Labour Commissioner 
[PRESCRIBED UNDER SUB-RULE (3) OF RULE 100]
HALF- YEARLY RETURN
Period ending 30th June 19 / 31st December 19
Name of Factory
Name of Occupier
Name of Manager
1. District
2. Postal Address
3. Nature of industry
4. Average number of workers employed daily*
Men
Women
Adolescent :
Male
Female
Children :
Male
Female
5. Number of days worked during the half year ending 30th June 19/ 31 st December 19
Signature of Occupier .......... Signature of Manager .......
Date of Dispatch .......... Date of Dispatch ..........................