See rule 78 (2) (d)) Register of Fines Name and address of the contractor : Nature & Location of Work : Name & address of Establishment under which Contract is carried on : Name and address of Principal Employer : Sl no Name of Workman Father’s / Husband’s name Designation / Nature of Employment Act / Omission for which fine imposed Date of offence 1 2 3 4 5 6 Whether workman showed cause against fine Name of person in whose presence employees explanation was heard Wage period & Wages payable Amount of fine imposed Date on which fine realised Remarks 7 8 9 10 11 12
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