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FORM C
[SEE RULE 4 (C)]

Bonus paid to employees for the accounting year ending on the ……………..
Name of the establishment…………………………..
No, of working days in the year………………………


SI. No.

Name of the employee

Father’s name

Whether he has completed 15 years of age at the beginning of the accounting year

Designation

No. of days worked in the year

Total salary or wage in respect of the accounting year

Amount of Bonus payable under Sec. 10 or Sec. 11 as the case may be.

1.

2.

3.

4.

5.

6.

7.

8.

 

 

 

 

 

 

 

 

Dedications

Puja bonus or other customary bonus paid during the accounting year

Interim bonus or bonus paid in advance

Deduction account of financial loss, if any, caused by misconduct of the employee

Total sum deducted under Cols. 9,10 and 11)

Net amount payable (col. 8 minus col.12).

Amount actually paid

Date on which paid

Signature/Thumb impression of the employee

9.

10.

11.

12.

13.

14.

15.

16.

 

 

 

 

 

 

 

 

 

 



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