,.

5;

GOVERNMENT OF KARNATAKA

No.LD 24 LET2A16 KarnatakaGover.nmentSecretariat,

Vikasa Sotrdha,
Baqgatore,Dated: l 6-01-zArc.

NOTIFICATION

Governmentof Kamataka are pleased to-introduce "The Karnataka State Self

Certification-Cum-Integrated
Periodic Returns Scherne-20|5"by issuingihis nrat
Notifiqation, inviting..o\|ecti''ons.-and
suggestionsfrom.the persorlslikely to be affected
'thereby within
I0 days.from the date of publicatiur of this Draft Notification in the
official gazette.Objections if any, shall be submittedto The Additional Chief Secretary
to Government,Labour Departrnent, Roorn No. 414, 4th Floor, Vikasa Soudha,
Bengaluru-560
001

Thesalientfeaturesof the said schemearesivenashereunder:-

TheKarnatakaStateSelfCertification-Cum-Integrated
PeriodicReturnsScheme-2015

l . Preamble: - The Karnataka State Self-Certification-cum-Consolidated

Periodic
ReturnScheme-2015 is introducedto streamlinethe enforcemefttproceduresunder
differentlabourlaws for their rneaningfulimplementationwith a voluntary spirit by
the employerlentrepreneur. The KarnatakaStateSelf-Certification-cum-Consolidated
Periodic Return Scheme-2015 aims at making the ernployer/ entrepreneur a
consciousand truthful citizen and law abidingpersonwho is willing to take care of
the rights and interest of the workers and ernptoyeesby complying with all the
provisionsof labour laws as applicable and enabtethe Departmentof Labour to
effectivelyprotect the rights and interestof the workerVemployeesand create a
peaceful,harmoniousand productiveenvironrnent aswell as co-operativerelationship
among and between the social partners Yiz, employees.ernployers and the
Govemment.

2 . ShortTitle and Commencementof the Scheme:-

The scheme shall be called the Karnataka Stae Setf Certification-Cum-

Consolidated Periodic Returns Scheme-2015.It shallcome into force from the date
of its notificationin the Official Gazette.
4'

3 . Definitions:-
-In this Scheme,unlessthecontextotherwiserequires,--
a) "Scheme" meaRs,the Karnataka State Self Certification-Cum-lntegrated
Periodic ReturnsScheme-2015
b) "Application Form" means the Form in which employer/entrepreneur
. submitshis intentionof entry into this Schemeas prescribedin Form-I.
.c) "Self Certification " means, a certificate submitted by the
emptroyer/entrepreneurto the notified authority, who optsto registerhis/her
esteblishmentunder.this.scheme to the effect that his/herestablishment
is in
full compliancewith the statutoryrequirementsunderapplicableenactments
' ineludedin this Schemeasprescribedin Fornr.-II.
d) "Integrated PeriodicReturn" meansa unified returnto be subnnitted under
this Scheme,asprescribed in Form-IItr.
e) "Employer's Manual" means the indicative sumrnary of statutory
requirements of the ernplbyerlentiepreneurunder the speiified Acts and
Rules of this Scheme,asprescribedin Forrn-IV.

A
Object of the Scheme:-The objeit of the Karnataka State Self-Certification-cum-
ConsolidatedPeriodic ReturnScherne-2015 is to bring spirit of voluntarycompliance
on the part of employer/entrepreneurand to reducemultiple visits by the Department
Officials for inspectionwithout compromisingthe serviceconditions,safety,health,
social securityand welfareof the workersas well as employeesandallow submission
of consolidatedPeriodic returnunderdifferent labour laws.

5. Applicability of the Scheme:-This Schemeis applicableto Shops,Commercial

.. to which the followins
Establishments, Factories and other establishments.
enactmentsare applicable;

l . The Paymentof WagesAct, 1936and the KarnatakaRulesmadethereunder

as amended
from time to time.
2 . The Minimum WagesAct, 1948and KarnatakaRules madethereunder
as amendedfrom
time to time.
J. The ContractLabour(Regulation& Abolition) Act, 1970and KarnatakaRules made
thereunderas amendedfrom time to time.
4 . The MaternityBenefitAct, 1961and Rules made thereunder
as amendedfrom time to
tlme.
5. The Payment of Bonus Act, 1965 and Rules made thereunderas amendedfrom time to
trme.
6. The Fayment of GratuityAct, 1972 and KarnatakaRules madethereunderas amended
f,romtime to time.
The Equal RemunerationAct, 1976 and Karnataka Rulesmadethereunderas arnended
from time to time.
8 . The KarnatakaShopsand Commercial EstablishmentAcq 1961.and KarnatakaRules
madethereunderasamended from time to time.
 9. The Inter State rnigrant workmen (RECS) Act, 1979 and Kar*ataka Rules made
thereunder asamendedfrom time to time.
l0.The KamatakaIndustrialEstablishrnentsQ.,lational& Festiva,lFlolidays)Act, 1963 and
Rulesmadethereunder as amendedfrom time to time.
ll.The Child Labour(Prohibition& Regulation)Act, 1986and KarnatakaRules made
thereunder asarnendedfrom time to time.
12.The KamatakaLabour Welfare Fund'Act, 1965and Rulesrnadethereunderas amended
from tirneto time.

6 . Procedureof Entry into the Scheme:- This Sclremeshall be optiona!and any

employerientrepreneur can opt for this Schemeby applyingto the notified authority
in the prescribedforrnat along with detal]s as per prescribedf,ormat and a se]f-
declarationasperprescribedformat.

Mode of Registrationand Time-frame for Approval :- Any' discrepancyin the

applicationor enclosuresshalt be.comrnunicatedto the applicantwjthin thirty(30)
days.from dateof receipt of the application in the office of notified authority. If the
notified authorityis satisfiedthat the appticq-ti-on"for
coveringestablishrnenis "" '.j-'
under
this Schemeis complete.in.alLrespect, the notified authorityshallissue'acertification
in Form-V.

