FORM G Register of Employment and Remuneration

To,

Year ......... Month ......... of .........
Wage Period
(Where Different) ................................................................
\
Name of Establishment ........................................................................................
Name of Employee ...............................................................................................
Nature of Work ....................................................................................................
Wage Period ........................................................................................................
Father’s Name.......................................................................................................
Rate of Wages .....................................................................................................

Date of Employment ..............................................................................................

Date	HoursofWork		Intervalfor Rest& Meals		Hours worked with the employer	Overtime		Casual or sickness Leave Availed during the Month/ Wage Period	Privilege Leave			Signature of Owner or Occupier	Remarks
Date	From	to	From	To	Hours worked with the employer	Hours Worked	Wages earned		Leave Due	Leave Available	Balance	Signature of Owner or Occupier	Remarks
1	2	3	4	5	6	7	8	9	10	11	12	13	14
1.
2.
3.
4.

Remuneration Due				Deductions					Net Amount Payable	Date of Payment	Signature of Employee
Basic salary or Wages	Over Time	Other Allowances If any	Total	Fines& Deductionson accountof Damageor loss	Other Deductions	AdvancePaid		Total
Basic salary or Wages	Over Time	Other Allowances If any	Total	Fines& Deductionson accountof Damageor loss	Other Deductions	Date	Amount	Total
1	2	3	4	5	6	7	8	9	10	11	12
1.
2.
3.
4.

Signature of Employer .................................................................

Labour Commissioner
Government of NCT of Delhi