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FORM XIX : WAGE SLIP

[Rule 78(1(a)(i)]

Name and address of contractor

____________________________

Name and Father’s /Husband’s Name of the workman

________________________________

Nature and location of work

___________________________________

For the Week / Fortnight /Month ending

________________________________

1. No. of days worked

________________________________

2. No. of units worked in case of piece – rate

________________________________

3. Rate of daily wages / piece –rate

________________________________

4. Amounts of overtime wages

________________________________

5. Gross wages payable

________________________________

6. Deductions , if any

________________________________

7. Net amount of wages paid

________________________________

Initials of the contractor or his

representative



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