8 . Self-Declarationand Affidavit :- For being enrolledfor the said Schenre,the

concemedemployer/entrepreneurshalt submit a "Self-Declaration"in the prescribed
format.andalsotosubmitan "Affrdavit" in the prescribed
fo.rmat.
9. Filing of Periodic Returns. :- After being enroltedfor the said Scheme,the
concernedemployer/entrepreneurshall fite the Self-CertifiedReturn in prescribed
format along with the required extracts of the registerlrecordEdocuments and
information. The return shall be filed between l't of March to 31't lv{arch of every
year. If any of the employer/entrepreneurfails to file the Periodic returnsshe/hewill
becomeineligibleto avail the benefitsof this Scheme.

1 0 Period
. of Validity of Scheme:- Factulalinformationgivenin the prescribedformats
and returnsshallbe the sameas on the date of filing the Return.The Self-Certified
declaration/undertakingand affidavit to abide by all the laws as applicableto the
Industry/EstablishmenVShop/Cornmerciat Establishment/Factory concernedshall be
valid for a periodof next Gne)iear,i.e. between2&129'h Februaryto 31't March of
everyyear.
Onceoptedfbr the Scheme,the sameshall continuedto be valid for five years
provided year-on-yearthe enrptoyer / entrepreneurshall file annual return as
prescribed.After the successfulcompliance underthe Schemefor five years, the
employer/ entrepreneur shall haveoption eitherto remaincoveredunderthe Scheme
or opt out of the scheme.The option must be exercisedin writing to the notified
authority. In casethe employer / entrepreneursuccessfully completesfive years
underthe Schemeand during any inspection,carriedout, if no violationsof laws is
detectedthe amornt of secuiity so depositedshallbe refunded.No interestshall be
payableon the amountof securitydepositedto the employer/entrepreneur.
ll.Registration Fee and Amount of Securityto be Deposited :- Any Establishment
can opt to enroll for the Schemefor all the applicablelegislationsmentionedin
provision-3of the Scheme.Theemployer/entrepreneur shall pay registiation
feesand
depositamount of securityas prescribed
underthe Scheme.The registrationfeesand
securityamountprescribed undertheschemeshallbe as under:-

st. No. of Workers Employed RegistrationFee. Amountof

No. (In Rs.) Securitv0n Rs.)-
Workerslessthan 100 Rs.10,000/- Rs.25.000/-
2 Workers 100 or more but less Rs.15,000/- Rs.50;000/-
than500
a
J More than 500 Workers Rs.25,000/- Rs. 1.00.000/-

In caseof increasein numberof workerVemployees after beingenr.glledfor the said

Scheme,the emplpygr / entrepreneurshall'remitthe remainiiig'-airplicatilb
amountof
. . . .securitydepositand'regisrration
feewithin one month of such'ihcrgase.

i2. Forfeiture of Security Deposit(1) Any employer/ entrepreneurwho fails to comply

rvith the terms and conditionsof the Schemeor fails to file return in time underthis
schemeor fails to abide by any undertakinggiven by him or any violationof law is
detected,then the amountof securityso depositedshall be forfeitedandin caseof the
violation of laws, further necessary action as per the law will be initiatedand the
establishmentwill ceaseto continueunderthe Scheme.However,therewill be no bar
on the re-entry of employer/entrepreneur into the Schemeagain after improvingthe
quality of complianceundervariouslabburlaws.
(2) Any employer / entrepreneur who withdrawsprematurelyfrom the Schemei.e.,
beforethe expiry of the prescribedperiodof five(5) years,then the amountof security
so depositedshall be forfeited.
l3.Responsibilities of Notified Authoritv :- 1) The application for inclusionof
establishments under the Schemeshall be made by the employer/entrepreneur in
triplicatein prescribedformataddressed to the notifiedauthority.
2) The Returnsin caseof establishments to be filed in prescribedformatin triplicate
to the notified authorityalongwith relevantdocuments.The returnsin prescribed
formatshall be filed beforethe lastdayof March of succeedingyearmanuallyor on-
line or as notifiedby the Government fromtime to time.
14. Procedure of Inspection under the Scheme:- An Establishment enrolledunder
this Scheme,shall not be inspected more than once in a year. Thereshall be a
comprehensiveinspectioncoveringall the applicableActs. In any year,not more
than 30Yoof the units coveredunderthe Schemeshall be picked up randornlyand
inspected.However,this doesnotbar inspections againstspecificwrittencomplaints
by the rvorkers,trade unionsandany other concernedperson/legalperson. In such
cases,prior permissionin writing shall be obtainedby the inspectingoff,icialfrom
the Commissionerof Labourin Kamataka.
 15. Continuation of Existing System:- This Scherne is voluntary far the
employerlentrepreneur. The establishmentswhich do not desire to opt for the
Scherneshall betreatedasper existingsystern.
16.Transparency and Accountability : The ernployerlentrepreneur, who hasobtained
registrationunderthis Schemeshall maintain all Records,Registersand other upto-
date information as requiredunder various labour laws either in soft-form or hard
copy-form at the work-spot/ unit office. Whenever Departmentauthoritiesrequire
records/ registerVinformationof the establishrnent.under the provisionsof any labour
lawg then the employerlentrepreneur is duty-botrnd to prodrrcethe sarne to. the
.. poncerned authority,in hardor soft form as desired by the Authcrity.

17.Display of ComplianceInformation:- The ernployer/entrepreneur shall displaythe

terms and conditionsof this Schenreas welF as the statusof complianceon a notice
board, whictr' is visible to atl the ernployeesand workers. The emplo er shalt also
ddctare that he/she has ofied for the Karnataka State Self-Certification-cum-
ConsolidatedPer'iodic Schente-20l5,on their website,if tlrey havea website.
.Return
18.-Removal of Difficukies:- [n case,there are any difficu]ties in irnp]ementaticin
of this
.. Scheme,the decisionof the Comrnissionerof Labour in Karnataka,on the specific
issue,shalt be bindingon theconcernedparties.

