F O R M II
EMPLOYMENT
CARD
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Name and sex of the worker |
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Age or date of birth |
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Fathers name |
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Identification marks |
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Address |
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Particulars of next of kin (wife and children, if any or dependent next of kin in case of worker has no wife or child) |
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Name Full address of dependents (Specify village, district and state) |
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Sl. No. |
Name
address of employer (Specify whether a contractor or sub-contractor) |
Particulars
of location of work site and description of work done |
Total
period for which the worker employed (From
to
) |
Actual
number of days worked |
Leave
taken (No.
of days should be specified) |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
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Sl. No. (As
on reverse) |
Nature
of work done by the workmen |
Wage period |
Wage
rate (with particular of unit in case of piece work) |
Total
wage earned by the worker during the period shown under column (5) |
Remarks |
Signature
of the employer |
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(7) |
(8) |
(9) |
(10) |
(11) |
(12) |
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Note: |
If the worker is employed both on piece and the rates, relevant
entries in each case should be made separately.
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