By order and in the name of the

Governor of Karnat'aka

#{lt{,\r,ah
(s.N. RAMAKRTSHNA)\& ,l
\,
Under Secretaryto Government,
Labour Department
a,
ro, \,)t
The Cornpiler, KarnatakaGazatte,Bangalore- with a requelt to publish the aboveNotification in
the Extraordinary Gazettewith a requestto furnish 50 copies of the Notificationto the Under
Secretary to Government,Labour Departrnentand 50 copies to the Commissionerof Labour in
Karnataka, Karm ika Bhavana,BannerghattaRoad, Bangalore.

Copy to:
1. The Commissioner of Labour in Karnataka, Karmika Bhavana, Bannerghatta
Road,Bangalore-560029
2. The P.S.to Hon. Ministerfor Labour Depaftment,Vidhana Soudha,
3. P.S.to AdditionalChiefSecretaryto Governrnent,Labour Departrnent
-
4. P.A. to DeputySecretary 1, Labour Department.
5. S.G.F/SpareCopies.
 TheKarnataka
StateSelfCertification-Curn-lntegrated
PeriodicReturnsScheme-2015
Form-l
Form)
{Application
From

To.
The Notified Authority,
Departmentof Labour
Governmento:fKarnataka

Subiect:-Applicationfor permissionto be coveredunderthe KarnatakaState Self Certification-

Cum-lntegratedPeriodic ReturnsScheme-2015. under labour laws beingenforcedby
Departmentof Labour,Government of Kainataka-regarding
Sir,
l/We have gone through the provisionsof the KarnatakaState Self Certification-Cum-
lntegratedPeriodic ReturnsScheme-2015 and have understoodthe same. l/We wish to be
coveredunder the said Scheme.The necessary informationand other.dgqgngl.tS.asrequired
under the scheme are herewith submittedfor your considerationand acceptance.l/We
undertaketo abide by all terms and conditionsof the scheme.'it is also certifiedthat l/We
amfare cornp€tentand duly authorizedto makeany statement or provide any informationto
any competentAuthority of LabourDepartmenton behalfof this establishment/enterprise. As
suchl/We requestyou kindlyissuemefusnecessary approvalfor the same.
Kindlyissuethe necessary
approvalatthe earliest.

you'
Thanking
Yoursfaithfuily,

(Name,hsignation and FullAddress

" of the Employer/ Manager)
Enc:- (1) Listof documents
(2)SelfDeclaration

Acknowledeement
Slip
This is to acknowledgethat an applicationin respect of the KarnatakaState Self
Certification-Cum-lntegratedPeriodic ReturnsScheme-2015. under labour laws has been
receivedby the undersignedfrom M/s.... ....(Fulladdressin Capitaland
the samehas been entered in the officereceiptRegisterat Sl. No........... Dt...................
Any
furthercorrespondence in favour in this regardmaybe done by statingthis Sl. No.....................

AuthorizedSignatory
ForDepartmentof Labour
Governmentof Karnataka
The KarnatakaState SelfCertification-€unr'tntegrated
PeriodicReturnsScheme-2ol5

L]STOF DOCUMENTS
TO BEATTACHEDWITH FORM-I

SL ENCLOSED,
DOCUMENTS
NO YESOR NO
RegistrationCertifrcateunder.KarnatakaShops and CcimmercialAct 1961
and Karnataka rutes 1963 / Licence obtained under Factories Act 1948 I
1
Registration Certificateof PrincipalEmp]oyer'fL'leence'of Contractorunder
ContractLabourAct whicheveris applicabh.
v ESIC Challani EPFResistration Certificate/ Chatlan
3 Details of Feesand SecurityDepositpaid dccunrents.
Permarrcnt and Postal Address & ID Proof of Proprietor / Partners
4
DirectorsI Occupiers.
5 Rent ,Agireement / OwnershipDeed/ LeaseDeed.
Copy'of. Memorandum"of'Assobiation and Article s of A ssociation;in caseof
6
Pvt. Ltd., Publiccompanies... .
7 PartnershipDeed in caseof PartnershipFirm.
Registration/ Licenceobtainedunder any Central I State Govt. Agencies
8 (TIN RegistrationCertificate,if RegisteredI VAT Registration/ServiceTax
/ Licence Obtainedfrom Indugriesand CornmerceDepartmentl
9 Declaration regardingnon-employmentof child Labour.
Lahd line. Mobile number,E-mail IDs Proprietor / Partners/ Directors/
10
Occupiers/ Contractor/ Ernployerfor cornrnunication.
t 1 Any otherrelatedDocuments.
 4
(.7

The Karnataka State Self Certification-Cum-IntegratedPeriod.icReturns Scheme-2015

Form-ll

SELFCERTIFICATION

liWe .
Slo/DlolWlo;...

Managerof IWs.

. That I/We have applied f,or gnantof coverageo.fgnil/.e.glablishmentby the name

of . . . . . situatedat (completeaddressof the unit)
-, -.. . . .:.J
.-.....i-r.r

Perigiic R.eturnScheme-2015of Departrnent

Self-Certification-cum-Consotidated
.ofLabour,Governmentof Karnataka,as notifiedvideNotificationNo.
dated.

l. That I have gone through the provisionsof the Scherneand have

fully understoodthe provisions of this Schemeand undertaketo
abideby the same.

2. That it is declaredthat l/we are complyingand will continue to

comply with all provisions of labour laws covere{ under this
Scheme.

3. That it is hereby further solemnlyaffirmedthat the contentsgiven

above are true and correct to the best of my/our knowledge and
belief.

4. That I agree to accept the penalty prescribed under specific

enactments and this Schemein caseof violationdetectedin this unit
/ establishment under any labourlaw coveredunder the Scheme
afterfiling of the informationreturnundertheScheme.

PLACE:

DATE: of the Applicant

Signature

(Name,Designation
and FullAddress)
,.i

INFORMATIONFORM OF SELFCERTIFICATION
UNDERTHESCHEMh

1 . Name and addressof the

Establishrnent

PhoneNo.l e-Mail/Fax/website
2 . Proprietor/FartnerlDirector of
EstahFi$rnent
PhoneNo./ e:MaitiFaxlWebsite
3. Registrationll icenceno. (Which
ever Labour Act appticable)
4. Nature of Business

5 . Nq..of Employees Mafe Female Total

a) Regulm

b) Contract

c) Daily Wages .

6. Weeklv holidav

IlMrlMrs/Miss..... hereby, certify that I am

Employer/Contractw of the establishmentwhoseidentification and generaldetailsare as
above. I, hereby declarethat I complywith all the provisions of following'Applicable
LabourAct's.

l. The KarnatakaShopsand CommercialEstablishment Act, 1961 and KarnatakaRules

thereunder.
2. The Minimum WagesAct, 1948andKarnatakaRulesthereunder.
3. The Paymentof WagesAct, 1936Rulesthereunder.
4. The Contract Labour (Regulation& Abolition) Act, 1970 and KarnatakaRules
thereunder.
5. The lv{aternityBenefitsAct, 1961andKarnatakaRulesthereunder.
6. The Paymentof Bonus Act, 1965andKarnatakaRulesthereunder.
7. The Payrnentof Gratuity Act,1972andKarnatakaRulesthereunder.
8. The EquatRemunerationAcq 1976andKarnatakaRulesthereunder.
9. The Industrial Employrnent(StandingOrders) Act, 1946 and KarnatakaRules
thereunder.
10.The PlantationLabour Act, 1951andKarnatakaRulesthereunder
11.The Motor TransportWorkersAct, 1961andKarnatakaRulesthereunder.
12. The KanratakaIndustrial Establishments(National & Festival Holidays)Act, 1963
and KarnatakaR*les thereunder.
I
10

13. The Beedi& Cigar Workers (Conditions of Ernpluyrnent)

Act, 1966 and Karnataka
Rulesthereunder.
14.The SalesPromotionEmployees(Conditionsof Service)Act, 1976 andK Karnataka
Rulesthereunder.
15. The Inter StateMigrant Workmen (Regulationof Employmentand Conditions of
Service)Act,1979and KarnatakaRulesthereunder.
16. The Child Labour (Prohibition and Regulation)Act, 1986 and Karnataka Rules
thereunder.
17.The Karnataka LabourWelfareFund Act. 1965.

I declarethatI havealsocompliedwith the following provision

. l. That I haveissuedappointmentletters,leavewith wagesbooksto all workers and I

havemaintainedall the registersand recordsprescribedunderKarnatakaShops &
Commercial EstablishmentAct.
2- ThatI haveissuedsalaryslip to all the workersandminimumwagesas per the Govt.
Notification and I have maintained ali the reQisteredand record'S-'urider-'The
. . lvllnimum.WagesAct, 1q48.,
3. The Wageswerepaid as p€r law and no deductions that arenot authorizedunder the
law havebeenmadefor the wagesthereofof the workers.
4. Thatno child belowthe age of 14 yearshasbeenemployedin the establishmentand
womenworkershavenot beendiscriminatedagainstin any.
5. That I havecompiiedwith the provisionsof the Paymentof Gratuity Act, 1972,that
the arrangementis madeto acceptthe nominationform of workers,that the notice in
form-U has been exhibited and ..... Workers are paid Rs.
As gratuity underthe Act duringthe year.
6- ThatI havepaidthe bonusto the employeesaSperthePaymentof Bonus Act, 1965.
7. That....... ....... Workerswereremoved or retrenched
duringthe
yearandI havepaid their duesas providedunderlabourLaws.
8. That I have maintainedthe registers/ recordsprescribedunder these Acts, and
displayedtherequiresnotices.
9. That I Undertaketo Provide,Statutorilyprescribedup{o-dateInformation,registers
andrecords,whenevercompetentauthorityof the Department asksthe same.

I herebystatethat the information given as abovearetrue and correctto the best of

my knowledge, informationand belief and in caseit is provedto be false,I will be
liablefor punishment as providedunderconcernedlaw.,

Yoursfaithfully,'

Date : (Signatureof EmployerlManager

Place: /AuthorizedSignatorywith
Full Name,Designationand PostalAddress)
* 1L

Form-]tl

( IntegratedPeriodicReturn)

The KarnatakaState Self Certification-Cum-

|ntegrated Periodic Returns
Schcrne-2015

Year Ending:-

1. Name ofthe Shop/EstabtLshrneat/Enterprise/Fmtory :

. .

t. a) Shopsdnd Ccmrnercia! Establishrnents

RegiSratio# Frctory LicerneLAny other Statt*ory Reg. Ne:-

2. F*tPostat Address :
--i
'
Lrcation Ad&ess Telephone Fax E-rnail
1)Shop/Establishment/Enterpris{Factory :

2) Registered Office / Head Office

3. Mture/ Type of Industry/Estaflishment :

4. Name and Residential Address of the PersonlPrincipalEmployer Responsible for

conductand control of the-Business :

Narne DesignationResidentialAddress Telephone Mobile E-mail

(o)
(R)

5. Nameand ResidentialAddress of the Occupierand Manager :

Name DesignationResidential Address Telephone
Mobile E-rnail

Occupier (o)
(R)
Manager (o)
(R)

6. Date of Commencementof ManufacturingProcess/ Business:

 1
et L2

T.Particulars of
No.of Persons No.ofPersons No. of Man No of man Total amout of
on roll ason on roll ason days hoursworked salary/wagespaid
l-l-20 (year 3l-12-20(year worked includingO.T. includingO.T.
commenceme commencemen during the duringthe wagesand
nt date) t date) Year year ailowances(in Rs)

7.A) No. of employeeswhose employmentis ceased:

Amountof No. of Amsunt of subsistence

..
employees allowance pald
No. of employees paid
Compensation
suspended
discharged/dismissed/
during
1 2 J 4

S.Particu of Earned Leave with W

No. of Employees No. of
No. of
No. of Discharged, Employees
Employees
Employees Dismissed, paid
AvailediGr
Eligiblefor Terminated, Wages\Salar
anted
Earned Rbtrenched,Resigned y in lieu of
Eamed
Leave or Retireddurinsthe Earned
Leave
Leave

i) Women

8.A) Whether the following Welfare Measures are provided?

l.Canteen
2.Creches
3.Shelters.RestroomsandLunchRoom
4.TransportFacility
T
13

9. Materni{r Benefits :-

g.AlParticularsof Maternity Benefits

t Total No. of womanworkers who worked for a period of 16O

daysin the last 12 months imnrediately precedingthe dateof
deliverv
2. No- of women workers dischargedl dismissed in thc last 12
months
3 . No. of.women workers for whom pre-natal conftnementan*
post-natalccnfinementis provided by the employer with free
ofcost
4. No. of Wornenwo*kersdied
a) Before Delivery

Delivery
..b)After

9.Blleavel additional Leave Details:

Item No. of Women Leave sanctioned Leave rejected
applied for leave
Miscarriase
illness (additional Leave
underSec.l0)

9.ClMaternitl' Benefit Paid details:

item No. of clainrs No. of leaves No. of claims Total benefit

received sanctioned reiected oaid in Runees
Confinement
Miscarriase
Illness
MedicalBonus

1,0.Particularsof Deductions made from sal

No. of Emoloveesinvolved Totalamountof deductionmade

iii) Breachof contract

iv) Others
fr L4

. i

11. Details of Payment of Bonus during the year :

No. of employees Percentageof bonus/Ex- Total amountof Bonus/ Eate of

elieible for bonus gratiadeclared Fx-gratia paid Payrnent

l,2.Contract Labour details:

Max. No. of
contrhct
Name and Period of No. of No. of
Nature of workmen' No. of days
addressof tk contract persons man'days
work ernployed on any worked
contFactors Fromlto ernployed worked
day during the
' vear

i)
ti)
v)

13. The Inter State MigrantWorkmen details:

Name and Period Nature Maximum No. of days No. of man Total Amount Arnount of
Address of of No. of worked days worked of salary/ displacement
of the Contract Work workers Wagespaid allowance
Contractor employedby includingO.T paid
each ' wagesand
contractor allowances
(Rs)

M w Total M w Total M w Total M w Total M w Total

# 1.5

14. Contribution of Labour Welfare Fund

L. Total numberof workerswhose narnesstand in the
Establishrnent Registersas on 3lst December
2.Employee'sCo'ntributionat the rate Rs 6 per Empfoyee
3. Employer'sContributionat the rate Rs 12 per Ernployee
4.Total of iterns2 and3
5.Whetherthe contribution is sent by Cheqtre, Bank Draft.
Money ordersor cashandDetailsthere of ' '' '"'
:

Certified that the info.rmation furnished above iq to the best cf my knowledge

arx* belief. ccrrect.

Signature.of Ernployer
/OccupierlN{anager
Dated:
Plme:
Name
Designation
 ,
+l
' a 16

i
Form-lV

Employer's
Manual

R E S P O N S I B I L I TO
I EFT
SH EE M P L O Y E RUSN D E RD I F F E R E N T
I
I
a
LABOURLAWS
(The provisions of different labourlaws to be complied given below are illustrative
and not exhaustiveand are meantfor generalguidance.for detailspleaserefer to
respectiveAct and Rules.)
1. Payment of Wages Act, 1936 and Karnataka rules framed
thereunder.

The employerhasto:

1'FixthewagesperiodwhichwiIlnof.exceedone'month....
2. Pay .the..wages.tothe employed'persons on or before 7th (employingleSsthan
1000persons)lOth (employingmorethan 1000persons)of everymonth.
3. Pay the wagesin currentcoins/currency noteV Bank Account
4. Deduct from the wages of an emplo-,ved person wages as per provisionsafter
following the due procedureonly.
5. Display the notice containingtheabstractof the Act and the rulesmadethereunder
in English, Hindi, Kannadaand in languagesof the majority of the employed
persons.
6. Maintain the following registers
- Registerforfines;
- Registerlor deductionsfor damageor loss;
- Registerof wages.
7. Pleasereadthe Act andRules

2. The Minimum Wages Act, 1948 & Karnataka rules framed

thereunder.

The employer has to:

l. Pay the minimum wagesto the workers as.notified by the Governmentof

Karnatakafrom time to time.
2. Fix and allow weekty dayof rest/substituteweekly - off.
3. Fixation of numberof daily workinghoursin caseof adult for t hours.
4. In case of over time working,to pay the workmen at double the rate of their
ordinary wage and to maintaina registerof overtimein PrescribedForm.
 17

5. To maintainthe followingrecordsand to producethe samefor inspectionto the

inspectingauthority:-
a) Register of Fines and Register of Deductions for damagesfor loss in
Prescribedform bothas laid down underthe Rules.
b) Annual Returnsin PrescribedForm.
c) Register of Wages in Prescribed Form containing signatures/thumb
. inrpressionto the workmen.
d) Wageslipsduly signedby the ernployerin PrescribedForm.
- 6. disptay'.the following notice in English, Hindi and in a languageas understoodby
the rnajority of the workers in the emptoyrnent at the main entrance of the
establishment andin theoffice in legiblecondition
A.Abstract of the Mi.nimurn Wages Act. 1948 and the Rules r,nadeby the
Governmentof Karnataka.there under in PrescribedForm
B.Name a.ndaddressof the'inspector:
C.The prevalentminirnumwagesas notified by the Government.
7. Authentica'tethe entriesin the registercf wagesand wagesslipsareauthenticated
by himself or by anypersonauthorizedby him in this behalf,
8. Abide by the provisionof the Minirnum WagesAct, 1948andthe Rules framed
by the Governmentof Karnatakafron-ltirne to tinre.
9. Fleasereadthe Act andRules

3. The Contract Labour (Regulation and Abolition) Act, 1970 and

Karnataka Rules framed thereunder.

The PrincipalEmployerand the Contractorof the establishrnent

shallprovidethe
following

l. Facilitiesto the contractlabourand in caseof failureon the partof contractorto

do so the principalemployeri.e. the establishmentshallprovidethe sameand may
recover the expenses from the contractoreither by deductionfrom any amount
payableto the contractorunderany contractor as a debtpayableby the contractor
as laid dorvnu/s20 of theAct:
2. CanteenfacilitiesasprescribedunderKarnatakaRules.
3. Rest roomsor suitablealternativeaccomrnodationto the contractlabour.
4. Other facilities like sufficient supply of r.vholesomedrinking water convenient
places,sufficientnumberof latrinesand urinals of the prescribed type washing
facilities etc,asprescribed underKarnatakaRu.les..
5. First-aid facilitiesto be rnadeavailableto the contractlabotxdurins all workins
hourswith prescribed contents.
6. Submit the Annual Return in PrescribedForm in duplicateto the Registering
Officer not laterthantheprescribeddate following the endof the yearto which it
relates.
t
r{ 18

7. Maintainthe Registerof Contractors in PrescribedForm

8. Recordcertificateat the end of the entriesin the Registerof Wagesindictingthat
the workmen concernedhavebeenpaidin his/ presence.
9.In casethe contractorfails to makepaymentof wageswithin the prescribedperiod
or make short payment,the establishment shall be liable to make the paymentof
wagesin full or the unpaid balancedue,as the casemay be to the contractlabour
employedby the contractor.
lO. Pleasereadthe Act and Rules

4. The Maternity Benefit Act, 196l and Karnataka rules framed

thereunder.

(The Act is Applicable where Five(S) or more persons are employed

on any day in the preceding twelve months)

(The Act is not appticablewherethe establishment

is. coveredunder the
Ernployees
StateInsurance
Act l%8);

The employer has to:

1.. Ensure that no woman is being employedknowingly during the six weeks
immediately f'ollowing the day of her delivery. Miscarriage or medical
termiqationof pregnancy.
2. Ensurethat the Maternity benefitat the rate of avbragedaily wage for the period
of her actualabsencefor deliveryor twelveweekswhicheveris less,is beingpaid
to the women employees,and in caseof her deathbefore receiving the maternity
benefit,the sameshall be givento thepersonnominatedby the saidwomen.
3. Ensurethat a medical bonusof two hundredand fifty rupeesis also beinggivento
the female employeesin casethe free of chargepre natal confinementand post
natalcareis not provided by the establishment.
4. Ensurethat a six weeks leavefor miscariageor medicalterminationof pregnancy
is also being given to the affectedwomenemployee.
5. Ensurethat leave with wagesfor two weeksfor tubectomy operationis given to
womenemployees.
6. Ensurethat every woman who hasdelivereda child who returnsto duty shall be
alfowedin the courseof her daily work two breaksof twenty minutesdurationfor
nursingthe child until the child attainsthe ageof fifteen months.
7. Maintainthe recordof womenemployeeof the establishmentin PrescribedForm
8. Exhibit an abstractof the Act andthe rulesthere under in PrescribedForm in the
languageof the locality at a conspicuous placein every part where the womenare
ernployed.
9. Pleasereadthe Act and Rules
 19

5. The Payment of-:Bonus Act, 1965 and Karnataka rules framed

thereunder.

(The Act is applicableto eslablishments

in which 10 or more persotlsareemployedon
any day in the precedingtwelvemonths).

The ernployer has to;

1,. Mai*tain in Fornr "A" the record in respect of computation of the 'Available
Surplus'in respectofany accounting vear.
2. Maintain the Set on andSetoff of allocablesurplus in Form-B
3. Maintain the recordaf theborus paid to ernployeesfor any accountingyearForr*-
C
4. Stlbmit Annual ReturninForun-D
5;'Pay the'bohus to the emf,oyeeswithin'8'mbntFn of the close of the accounting.
_..:.yemi ..

6 Produce the accounts,books,registersor other docurnentswheneverasked for

inspecticn.
7. Pleaseread the Act andRules

6. The Payment of Gratuity Act, lw2 and Karnataka Rules framed

thereunder.

(The Act is applicableto establishmentsin which Ten(10) or more personsare

employedon any day in theprecedingtwelve months).

The employer has to:

1. Give notice of openingin Prescribed Forrn to the ControllingAuthoritywithin 30

days.
2. Give a notice in Preseribed Form to the Controlling Authority in caseof any
changein the name,address, employeror natureof business.
3. Give a notice in Prescribed Form to the Controlling Authority in caseof close
down of husinessat leastsixtydaysbeforethe intendedclosure.
4. Ensurethat a noticeis displayednearthe main entrancein bold letterin Hindi and
in a languageunderstoodby at least one third of the employees,specifyingthe
name of, the officer with designationauthorizedby the employerto receiveon his
behalfnoticesundertheAct or the rules;
',
!-1r 20

five years are being paid/shall be paid gratuity on superannuation/retirement/

resignationand the nomineesof an employeewho dies during the serviceare also
beingpaid/shallbe paid gratuity eventhoughfive yearsof servicehave not been
rendered.
6. Ensurethat the amountof gratuity is/shallbe determinedby the ernployerand the
noticein writing is/shall be given to the personto whom the gratuity is payable
andalsoto the Controlling Authority.
7. Ensurethat the arnoufttof gratuifis /'shattbe paidwithin 30 days from the dateit
. becomespayableas hasbeenlaid downunderthe Act and the Rules.
8. Ensurethat an abstractof Act'and the rulesrnadethereunder in PrescribedForm
in Englishand in Hindi hasbeendisplayedat a conspicuous place.
9. Pleasereadthe Act and Rutes

''7: The Equal RiimunEi"ation

Act, 1976and Khinataka rules framed
thereundei.'.

l. Employer has to pay remunerationat equalratesto men & women workers for
performingsameor similar natureof work.

2. Employerhasto maintain Registerin form 'D'.

3. Please
readthe Act and Rules

8. The Karnataka Shops and Commercial Establishment Act, 1961 and

Karnataka rules framed thereunder.

1. ObtainRegistrationof the shop or commercialestablishment

as requiredunderthe
Act and also get it amendedfrom time to time if any change occurs in the
particulars.

2. GiveAppointmentlettersin Form-Qto eachEmployee.

3. Fix the weekly hours, weekly holidays,compensatory holidays, daily hours,

intervalsfor rest, spreadover period as specifiedin the Act and rules madethere
under.

4.Pay extrawagesof overtimeas twice of theordinaryrateof wages.

a) Maintainthe following registers:
b) AttendanceRegister
c) InspectionBook
d) Leavewith WagesRegister
 21

e) Extra Wages for overtime register, Register of Fines, and Register of

Deductionsfor damagesfor lossin PrescribedForm and all otherregistersas
requiredunder law.

5. Give the annt"lalleavewith wages,andotheradmissibleleaveas prescribed.

6. Provide safe and hygienic working conditionas prescribed.

7.Submittheprescribedannua[returnswithinthestipu}atedtirrre.

8. Abide by all the provisions of the Karrptaka Shops and Commercial

EstablishmentAct, 196l and the Rulesframedthereunderby the Governmentof
Karnatakafrom tirne to time.

9. Pleasereadthe Rct and Rules

9.InterStateMigrant.Workmen(Regu|ationofEmp|oymentand
Conditions of Service) Act, 1979 and Karnataka ru.l€s framed
thereunder.
The Employer has.to

t. Obtainthe registrationfrom the notifiedauthority.

2. Ensurethat the contractorshouldget licencefrom the statefrorn which the labouris
broughtand the statewherethe labourworks.
3. Maintain the details of contractorsand maximum number of inter-statemigrant
workmen employed by them.
4. Pay displacement.allowanceand joumey allowance to the inter-statemigrant
workmen
5. Ensure that health, safety and welfare facilities are provided to the inter-state
migrant workrnen
6. Maintain register of contractors,registerof workmen employed by contractors,
return journey allowance register,muster roll, register of wages, registerof
deductionfor damagesor loss,registerof fine, register of advances,registerof
over-time
7. Issueservicecertificateto employees who leaveservice.
8. Submitannualreturn in XXIII andXXIV
9. Pleasereadthe Act and Rules
 22

; l0.Karnataka Industrial establishments (IYational a-nd Festival

: Holidays) Act 1963 and Karnataka rules framed thereunder.

1. The employerhas to display the list of nationaland FestivalHoliday for that

calendar year in Engtish and Kannada in a conspicuousplace in the
Establishment.
'
2. The employerhas to ensurethat prescribedand declarednational and festival
holidaysare given to the employeeswith wages.If any employeeworks on such
holidays,employeesare entitledtwice the wagesor substituted
holiday with wage
QnanYotherdav.

3. The employerhas to give holiday with wageson the polling day for House of
Peopleor to the StateLegisl.ativeAssembly.

4. Please
readtheAct and Rules

l1.The Child Lnbour' (Prohibition- and Regulation)Act, 1986 and

Karnataka rules framed thereunder.
Note:Child meansa personwho has not completedhis fourteenthyear of age.

The Employerhas to ensurethat.

1. No child has been employed or permiuedto work in any of the occupations

set forth in part-A; of the Scheduleor in any workshopwherein any of the
processes setiodh in part-B of the scheduleis carriedon.

2. No child is permittedto work in the establishment

for more than four and half
hourson any day.

3. The periodof work of a child on eachday hasbeenso fixed that no period

exceedsthreehours and no child shall work for morethan three hours before
he hashadan interval.forrest for at leastonehoursandthe spreadover is not
morethansix hoursincluding the time spentin waitingfor work.

4. No child has beenpermittedor requiredto work between7 P.M. to 8.A.M.

andnot requiredor permittedto work overtime.

5. Everychildemployedin an establishment
hasbeenalloweda weeklyholiday.

6. The notice to inspector as required u/s 9(2) of the Act has been given
containingthe inforrnationas per section9(1) of theAct;
7. Therecordin prescribedForm hasbeen/shallbe maintained.
f . - 73

t? 8. The notice containing abstractof section3 and 14 has bean displayed at the
t
I
!
placeof work in local languageandin Englishlanguage.

9. The health facilities and safetyof chitd asrequiredufs tr3have beenprovided.

10.All the provisionsof the Act andthe rutesarelstrall

be complied with.

I t. Pleasereadthe Act and Rutes

'Welfare
l2.*furn#*ka- L,aheur Fund Act 1965 and Karnataka rules
framed thereunder.

alEnployer shalt pay ernployer arr* ernployeeeo*r*ibution to the l,abour

We!fureFundat ttre.rateof.B+!.? g,SRs6tobe de&rctedfrorn December
rnorxh's sahry. within the prescribedtinrelirn4t in Form D

b) Emsoyer shaFtiansfer any unpaidaccumu*ation

to the Labour Welfare Fund
'
within prescribedtime lir*it

c) Ernpbyer shall maintain and keepregiserof wages in Fornr A, and

ccnsolithted register of unclaimed wagesand fine kr f,orrnB

d) Pleaseread the Act and Rules

 24

ANNEXURE

FORMFORSEIFCERTIFICATION
ANDCONSOLIDATED
ANNUAL
RETURN
TOBESUBMITTED
BY

I, Mr./Mrs./Miss. ......hereby,certify that I am

Ernployer/Contractorof the establishment whose identificationandgeneraldetailsare as
follows. I, herebycertify that the statusof complianceof following Labour Laws and
annualinformationof my enterpriseduring the year. ... is as.under.

l.The KamatakaShopsand CommercialEstablish.ments

Act, l96l and karnatakaRules

2.The Paymentof WagesAct. 1936 and the karnatakaRules made there under as
amendedfrom time to time.
3.The Minimum WagesAct, 1948 and karnatakaRules madethere under as amended
from tinid to time.
4.The Contract Lalrour (R.egulation& Abofition) Act, 1970and kamataka Rules made
-'..' there underasamendedfrom time to time.
'
5.The MaternityBenefitAct, 1961 and karnatakaRules madethere under as amended
from time to time.
6.The Paymentof BonusAct, 1965 and karnatakaRules madethereunder as dmended
from time to tirne.
7-The Paymentof GratuityAct, 1972 and karnatakaRulesmadethereunder as amended
from time to time.
8.The EqualRemuneration Act, 1976 and karnatakaRulesmadethereunderas amended
from time to time.
9-.TheIndustrialEmployment(Standing Orders) Act, I 946 andkarnatakaRules made
there underasamended from time to time.
10.TheBeedi and Cigar Workers (Conditions of Employment)Act, 1966and karnataka
Rulesmadethereunderas amendedfrom time to time.
I 1.The Inter StateMigrant Workmen (Regulationof Employmentand Conditionsof
Service) Act, 1979and karnatakaRules made there underas amendedfrom time to
time.
l2.The Motor TransportWorkersAct, 1961 and karnatakaRulesmadethere under as
amendedfrom time to time.
t
II t
t -
I t. NameandAddressof Establishment:
TeleNo. Mobile No. FaxNo. E-mail
address.

2. Nanreardresidentialaddressof the
Emp&uyer/contractor: .
TeleNo. Mobile No. Fax No. fudl
address

3. Nameandresiderxial addressof the rrlanageror

persm respoiesib&s fcr strpervision
or cs*rol af the establishrncftt:
TeleNo: MohileNo. Fax'Nc. E-mail -.i
ad&ess,..:-:. -.

4. Regis*atisrNo.llicence No. and year of

co.mfllencelnent
of the establishment:

5. Nature of Btrsfures$activity:
EmplolrnentPortal Reg-No.. Whethervacancyuploaded:Y/N

6. Numberof Employeesemployed:
(inctudingcontractworkers)

Typecf Un- Serniskilled Skilled Total Male Female

Worker skilled
Direct
Through
Contrrctor
Total
 4
"i 26

/.et\
rto,/*i" r,q'i
Governmentof Karnatakr Departmentof Labour
- fiffi.,';
{')- -{+.7'{tl:'}

a a a a a a a a a a a a a a

.. ...t-q..r-......lalaa.......rrrrrrrr.r....rrr

Date:

Form-V
Certificateissuedby the NotifiedAuthority for the Establishment
for
having admitted.underThe.Karnatakastate self certif:ication-c
um-
lntegiated Periodic Returns Scheme-2015

1 . Name and addressof the

Establishment

PhoneNo./ e-Mail/Fax/website
2. Name of Proprietor/
Partner/Directorof
Establishment
PhoneNo./ e-Mail/Fax/Website
3 . Registration/Licence
no. (Which
everLabourAct applicable)
4 . Natureof Business

5 . No. of Employees Male Fem ale Total

a) Regular

b) Contract

c) Daily Wages

5. Weeklvholidav

The above establishmenthas been admitted for the Karnataka State Self Certification-Cum-
Integrated Periodic ReturnsScheme-2015. The following Labour Laws are applicableto the
abovesaid establishment.This certificateis valid for five (5) yearsfrom the dateof issue.
* 27

ApplicableLrbcur Lawsfar the Estabhshments:

l. The KarnatakaShopsand Commercial EstablishmentAct, 196l and Kamataka Rules

thereunder.
2. The Minimum WagesAct, 1948 and KarnatakaRulesthereunder.
3. The Paymentof WagesAct, 1936Rulesthereunder.
4. The Contract Labour (Regulation & Abolition) Act, lW} arx* Karnataka Rules
thereunder.
5. The Matemity BenefrtsAet, 196l ard Karn-atakaRulestherewrder.
6. The Payrnentof Bo+nnAct, l965 and Karriatbka Rules ttreretmder.
7. The Payrnentof Gratuity Act, \W2 and.i{arnatakaRulesthereunder.
8. The EqualRemuneraticnAct, t9?6andKarnataka Ruhsthereunder.
9. The Inter StateMigrar* Workrnen (Regulation of Ernploymentand Conditions of
Service)Act, lyl'g && Kmnataka Rules thereunder.
10. The Karndaha I*rdustriat Establishnrents (Natio+ral & Festival Holidays) Act, 1961
.- andKarnatakaRulesthere*nder.
I l. The Chikt Labour (Prohibitiml and Regutation) Act, 1986 and Karnataka Rules
thereun&r.
12. The KarnatakaLabourWetfare Fund Act, 1965.

Signatureof ttreNotifred Authority

Dated:
Place: