FORMS

Form 1	Application For Permission To Construct, Extend Or Take Into Use Any Building As A Factory
Form 2	Application for registration and grant of renewal of licence for the year ........ And notice of occupation specified in sections 6 and 7
Form 3	Licence to work a factory
Form 4	Notice of change of manager
Form 5	Certificate of fitness
Form 6	Record of eye examination
Form 7	Record of limewashing, painting, etc.
Form 8	Humidity register
Form 9	Register of workers employed for work on or near machinery in motion
Form 10	Report of examination of hoists and lifts
Form 11	Report of examination or test of pressure vessels or plant
Form 12	Register of examination of gasholders
Form 13	Report of examination of water-sealed gasholder
Form 14	Register of compensatory holidays
Form 15	Overtime muster roll for exempted workers
Form 16	Notice of periods of work for adult workers
Form 17	Register of adult workers
Form 18	Notice of periods of work for child workers
Form 19	Register of child workers
Form 20	Register of leave with wages
Form 21	Leave book
Form 22	Nomination for payment of pay due for period of holidays in the event of death of worker
Form 23	Certificate of fitness
Form 24	Health register
Form 25	Report of accident or dangerous occurrence resulting in death or bodily injury
Form 26	Report of dangerous occurrence which does not result in death or bodily injury
Form 27	Notice of poisoning or disease
Form 28	Abstract of the factories act, 1948 and the Factories rules
Form 29	Annual return
Form 30	Half-yearly return
Form 31	Muster roll
Form 32	Register of accidents and dangerous occurrences

FORM - 1

Prescribed under Rule 4(2)

APPLICATION FOR PERMISSION TO CONSTRUCT, EXTEND OR TAKE INTO USE ANY BUILDING AS A FACTORY

1. Applicant’s name, calling and address :

2. Full name and postal address of factory :

3. Situation of factory :

(a) Province :

(b) District :

(c) Town or village :

(d) Nearest Police Station :

(e) Nearest railway station or steamer ghat :

4. Particulars of plant to be installed :

Signature of applicant :

Date :

Note : This application shall be accompanied by the following documents :-

(a) a flow chart of the manufacturing process supplemented by a brief description of the process in its various stages;

(b) plans, in duplicate, drawn to scale showing –

(i) the site of the factory and immediate surroundings including adjacent buildings and other structures, roads, drains, etc.; and

(ii) the plan, elevation and necessary cross-sections of the various buildings indicating all relevant details relating to natural lighting, ventilation and means of escape in case of fire. The plans shall also clearly indicate the position of the plant and machinery, aisles and passage-ways; and

(c) such other particulars as the Chief Inspector may require.

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FORM - 2

Prescribed under Rules 6, 8(2) and 15

APPLICATION FOR REGISTRATION AND GRANT OF RENEWAL OF LICENCE FOR THE YEAR ........ AND NOTICE OF OCCUPATION SPECIFIED IN SECTIONS 6 AND 7

(To be submitted in triplicate)

1. (a) Full name of the factory :

(b) Factory licence number

if already registered before :

2.(a) Full postal address and

situation of the factory :

(b) Full postal address to which

communications relating to factory

should be sent :

3. Nature of manufacturing

process or processes –

(a) carried on in the factory in the last

twelve months (in the case of factories

already in existence); and :

(b) to be carried on in the factory during

the next twelve months (in the case of

all the factories) :

4. Names and values of principal Name Value

products manufactured during 1. ................. ....... ………………….

the last twelve months (in the 2. ................. ....... ……………….

case of factories already in 3. ................. ....... ………………….

existence)

:

5. (a) Maximum number of workers

proposed to be employed in any one

day during the year :

(b) Maximum number of workers employed

on any one day during the last twelve

months (in the case of factories

already in existence) :

(c) Number of workers to be ordinarily

employed in the factory :

6. (a) Nature and total amount of power

(kilowatts) –

(i) installed; or :

(ii) proposed to be installed :

(b) Maximum amount of power (kilowatts)

proposed to be used :

7. Full name and residential address of the

person who shall be the manager of the

factory for the purposes of the Act :

8. Full name and residential address of the

occupier, that is : -

(a) the proprietor of the factory in case of a

private firm or proprietary concern :

(b) the directors in case of a public 1. .....................

limited liability company or firm 2. .....................

3. .....................

4. .....................

5. .....................

(c) (i) the managing agent in case where a

managing agent is employed :

(ii) the directors of the above 1. .....................

managing agent 2. .....................

3. .....................

4. .....................

(d) the shareholders in case of a private 1. .....................

company where no managing agent 2. .....................

is employed, or 3. .....................

4. .....................

(e) the chief administrative head in case of

a Government or local fund factory :

9. Full name and address of the owner of

the premises or building (including the

precincts thereof) referred to in

section 93 :

10. In the case of a factory constructed or

extended after the date of

commencement of the rules –

(a) reference number and date of approval

of the plans for site whether for old

or new building and for construction

or extension of factory by the State

Government/ Chief Inspector; and :

(b) reference number and date of

approval of the arrangements, if any,

made for the disposal of trade waste

and effluents and the name of the

authority granting such approval :

11. (a) Amount of fee paid : Rs. .............

(b) In case of payment in Treasury -

(i) name of Treasury :

(ii) date of payment; and :

(iii) challan number(challan to be enclosed) :

(c) In case of transmission by crossed

cheque -

(i) name of nationalised bank :

(ii) crossed cheque number; an :

(iii) date of cheque :

(Crossed cheque drawn in favour

of the Chief Inspector of Factories

to be enclosed)

(d) In case of transmission by crossed

postal order -

(i) name of post office :

(ii) crossed postal order number; and :

(iii) date of postal order :

(Crossed postal order drawn in favour

of the Chief Inspector of Factories to

be enclosed)

Signature of occupier :

Date :

Signature of manager :

Date :

Notes :

1. This form should be completed in ink in block letters or typed.

2. If power is not used at the time of filling up this form, but is introduced later, the fact should be communicated to the Chief Inspector of Factories immediately.

3. If any of the persons named against item 8 is minor, the fact should be clearly stated.

4. In the case of a factory where under the proviso to sub-sections (1) and (2) of section 100, a person has been nominated as the occupier, information required in item 8 should be supplied only in respect of that person.

5. In the case of a factory where a managing agent or agents have been appointed as occupiers under the Indian Companies Act, 1956, information required in item 8 should be supplied only in respect of that person or persons.

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FORM - 3

Prescribed under Rule 7(1)

LICENCE TO WORK A FACTORY

Licence No. ------------------ Reg.No. -------------- Date of Reg. -----------------

Licence is hereby granted to -------------------------------------------------------------------------

for the premises known as -------------------------------------------------------------------------

situated at -------------------------------------------------------------------------

for use as a factory within the limits stated hereinafter, subject to provisions of the Factories Act, 1948, and the rules made thereunder.

The ------------------- 19.. Issuing Authority

	Calendar Year	Valid For		Fee	Date of Payment	Excess fee for late payment	Date of payment	Signature of the Issuing Authority
		Maximum number of workers on any one day	Maximum Installed Power Capacity in Kilo watts
Granted Under Rule 7
Renewed Under Rule 8

TRANSFERS

To whom transferred

Year of transfer

Date of payment of Transfer fee

Signature of the Issuing Authority

AMENDMENTS

Year when Amended	Amended		Date of payment of amendment fee	Additional fee	Date of Payment	Signature of the Issuing Authority
	Workers	Installed Power Capacity in Kilowatts

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FORM - 4

Prescribed under Rule 16

NOTICE OF CHANGE OF MANAGER

1. (a) Name of the factory :

(b) Current licence number of the factory :

2. Postal address of the factory :

3. Name of outgoing manager :

4. (a) Name of new manager :

(b) Residential address :

(c) Telephone number :

5. Date of appointment of new manager :

6. Signature of new manager :

Signature of occupier :

Date :

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FORM - 5

Prescribed under Rule 19(2)

CERTIFICATE OF FITNESS

1. (a) Serial Number : Serial Number :

(b) Date : Date :

2. Name of person : I certify that I have

examined personality examined (name) .........................

3. Father’s Name : son/daughter of ........... ............................

4. Sex : ...........................

5. Residence : residing at ...........…………………………..

.............………………………………...........

6. Date of birth, if available : who is desirous of being employed in a factory, and

and/or certified age that his/her age, as nearly as can be ascertained from

or certified age my examination, is ........ years, and

7. Physical fitness : that he/she is fit for employment in factory as an adult/child

8. descriptive marks : His /her descriptive marks are ......................

9. Reason for

(a) refusal of certificate

or.....……………

(b) certificate being.... :

……………………

Signature or left hand : Signature or left hand thumb

Thumb impression of the impression of the person examined :

person examined

Initials of Certifying Surgeon : Signature of Certifying Surgeon :

Note :

In case of physical disability, the exact details of the cause of the physical disability should be clearly stated.

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FORM - 6

Prescribed under sub -rule (4) of rule 77

RECORD OF EYE EXAMINATION

Sl. No.	Department/ Works	Name of Worker	Sex	Age(on last birthday)	Occupation		Examination of eye sight		Signature of opthal mologist	Remarks
					Nature	Date of employment	Date	Result
1	2	3	4	5	6	7	8	9	10	11

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FORM - 7

Prescribed under Rules 20, 51 and 88(8)(b)

RECORD OF LIMEWASHING, PAINTING, ETC.

Part of factory, e.g., name of room	Parts limewashed, painted, varnished or oiled, eg. walls, ceilings, wood work, etc.	Treatment, i.e., whether limewashed, painted, varnished or oiled	Date on which limewashing, painting, varnishing or oiling was carried out			Remarks
			Date	Month	Year
1.	2.	3.	4.	5.	6.	7.

Signature of the manager :

Date :

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FORM - 8

Prescribed under Rule 28

HUMIDITY REGISTER

Department : …………………..

Hygrometer : Distinctive mark or number : ………………………….

Position in department : ………………………….

Year : …………………………….. Month : ………………

Date	Readings of hygrometer						If no humidity insert ‘none’	Remarks	Signature of the person taking the reading
	Between 7 and 9 a.m.		Between 11 a.m. and 2 p.m. (but not in the rest interval)		Between 4 and 5.30 p.m.
	Dry bulb	Wet bulb	Dry bulb	Wet bulb	Dry bulb	Wet bulb
1^st 2^nd 3^rd 4^th 5^th 6^th 7^th 8^th 9^th 10^th 11^th 12^th 13^th 14^th 15^th 16^th 17^th 18^th 19^th 20^th - - - - 31^st

Certified that the above entries are correct.

Signature and designation of the

person taking the readings :

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FORM - 9

Prescribed under Rule 58

REGISTER OF WORKERS EMPLOYED FOR WORK ON OR NEAR MACHINERY IN MOTION

1. Name of worker :

2. Serial number as in the register of workers under section 62 :

3. Father’s name :

4. Date of birth and age :

5. Nature of work :

6. Qualifications, if any, or period of service on similar work :

7. Date when tight fitting clothing was provided :

8. Remarks :

I certify that the above mentioned worker whose signature or left hand thumb impression is given below is a properly trained male adult worker who is competent to mount or shift belts, lubricate or do other adjusting operations on the machinery installed in my factory while they are in motion.

Signature or left hand thumb

impression of worker :

Signature of Occupier :

Date :

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FORM - 10

Prescribed under Rule 60 (1)

REPORT OF EXAMINATION OF HOISTS AND LIFTS

Occupier (or owner) of premises :

Address :

1. (a) Type of hoist or lift and identification :

number or description

(b) Date of construction or reconstruction :

(if ascertainable)

2. Are all parts of the hoist or lift of good :

mechanical construction, sound

material and adequate strength

(so far as ascertainable) ?

3. Are the following parts of the hoists :

or lift properly maintained and in

good working order ? If not, state

what defects have been found

(a) Enclosure of hoistway or liftway :

(b) Landing gates and cage gate (s) :

(c) Interlocks and the landing gates

and cage gate(s) :

(d) Other gate fastenings :

(e) Cage and platform and fittings,

guides, buffers, interior of the

hoistway or liftway :

(f) Overrunning devices :

(g) Suspension ropes or chain and

their attachments :

(h) Safety gear i.e., arrangements for

preventing fall of platform or

cage brakes :

(i) Brakes :

(j) Worm or spur gearing :

(k) Other electrical equipment :

(l) Other parts :

4. What parts (if any) were inaccessible ? :

5. Repairs, renewals or alterations,

(if any) required and the period

within which they should be executed :

6. Maximum safe working load subject to

repairs, renewals or alterations

(if any) specified in item 5 :

7. Other particulars :

I/We certify that on (date)...............……I/We thoroughly examined this hoist or lift and that the above is a correct report of the result.

Signature :

Qualification :

Address :

Date :

If employed by a company association,

name and address of the company

or association :

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FORM - 11

Prescribed under Rule 62(9)(b)

REPORT OF EXAMINATION OR TEST OF PRESSURE VESSELS OR PLANT

1. Name of occupier (or factory) :

2. Situation and address of factory :

3. Name, description and distinctive number of

pressure vessel or plant :

4. Name and address of manufacturer and reference

to their test certificate or certificate of competent

person :

5. Nature of process in which pressure vessel or

plant is used :

6. Particulars of pressure vessel or plant : -

(a) Date of construction :

(b) Thickness of walls :

(c) Date on which the pressure vessel or plant was

first taken into use :

(d) Maximum permissible working pressure

recommended by the manufacturer :

(e) Design pressure, if known :

(f) Brief history of pressure vessel or plant was

taken into use :

7. Date of last hydrostatic test (if any) and pressure

applied :

8. Is the pressure vessel or plant in open, or

otherwise exposed to weather or to damp? :

9. What parts (if any) were inaccessible :

10. What examination and test were made ?

(Specify pressure if hydrostatic test carried out ) :

11. Condition of pressure vessel or plant }

(State any defects materially affecting } External :

the maximum permissible working }

pressure or the safe working of the } Internal :

pressure vessel or plant. }

12. Are the required fittings and appliances provided

in accordance with the rules :

13. (a) Are all fittings and appliances properly maintained :

and in good condition?

(b) Have the pressure settings been checked and :

corrected ?

14. (a) Repairs (if any) required :

(b) Period within which the repairs should be executed :

(c) Any other condition which the person making the :

examination thinks it necessary for securing for

working :

15. Maximum permissible working pressure, calculated :

from dimensions and from the thickness and other

data by the present examination, due allowance

being made for conditions of working if unusual or

exceptionally severe. (State minimum thickness of

walls measured during the examination)

16. Where repairs affecting the maximum pressure

are required, state the working pressure –

(a) before the expiration of the period specified in :

item 14.

(b) after the expiration of such period if the required :

repairs have not been completed

(c) after the completion of the required repairs :

17. Other observations :

I certify that on (date)......................the pressure vessel or plant described above was thoroughly cleaned and (so far as its construction permits) made accessible for thorough examination and for such tests as were necessary for thorough examination and that on the said date, I thoroughly examined this pressure vessel or plant, including its fittings, and that the above is a true report of my examination.

Signature :

Qualification :

Address :

Date :

If employed by a company or

association, name and address

of the company or association :

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FORM - 12

Prescribed under Rule 63 (8)(b)

REGISTER OF EXAMINATION OF GASHOLDERS

Distinguishing Number or Letters of Gas holder	Particulars of manufacture					Particulars of examination carried out Under sub-rules 63(4) And (5)			Particulars of repair
	Maker’s Name	Date of manufacture	No. of lifts	Max. capacity in cubic metres	Pressure thrown by gas-holder when full of gas	Method of examination used	Date of examination	Name & desg. Of the person making this exam.	Nature of repairs	Date of repairs and painting	By when repairs are carried out	Remarks
1	2	3	4	5	6	7	8	9	10	11	12	13

Signature of Occupier or manager :

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FORM - 13

Prescribed under Rule 63 (8)(c)

REPORT OF EXAMINATION OF WATER-SEALED GASHOLDER

1. Name of occupier (or factory) :

2. Situation and address of factory :

3. Name, description, distinguishing

number or letter and type of gasholder :

4. Name and address of the manufacturer :

5. (a) Number of lifts :

(b) Maximum capacity in cubic meters :

(c) Pressure thrown by holder when full of gas :

full of gas

6. Particulars of gas to be stored in the holder :

7. Particulars as to the condition of : -

(a) crown :

(b) side sheeting, including grips and cups :

(c) guiding mechanism (Roller carriages, :

rollers, pins, guide rails or ropes ) :

(d) tank; and :

(e) other structure, if any

(columns, framing and bracing) :

8. Particulars as to the position of the

lifts at the time of examination :

9. Particulars as to whether the tank and lifts :

were found sufficient in level for safe working

and if not, as to the steps taken to remedy the

defect.

10. Date of examination and by when it was :

carried out

11. Condition of vessel : -

(a) External :

(b) Internal :

12. (a) Are all fittings and appliances properly :

Maintained and in good conditions?

(b) Repairs, if any, required and period within :

which they should be executed

(c) Any other condition which the person :

making the examination thinks it necessary

for securing safe working :

13. Other observations :

I certify that on (date)..................... the gasholder described above was thoroughly examined and such of the tests as were necessary made on the same day and that the above is a true report of any examination.

Signature :

Qualification :

Address :

Date :

If employed by a company or

association, name and address of the :

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FORM - 14

Prescribed under Rule 102(4)(a)

REGISTER OF COMPENSATORY HOLIDAYS

Sl.No.	Number in the register of workers	Name	Group or relay numbers	Numbers and date of exempting order	Year	Weekly rest days last due to the exempting order in				Date of compensatory holidays given in				Last year days carried to the next year	Remarks
						January to March	April to June	July to September	October to December	January to March	April to June	July to September	October to December
1.	2.	3.	4.	5.	6.	7.	8.	9.	10.	11.	12.	13.	14.	15.	16.

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FORM - 15

Prescribed under Rule 103

OVERTIME MUSTER ROLL FOR EXEMPTED WORKERS

Month ending ………… 19……

Number in the Register of adult Workers	Name of exempted worker	Department	Dates on which overtime has been worked	Extent of overtime on each occasion	Total overtime hours worked or production in case of piece workers	Normal hours	Normal rate of pay for piece work or rate of pay per hour	Overtime rate of pay	Normal earnings	Overtime earnings	Total earnings	Date on which Overtime payment made
1	2	3	4	5	6	7	8	9	10	11	12	13

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FORM - 16

Prescribed under Rule 104

NOTICE OF PERIODS OF WORK FOR ADULT WORKERS

Name of the factory………………………Place………………………District………………

Periods of work Groups Delays	Men														Women														Description of Groups Group Nature Letter of work	Remarks
	Total no. of men employed														Total no. of women employed
	A				B				C			D			E			F				G			H
	1	2	3	1		2	3	1		2	3	1	2	3	1	2	3		1	2	3	1	2	3		1	2	3

On working days

From ..

To ..

From ..

To ..

From ..

To ..

On partial

Working days

From ..

To ..

From ..

To ..

Date on which this notice is first exhibited : Signature of manager :

Date :

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FORM - 17

Prescribed under Rule 105

REGISTER OF ADULT WORKERS

Sl. No.	Name	Residential Address	Father’s Name	Nature Of Work	Letter of group as in Form 16	Number of relay if working in shifts	Number and date of certificate if an adolescent		Remarks
							Number of certificate And date	Token number giving Reference to the certificate
1	2	3	4	5	6	7	8	9	10

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FORM - 18

Prescribed under Rule 110

NOTICE OF PERIODS OF WORK FOR CHILD WORKERS

Name of factory ……………………… Place …………………. District……………...

	Children						Description of group		Remarks
Period of work	Total number of children employed						Group letter	Nature of work
Groups	A		B		C
Relays	1	2	1	2	1	2
A B From C To

Date on which this notice is first exhibited :

Signature of manager :

Date :

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FORM - 19

Prescribed under Rule 111

REGISTER OF CHILD WORKERS

Sl. No.	Name	Residential Address	Father’s name	Date of First Employment	Number of certificate and its date	Token number giving reference to certificate	Letter of Group as in Form 18	Number of relay, if working in shifts	Remarks
1	2	3	4	5	6	7	8	9	10

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FORM - 20

Prescribed under Rule 112

REGISTER OF LEAVE WITH WAGES

Part I - Adults

Part II - Children

Factory : Name of worker :

Department : Father’s Name :

Sl. No.	Sl.no. in the register of adult/ child workers	Date of entry into service	Interruptions					Leave due with effect from	Whether leave not desired during the next 12 months	Date from which the worker is allowed leave	Wages for Leave Paid in	Discharged worker		Rem- arks
			Sickness and accidents	Authorized Leave	Lock Out or Legal Strike	Involuntary unemployment	Others					Date of Discharge	Date & amount of payment made in lieu of leave due
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15

Note:- Separate page shall be allotted to each worker

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FORM - 21

Prescribed under Rule 113(1)

LEAVE BOOK

Factory : Name of worker :

Department : Father’s name :

Sl. No.	Sl.no. in the register of adult/ child workers	Date of entry into service	Interruptions					Leave due with effect from	Whether Leave not desired during the next 12 months	Date from Which the worker is allowed leave	Wages for Leave Paid in	Discharged worker		Rem- arks
			Sickness	Authorised Leave	Lock out or legal strike	Involuntary unem Ployment	Others					Date of di scharge	Date & amount of payment made in lieu of leave due
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15

Note: The leave book shall be made out separately for each worker on thick bound sheets.

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FORM - 22

Prescribed under Rule 118

NOMINATION FOR PAYMENT OF PAY DUE FOR PERIOD OF HOLIDAYS IN THE EVENT OF DEATH OF WORKER

I hereby require that in the event of my death before resuming work, the balance of my pay due for the period of holidays shall be paid to ………………………………….

who is my .........................….........and resides at ........................................................

Witnesses : Attested.

Signature :

Signature or left hand thumb

impression of worker :

Name :

Designation :

Address :

Particulars of worker such

as serial number in the

Signature : register of adult/child workers,

section or department, etc. :

Name :

Designation :

Address : Date :

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FORM - 23

Prescribed under paragraph various Schedules to Rule 120

CERTIFICATE OF FITNESS

Serial number :

I certify that I have personally examined (name) ………………………………………………. Son of (father’s name)......................................................... residing at (address).................………………… who is desirous of being employed as (designation) ..................…………………………. in (process, department and factory) ..........……… …………………….............................................and that his age, as nearly as an be ascertained from my examination, is..............……………..years, and that he is, in my opinion, fit/ unfit for employment in the above mentioned factory as mentioned above.

2. He may be produced for further examination after a period of ..........................................

3. The serial number of the previous certificate is....................

Signature or left hand thumb impression

of person examined :

Signature of Certifying Surgeon :

Date :

I certify that I examined the person mentioned above on

I extend this certificate until (if certificate is not extended, the period for which the worker is considered unfit for work is to be mentioned)

Signs and symptoms Observed during Examination

Signature of the certifying surgeon

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FORM - 24

Prescribed under various Schedules to Rule 120

HEALTH REGISTER

Sl. No.	Department /Works	Name of worker	Sex	Age (at last Birthday)	Date of employment on present work	Date of leaving or transfer to other work with reasons for discharge or transfer	Nature of job or occupation	Raw materials, products or by- products likely to be exposed to	Dates of med ical examinati on and the res ults thereof		Signs and symptoms observed during examination	Nature of tests and results thereof	If declared unfit for work, state period of suspension with reasons in details	Whether certificate of unfitness issued to the workers	Re-certified fit to resume duty on	Signature of the Certifying surgeon with date
									Dates	Result Fit or Unfit
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17

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FORM - 25

Prescribed under Rule 121(3)

REPORT OF ACCIDENT OR DANGEROUS OCCURRENCE RESULTING IN DEATH OR BODILY INJURY

E.S.I.C. Employer’s Code number : E.S.I.C. Insurance

Number of the injured person :

1. Name of occupier ( or factory)/employer :

2. Address of works / premises where the :

accident or dangerous occurrence

took place :

3. Nature of industry :

4. Branch or department and exact place

where the accident or dangerous

occurrence took place :

5. Name and address of the injured person :

6. (a) Sex :

(b) Age (at the last birthday) :

(c) Occupation of the injured person :

7. Local E.S.I.C. Office to which the

injured person is attached :

8. Date, shift and hour of accident or

dangerous occurrence :

9. (a) Hour at which the injured person

started work on the day of accident

or dangerous occurrence :

(b) whether wages in full or part are

payable to him for the day of the

accident or dangerous occurrence :

10. (a) Cause or nature of accident or

dangerous occurrence :

(b) If caused by machinery : -

(i) Give the name of machine and

the part causing the accident

or dangerous occurrence :

(ii) state whether it was moved

by mechanical power at the time of

accident or dangerous occurrence :

(c) State exactly what the injured person

was doing at the time of accident

or dangerous occurrence :

(d) In your opinion, was the injured

person at the time of accident or

dangerous occurrence : -

(i) acting in contravention of provisions :

of any law applicable to him; or

(ii) acting in contravention of any orders

given by or on behalf of his

employer, or :

(iii) acting without instructions

from his employer? :

(e) In case reply to (d) (i), (ii) or (iii)

is in the affirmative , state whether

the act was done for the purpose

of and in connection with the

employer’s trade or business :

11. In case the accident or dangerous

occurrence took place while

travelling in the employer’s

transport, state whether -

(a) the injured person was

travelling as a passenger

to or from his place of works :

(b) the injured person was travelling

with the express or implied

permission of his employer :

(c) the transport is being operated

by or on behalf of the employer or

some other person by whom it is

provided in pursuance of

arrangements made with the

employer; and :

(d) the vehicle is being/not being

operated in the ordinary course

of public transport service :

12. In case the accident or dangerous

occurrence took place while meeting

emergency, state :-

(a) its nature ; and :

(b) whether the injured person at the

time of accident or dangerous

occurrence was employed for the

occurrence was trade or business

in or about the premises at which

the accident or dangerous

occurrence took place. :

13. Describe briefly how the accident or

dangerous occurrence took place :

14. Names and addresses of

witnesses (1) :

(2) :

15. (a) Nature and extent of injury

(e.g. fatal, loss of finger,

fracture of leg, scald, scratch

followed by sepsis, etc.) :

(b) Location of injury (e.g. right leg,

left hand, left eye, etc.) :

16. (a) If the accident or dangerous

occurrence was not fatal, state

whether the injured person was

disabled for more than 48 hours :

(b) date and hour of return of work :

17. (a) Physician, dispensary or hospital

from whom or which the injured

person received or is receiving

treatment :

(b) Name of dispensary/panel doctor

elected by the injured person :

18. (a) Has the injured person died ? :

(b) If so, date of death :

I certify that to the best of my knowledge and belief the above particulars are correct in every respect.

Signature of manager/employer :

Name, designation and address

of manager/employer :

Date of dispatch of report :

(This space is to be completed by the Inspector of Factories)

District ………………………….. Date of receipt :

Number of the accident or dangerous occurrence: Causation :

Other particulars (e.g. fatal, leg injury, arm injury, etc.) :

Date of investigation :

Result of investigation :

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FORM - 26

Prescribed under Rule 121(3)

REPORT OF DANGEROUS OCCURRENCE WHICH DOES NOT RESULT IN DEATH ORBODILY INJURY

1. Name and address of factory :

2. Name of occupier :

3. Name of manager :

4. Nature of industry :

5. Branch or department and exact

place where the dangerous occurrence

took place :

6. Date and hour of dangerous occurrence :

7. Nature of dangerous occurrence

(State exactly what happened :

I certify that to the best of my knowledge and belief the above particulars are correct in every respect.

Signature of manager :

Name, designation and

address of manager :

Date of despatch of

report :

(To be completed by the Inspector of Factories)

District : Date of receipt :

Number of the Causation :

dangerous occurrence :

Date of investigation :

Result of investigation :

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FORM - 27

Prescribed under Rule 122.

NOTICE OF POISONING OR DISEASE

(See instruction on reverse)

1. Name of factory :

2. Address of factory :

3. Address of office of occupier :

4. Residential address :

5. Nature of industry :

6. (a) Name of patient :

(b) Works number of patient :

(c) Address of patient :

7. Precise occupation of patient :

8. Nature of poisoning or disease

from which patient is suffering :

9. Has the case been reported to

the Certifying Surgeon :

Signature of manager :

Date :

(To be filled in by the Chief Inspector)

Number of the case :

Remarks :

Notice of poisoning or disease

Extract from the Factories Act, 1948 (Section 89)

Where any worker in a factory contracts any disease specified in the schedule, the manager of the factory shall send a notice thereof to such authorities, and in such form and within such time, as may be prescribed.

SCHEDULE

LIST OF NOTIFIABLE DISEASES

1. Lead Poisoning, including poisoning by any preparation of lead or their sequelae.

2. Lead tetra-ethyl poisoning.

3. Phosphorous poisoning or its sequelae.

4. Mercury poisoning or its sequelae.

5. Manganese poisoning or its sequelae.

6. Arsenic poisoning or its sequelae.

7. Poisoning by nitrous fumes.

8. Carbon disulphide poisoning.

9. Benzene poisoning, including poisoning by any of its homologues, their nitro or amide derivatives or its sequelae.

10. Chrome ulceration or its sequelae.

11. Anthrax.

12. Silicosis.

13. Poisoning by halogen derivatives of the hydrocarbons of the aliphatic series.

14. Pathological manifestations due to : –

(a) radium or other radio-active substances; and

(b) x-rays.

15. Primary epitheliomatous cancer of skin.

16. Toxic anaemia.

17. Toxic jaundice due to poisonous substances.

18. Oil acne or dermatitis due to mineral oils and compounds containing mineral oil base.

19. Byssinosis.

20. Asbestosis.

21. Occupational or contact dermatitis caused by direct contact with chemicals and paints. These are of two types that is, primary irritants and allergic sensitizers.

22. Noise induced hearing loss (exposure to high noise levels).

Extract from the ...................…………….Factories Rules, 19....(Rule...)

A notice in Form 27 should be sent forthwith both to the Chief Inspector and to the Certifying Surgeon, by the manager of a factory in which there occurs a case of lead, phosphorous, mercury, manganese, arsenic, carbon bisulphide or benzene poisoning by nitrous fumes or by halogens or halogen derivatives of the hydrocarbons of aliphatic series; or of chrome ulceration, anthrax, silicosis, toxic anaemia, toxic jaundice, primary epitheliometous cancer of skin, or of pathological manifestations due to radium or other radio-active substances or x-rays.

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FORM - 28

Prescribed under Rule 124

ABSTRACT OF THE FACTORIES ACT, 1948 AND THE .........................

FACTORIES RULES,....................

(To be affixed in a conspicuous and convenient place at or near the main entrance to the factory )

Interpretation

1. “Factory” means any premises including the precincts thereof -

(i) wherein ten or more workers are working, or were working on any day of the preceding twelve months, and in any part of which a manufacturing process is being carried on with the aid of power, or is ordinarily so carried on, or whereon twenty or more workers are working, or were working on any day of the preceding twelve months, and in any part of which a manufacturing process is being carried on without the aid of power, or is ordinarily so carried on but does not include a mine subject to the operation of the Mines Act, 1952 (35 of 1952), or a mobile unit belonging to the armed forces of the Union, a railway running shed or a hotel, restaurant or eating place.

Explanation :- For computing the number of workers for the purposes of this clause all the workers in different relays in a day shall be taken into account.

2 .“Worker” means a person employed, directly or through any agency (including a contractor) with or without the knowledge of the principal employer, whether for remuneration or not, in any manufacturing process, or in any other kind of work incidental to, or connected with, the manufacturing process, or the subject of the manufacturing process; but does not include any member of the armed forces of the Union.

3. “Manufacturing process” means any process for -

(i) making, altering, repairing, ornamenting, finishing, packing, oiling, washing, cleaning, breaking up, demolishing, or otherwise treating or adapting any article or substance with a view to its use, sale, transport, delivery or disposal, or

(ii) pumping oil, water, sewage or any other substances; or

(iii) generating, transforming or transmitting power; or

(iv) composing types of printing, printing by letter press, lithography, photogravure or other similar process or book binding; or

(v) constructing, reconstructing, repairing, refitting, finishing or breaking up ships or vessels ; or

(vi) preserving or storing any article in cold storage.

Working hours, holidays, intervals after rest, etc.

4. Hours of work for adults (Sections 51 and 54).- No adult worker shall be required or allowed to work in a factory for more than 48 hours in any week and for more than 9 hours in any day.

5. Relaxation of hours of work for adult (Section 64) .- The ordinary limits on working hours of adults may be relaxed in certain special cases, e.g., workers engaged on urgent repairs; in work in the nature or preparatory or complementary work which must necessarily be carried on outside the limits laid down for the general working of the factory; in work which is necessarily so intermittent that the intervals for rest; in any work which for technical reasons must be carried on continuously; in making or supplying articles of prime necessity which must be made or supplied every day; in a manufacturing process which cannot be carried on except during fixed seasons, or at times dependent on the irregular action of natural forces; in engine rooms or boiler houses or in attending to power plant or transmission machinery; in the printing of news papers, who are held up on account of the breakdown of machinery; in the loading or unloading of railway wagons or lorries or trucks; and in any work which is notified by the State Government in the Official gazette as a work of national importance.

Except in the case of urgent repairs, the relaxation shall not exceed the following limits of work inclusive of overtime :-

(i) the total number of hours of work in any day shall not exceed ten;

(ii) the spread over inclusive of intervals for rest, shall not exceed 12 hours in any one day;

(iii) the total number of hours of work in a work, including overtime, shall not exceed sixty;

(iv) the total number of hours of overtime work shall not exceed fifty for any one quarter.

6. Payment for overtime (Section 59).- Where a worker works in a factory for more than 9 hours in any day or for more than 48 hours in any week, he shall, in respect of overtime work, entitled to wages at the rate of twice his ordinary rate of wages.

7. Exemption of supervisory staff (Section 64).- Chapter VI, other than the provisions of clause (b) of sub-section (1) of section 66 and of the proviso to that sub-section, of the Act-Working hours of adults - does not apply to persons holding positions of supervision or management or are employed in a confidential position in a factory, provided that where the ordinary rate of wages of such person does not exceed rupees seven hundred and fifty per month, they are entitled to extra wages in respect of overtime work under Section 59.

8. Weekly holiday (Adults) (Section 52).- No adult worker shall be required or allowed to work in a factory on the first day of the week, unless -

(a) he has, or will have, a holiday for a whole day on one of the three days immediately before or after the said day, and

(b) the manager of the factory has, before the said day or the substituted day under clause (a) whichever is earlier, -

(i) delivered a notice at the office of the Inspector of his intention to require the worker to work on the said day and of the day which is to be substituted; and

(ii) displayed a notice to that effect in the factory:

Provided that no substitution shall be made which will result in any worker working for more than ten days consecutively without a holiday for a whole day.

9. Compensatory holidays (Section 53)- Where a worker in a factory, as a result of exemption from the ordinary provision relating to weekly holidays, is deprived of any of the weekly holidays, he shall be allowed, within the month in which the holidays were due to him or within the two months immediately following that month, compensatory holidays of equal number of the holidays so lost.

10. Intervals for rest for adults (Section 55 and 56).- The periods of work of adult workers in a factory each day shall be fixed that no period shall exceed 5 hours and that no worker shall work for more than 5 hours before he has had an interval for rest of at least half an hour and that inclusive of his intervals for rest shall not spread over more than ten and a half hours in any day or, with the permission of the Chief Inspector in writing, 12 hours.

11. Prohibition of double employment (Section 60,71 & 99).- No child or, except in certain circumstances, an adult worker, shall be required or allowed to work in any factory on any day on which he has already been working in any other factory.

If a child works in a factory on any day on which he has already been working in another factory, the parent or guardian of the child or the person having custody of or control over him or obtaining any direct benefit from his wages, shall be punishable with fine, which may extend to Rs. 50 unless it appears to the court that the child so worked without the consent or connivance of such parent, guardian or person.

12. Prohibition of employment of children under 14 (Section 67).- No child who has not completed his fourteenth year shall be required or allowed to work in any factory.

13. ours of work for children (Section 71).- No child shall be employed or permitted to work in any factory for more than four and a half hours in any day and during the period of at least twelve consecutive hours which shall include the interval between 10 P.M. and 6. A.M. The periods of work of all children employed in a factory shall be limited to two shifts which shall not overlap or spread over more than 5 hours each and each child shall be employed in only one of the relays.

The provision relating to weekly holidays shall also apply to child workers and no exemption form this provision may be granted in respect of any child.

14. Prohibition of employment of women (Section 66).- No women shall be required or allowed to work in any factory except between the hours of 6 A.M. and 7 P.M. The State Government may vary those limits or exempt this restriction in case of women working in fish-curing or fish-canning factories.

Leave with wages

15. Leave with wages (Section 79, 80 and 83 and Rules).- Every worker who has worked for a period of 240 days or more in a factory during a calendar year shall be allowed during the subsequent calendar year leave with wages for a number of days calculated at the rate of -

(i) if an adult, one day for every twenty days of work performed by him during the previous calendar year; and

(ii) if a child, one day for every 15 days of work performed by him during the previous calendar year.

Explanation. 1. For the purpose of this sub-section –

(a) any days of lay off, by agreement or contract or as permissible under the standing orders;

(b) in the case of female worker, maternity leave for any number of days not exceeding twelve weeks; and

(c) the leave earned in the year prior to that in which the leave is enjoyed;

shall be deemed to be days on which the worker has worked in a factory for the purpose of computation of the period of 240 days or more, but he shall not earn leave for these days.

Explanation 2.- The leave admissible under this sub-section shall be exclusive of all holidays whether occurring during or at either end of the period of leave.

For the leave allowed to him, a worker shall be paid at a rate equal to the daily average of his total full-time earning, for the days on which he actually worked during the month immediately preceding the leave exclusive of any overtime and bonus, but inclusive of dearness allowance and the cash equivalent of the advantage accruing through the concessional sale to the worker of food grains and other articles.

A worker whose service commences otherwise than on the first day of January shall be entitled to leave with wages at the rate indicated above, if he has worked for two-thirds of the total number of days in the remainder of the calendar year.

If a worker is discharged or dismissed from service or quits his employment or is supperanuated or dies while in service, during the course of the calendar year, he or his heir or nominee as the case may be, shall be entitled to wages in lieu of the quantum of leave to which he was entitled immediately before his discharge, dismissal, quitting of employment, superannuation or death, calculated at the rates specified above, even if he had not worked for the entire period specified above. Such payment shall be made –

(i) whether the worker is discharged or dismissed or quits employment, before the expiry of the second working day from the day of such discharge, dismissal or quitting; and

(ii) where the worker is superannuated or dies while in service, before the expiry of two months from the date of such superannuation or death.

If the employment of a worker who is entitled to leave with wages is terminated by the occupier before he has taken the entire leave to which he is entitled, or if having applied for and having not been granted such leave, the worker quits his employment before he has taken the leave, the occupier of the factory shall pay him the amount payable in respect of the leave not taken, and such payment shall be made before the expiry of the second working day after the day on which his employment is terminated and a worker who quits his employment, on or before the next pay day.

The manager shall maintain a register of leave with wages in the prescribed Form 20 and shall provide each worker with a book called the “Leave Book” in the prescribed Form 21. The leave book shall be the property of the worker and the manager or his agent shall not demand it except to make entries of the dates of holidays or interruptions in service, and shall not keep it for more than a week at a time. If a worker loses his leave book, the manager shall provide him with another copy on payment of paise ..............and shall complete it from his record.

Health

16. Cleanliness (Section 11).- Except in cases specially exempted, all inside walls and partitions, all ceilings or tops of rooms and all walls, sides and tops of passages and stair-cases in a factory shall be kept whitewashed or colour washed. The whitewashing or colour washing shall be carried out at least once in every period of fourteen months. The floor of every workroom shall be cleaned at least once in every week by washing, using disinfectant, where necessary, or by some other effective method.

17. Disposal of wastes and effluents (Section 12).- Effective arrangements shall be made in every factory for the treatment of wastes and effluents due to the manufacturing process carried on therein, so as to render them innocuous, and for their disposal.

18. Ventilation and temperature (Section 13).- Effective and suitable provision shall be made in every factory for securing and maintaining in every workroom adequate ventilation by the circulation of fresh air and such a temperature as will secure to workers therein reasonable conditions of comfort and prevent injury to health.

19. Overcrowding (Section 16).- Unless exemption has been granted, there shall be in every workroom of a factory in existence on the date of commencement of this Act at least 350 cubic feet and of a factory built after the commencement of this Act at least 500 cubic feet of space for every worker employed therein, and for this purpose no account shall be taken of any space which is more than 14 feet above the level of the floor of the room.

20. Lighting (Section 17).- In every part of a factory where workers are working or passing, there shall be provided and maintained sufficient and suitable lighting, natural artificial, or both.

21. Drinking water (Section 18 and Rules).- In every factory effective arrangements shall be made to provide and maintain at suitable points conveniently situated for all workers employed therein, a sufficient supply of wholesome drinking water.

In every factory wherein more than 250 workers are ordinarily employed the drinking water shall, during hot weather be cooled by ice or other effective methods. The cooled drinking water shall be supplied in every canteen, lunchroom and restroom and also at conveniently accessible points throughout the factory.

22. Latrines and urinals (Section 19 and Rules).- In every factory sufficient latrine and urinal accommodation of the prescribed types (separate enclosed accommodation for male and female workers) shall be provided conveniently situated and accessible to workers at all times while they are at the factory. Every latrine shall be under cover and so partitioned off as to secure privacy and shall have a proper door and fastenings. Sweepers shall be employed whose primary duty it would be to keep clean latrines, urinals and washing places.

23. Spittoons (Section 20).- In every factory, there shall be provided a sufficient number of spittoons of the type prescribed in convenient places and they shall be maintained in clean and hygienic condition. No person shall spit within the premises of factory except in the spittoons provided for purpose. Whoever spits in contravention of this provision shall be punishable with fine not exceeding five rupees.

Safety

24. Fencing of machinery (Section 21).- In every factory dangerous parts of machinery e.g., every moving part of a prime mover and every flywheel connected to prime mover, etc. etc. shall be securely fenced by safeguards of substantial construction which shall be constantly maintained and kept in position while the parts of machinery they are fencing in motion or in use.

25. Work on or near machinery in motion (Section 22).- No woman or young person shall be allowed in any factory to clean, lubricate or adjust any part of a prime mover or any transmission machinery is in motion, or to clean, lubricate or adjust any part of any machine if the cleaning, lubrication or adjustment thereof would expose the woman or young person to risk of injury from any moving part either of that machine or of any adjacent machinery.

26. Employment of young persons on dangerous machines (Section 23).- No young person shall work at any machine declared to be dangerous unless he has been fully instructed as to the dangers arising in connection with the machine and precautions to be observed and has received sufficient training in work at the machine or is under adequate supervision by a person who has a thorough knowledge and experience of the machine.

27. Casing of new machinery (Section 26).- In all machinery driven by power and installed in any factory after the commencement of this Act, every set screw, bolt or key on any revolving shaft, spindle, wheel or pinion shall be so sunk, encased or otherwise effectively guarded as to prevent danger; all spur, worm and other toothed or friction gearing which does not require frequent adjustment while in motion shall be completely encased, unless it is so situated as to as safe as it would be if it were completely encased.

Whoever sells or lets on hire or, as agent of a seller or hirer, causes or procures to be sold or let on hire, for use in a factory any machinery driven by power which does not comply with these provisions or any rules made under this section, shall be punishable with imprisonment for a term which may extend to three months or with fine which may extend to five hundred rupees or with both.

28. Prohibition of employment of women and children near cotton openers (Section 27).- No woman or child shall be employed in any part of a factory for pressing cotton in which a cotton opener is at work.

29. Excessive weights (Section 34 and Rules).- No woman or young person shall, unaided by another person, lift, carry or move by hand or on head, any material, article, tool or appliance exceeding the maximum limit in weight set out in the following schedule :-

SCHEDULE

Persons Maximum weight of material,

article, tool or appliance

(a) Adult male 55 Kilograms

(b) Adult female 30 Kilograms

(c) Adolescent male 30 Kilograms

(d) Adolescent female 20 Kilograms

(e) Male child 16 Kilograms

(f) Female child 14 Kilograms

30. Protection of eyes (Section 35 and Rules).- Effective screens or suitable goggles shall be provided for the protection of persons employed in or in the immediate vicinity of processes which involve risk of injury to eyes from particles or fragments thrown off in the processes or which involve risk of injury to eyes by reason of exposure to excessive light or infra-red or ultra-violet radiations.

31. Precautions in case of fire (Section 38 and Rules).- Every factory shall be provided with adequate means of escape in case of fire for the persons employed therein. The doors affording exit from any room shall, unless they are of sliding type, be constructed to open outwards. Every window, door or other exit affording a means of escape in case of fire, other than the means of exit in ordinary use, shall be distinctively marked. Effective and clearly audible means of giving warning in case of fire to every person employed in the factory shall be provided. Effective measures shall be taken to ensure that wherein more than twenty workers are ordinarily employed in any place above the ground floor, or wherein explosive or highly inflammable materials are used or stored, all the workers are familiar with the means of escape in case of fire and have been adequately trained in the routine to be followed in such case.

Welfare

32. Washing facilities (Section 42 and Rules).- In every factory adequate and suitable facilities for washing shall be provided and maintained for the use of the workers therein. Such facilities shall include soap and nail brushes or other suitable means of cleaning and the facilities shall be conveniently accessible and shall be kept in a clean and orderly condition.

If female workers are employed separate washing facilities shall be provided and so enclosed or screened that the interiors are not visible from any place where persons of the other sex work or pass.

33. Facilities for storing and drying clothing (Section 43 and Rules).- In the case of certain dangerous operations e.g., lead processes, liming and tanning of raw hides and skins etc. suitable places for keeping clothing not worn during working hours and for the drying of wet clothing shall be provided and maintained.

34. Facilities for sitting (Section 44).- In every factory suitable arrangements for sitting shall be provided and maintained for all workers obliged to work in a standing position in order that they may take advantage of any opportunities for rest which may occur in the course of their work.

35. First-aid and ambulance room (Section 45).- There shall in every factory be provided and maintained sops to be readily accessible during all working hours first-aid boxes or cupboards equipped with the prescribed contents. Each first-aid box or cupboard shall be kept in the charge of a separate responsible person who holds a certificate in first-aid treatment recognised by the State Government who shall always be available during the working hours of the factory.

In every factory wherein more than 500 workers are ordinarily employed there shall be provided and maintained an ambulance room of the prescribed size, containing the prescribed equipment, and in the charge of such medical and nursing staff as may be prescribed and those facilities shall always be made readily available during the working hours of the factory.

36. Canteens (Section 46 and Rules).- In specified factories wherein more than 250 workers are ordinarily employed, a canteen or canteens shall be provided and maintained by the occupier for the use of the workers. Food, drink and other items served in the canteen shall be sold on a non-profit basis and the prices charged shall be subject to the approval of a Canteen Managing Committee which shall be appointed by the manager and shall consist of an equal number of persons nominated by the occupier and elected by the workers. The number of elected workers shall be in the proportion of 1 for every 1,000 workers employed in the factory, provided that in no case shall there be more 5 or less than 2 workers on the Committee. The Committee shall be consulted from time to time as to the quality and quantity of food stuffs to be served in the canteen, the arrangement of the menus, etc. etc. Where the canteen is managed by a co-operative society, it is not necessary to appoint a Canteen Managing Committee and the prices to be charged may include a margin of profit up to a maximum of 5 per cent of its working capital.

37. Shelters, restrooms and lunchrooms (Section 47).- In every factory wherein more than 150 workers are ordinarily employed, adequate and a suitable lunchroom, with provision for drinking water, where workers can eat meals brought by them, shall be provided and maintained for the use of the workers.

38. Creches (Section 48 and Rules).- In every factory wherein more than 30 women workers are ordinarily employed there shall be provided and maintained a suitable room or rooms for the use of children under the age of six years of such women. The creche shall be adequately furnished and equipped and in particular there shall be one suitable cot or a cradle with the seating accommodation for the use of each mother while she is feeding or attending to her child, and a sufficient supply of suitable toys for older children.

There shall be in or adjoining the creche a suitable washroom for the washing of the children and their clothing. An adequate supply of clean clothes, soap and clean towels shall be made available for each child while it is in the creche at least a quarter litre of clean pure milk shall be available for each child on every day it is accommodated in the creche and the mother of such a child shall be allowed in the course of her daily work suitable intervals to feed the child. For children above two years of age, there shall be provided, in addition, an adequate supply of wholesome refreshment. A suitably fenced and shady open air playground shall also be provided for the older children.

39. Welfare Officers (Section 49).- In every factory wherein 500 or more workers are ordinarily employed the occupier shall employ in the factory such number of Welfare Officers as may be prescribed.

Special Provisions

40. Dangerous operations (Section 87 and Rules).- Employment of women, adolescents and children is prohibited or restricted in certain operations declared to be dangerous, e.g., electroplating, manufacture and repair of electric accumulators, glass manufacture, grinding or glazing of metals, manufacture and treatment of lead and certain compounds of lead, sand blasting, etc.

41. Notice of accidents (Section 88 and Rules).- When an accident occurs which results in the death of any person or which results in such bodily injury to any person as is likely to cause his death, or any dangerous occurrence specified in the schedule annexed hereto takes place in a factory, the manager of the factory shall forthwith send a notice thereof by telephone, special messenger or telegram to the Inspector and the Chief Inspector. When any accident or any dangerous occurrence specified in the schedule annexed hereto, which results in the death of any person or which results in such bodily injury to any person as is likely to cause his death, takes place in a factory, forthwith notice shall be sent also to the District Magistrate or Sub-divisional Officer, to the officer-in-charge of the nearest police station; and to the relatives of the injured or deceased person.

SCHEDULE

1. Bursting of a plant used for containing or supplying steam under pressure greater than atmospheric pressure.

2. Collapse or failure of a crane, derrick, winch, hoist or other appliances used in raising or lowering persons or goods, or any part thereof, or the overturning of a crane.

3. Explosion, fire, bursting out, leakage or escape of any molten metal, or hot liquor or gas causing bodily injury to any person or damage to any room or place in which persons are employed, or fire in rooms of cotton pressing factories when a cotton opener is in use.

4. Explosion of a receiver or container used for the storage at a pressure greater than atmospheric pressure of any gas or gases (including air) or any liquid or solid resulting from the compression of gas.

5. Collapse or subsidence of any floor, gallery, roof, bridge, tunnel, chimney, wall, building or any other structure.

42. Notice of certain diseases (Section 89 and Rules).- Where any worker in a factory contracts any of the following diseases, the manager of the factory shall send notice in Form 27 thereof forthwith both to the Chief Inspector and the Certifying Surgeon :-

Lead, phosphorus, mercury, manganese, arsenic, carbon bi-sulphide or benzene poisoning; or poisoning by nitrous fumes or by halogens or halogen derivatives of the hydrocarbons of the aliphatic series; or of chrome ulceration, anthrax, silicosis, toxic anaemia, toxic jaundice, primary opitheliomatous cancer of the skin, or pathological manifestations due to radium or other radio-active substances or x-rays.

43. No charge for facilities and convenience (Section 114).- No fee or charge shall be realised from any worker in respect of any arrangements or facilities to be provided, or any equipments or appliances to be supplied by the occupier under the provisions of this Act.

44. Powers of Inspectors (Sections 9 and 82).- Inspectors have power to inspect factories any time and may require the production of registers, certificates, etc. prescribed under the Act and the Rules.

Any Inspector may institute proceedings on behalf of any workers to recover any sum required to be paid by an employer under the provisions relating to leave with wages, which the employer has not paid.

45. Obligations of workers (Section 97 and 111).- No worker in a factory :

(i) shall wilfully interfere with or misuse any appliance, convenience or other thing provided in a factory for the purposes of securing the health, safety or welfare of the workers therein;

(II) shall wilfully and without any reasonable cause do anything likely to endanger himself or others; and

(iii) shall wilfully neglect to make use of any appliance or other thing provided in the factory for the purpose of securing the health or safety of the workers therein.

If any worker employed in a factory contravenes any of these provisions or any rule or order made thereunder he shall be punishable with imprisonment for a term which may extend to three months, or with fine which may extend to Rs. 00, or with both.

If any worker employed in a factory contravenes any provision of this Act or any rules or orders made thereunder, imposing any duty or liability on workers, he shall be punishable with fine which may extend to Rs. 20.

46. Certificates of fitness (Sections 69, 70 and 98).- No child who has completed his fourteenth year or an adolescent shall be required or allowed to work in any factory unless a certificate of fitness granted with reference to him is in the custody of the manager of the factory and such child or adolescent carries, while he is at work, a token giving a reference to such certificate. Any fee payable for such a certificate shall be paid by the occupier and shall not be recoverable from the young person, his parents or guardian.

An adolescent who has been granted a certificate of fitness to work in a factory as an adult and who while at work in a factory carries a token giving reference to the certificate shall be deemed to be an adult for all the purposes of the provisions of the Act relating to the working hours of adults and the employment of young persons. An adolescent who has not been granted a certificate of fitness to work in a factory as an adult shall, notwithstanding his age, be deemed to be a child for all the purposes of this Act.

Whoever knowingly uses or attempts to use, as a certificate of fitness granted to himself, a certificate granted to another adolescent to work in a factory as an adult, or who having procured such a certificate knowingly allows it to be used, or an attempt to use it to be made, by another person, shall be punishable with imprisonment for a term which may extend to two months or with fine which may extend to Rs. 100 or with both.

47. Registers, notices and returns (Sections 61, 62, 63, 72, 73, 74 and 110 and Rules).- A register of adult workers in the prescribed Form 17 and a register of child workers in the prescribed Form 19 shall be maintained by the manager of every factory.

A notice of periods of work for adults and a notice of periods of work for children in the prescribed forms 16 and 18 shall be correctly maintained and displayed in every factory. No adult worker or child shall be required or allowed to work in any factory otherwise than in accordance with their respective notices of periods of work displayed in the factory.

The owners, occupiers or managers of factories shall submit the prescribed periodical returns to the Inspector regularly.

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FORM - 29

Prescribed under Rule 125

ANNUAL RETURN

For the year ending 31^st December, 19..........

1. Registration number of factory :

2. Name of factory :

3. Name of occupier :

4. Name of the manager :

5. District :

6. Full postal address of factory :

7. Nature of industry :

Number of workers and particulars of employment

8. No. of days worked in the year :

9. No. of man-days worked during the year

(a) Men :

(b) Women :

(c) Children :

10. Average number of workers employed daily (See explanatory note)

(a) Adults (i) Men :

(ii) Women :

(b) Adolescents (i) Male :

(ii) Female :

(c) Children (i) Male :

(ii) Female :

11. Total no. of man-hours worked including overtime.

(a) Men :

(b) Women :

(c) Children :

12. Average number of hours worked per week (See explanatory note)

(a) Men :

(b) Women :

(c) Children :

13. (a) Does the factory carry out any process or operations declared as dangerous under Section 87 (See Rule 116):

(b) If so, give the following information

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Name of the dangerous process Average no. of persons employed daily in each

Or operations carried on of the processes or operations given in Col.1

1 2

-----------------------------------------------------------------------------------------------------------------------

i)

ii)

iii) etc.

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Leave with Wages

14. Total number of workers employed during the year :

(a) Men :

(b) Women :

(c) Children :

15. Number of workers who were entitled to annual leave wit wages during the year

(a) Men :

(b) Women :

(c) Children :

16. Number of workers who were granted leave during the year

(a) Men :

(b) Women :

(c) Children :

17. (a) Number of workers who were

discharged, or dismissed from

the service, or quit employment,

or were superannuated, or died

while in service during the year

:

(b) Number of such workers in respect

of when wages in lieu of leave

were paid :

18. (a) Number of Safety Officers required

to be appointed as per notification

under Section 40-B

:

(b) Number of Safety Officers

appointed :

Ambulance room

19. Is there an ambulance room provided

in the factory as required under

Section 45 ? :

Canteen

20. (a) Is there a canteen provided in

the factory as required under

Section 46? :

(b) Is the canteen provided managed

i) departmentally, or :

ii) through a contractor? :

Shelters or Rest Rooms and Lunch Rooms

21. (a) Are there adequate and suitable

shelters or rest rooms provided in

the factory as required under

Section 47? :

(b) Are there adequate and suitable

lunch rooms provided in the factory

as required under Section 47? :

Creches

22. Is there a Creche provided in the

factory as required under Section 48 ? :

23. (a) Number of Welfare Officers to be

appointed as required under

Section 49 :

(b) Number of Welfare Officers

appointed :

Accidents

24. (a) Total number of accidents

(See explanatory notes)

i) Fatal :

ii) Non-Fatal :

(b) Accidents in which workers

returned to work during the year

to which this return relates :

i) Accidents (workers injured)

occurring during the year in

which injured workers returned

to work during the same year

(aa) Number of accidents :

(bb) Man-days lost due to accidents :

:

ii) Accidents (workers injured)

occurring in the previous year

in which injured workers

returned to work during the

year to which this return relates

(aa) Number of accidents :

(bb) Man-days lost due to accidents :

(c) Accidents (workers injured)

occurring during the year in

which injured workers did not

return to work during the

year to which this return relates

i) Number of accidents :

ii) Man-days lost due to accidents :

Certified that the information furnished above is to the best of my knowledge and belief, correct.

Signature of the manager

Date

Explanatory Notes :

1. The average number of workers employed daily should be calculated by dividing the aggregate number of attendance on working days (that is, man-days worked by the number of working days in the year. In reckoning attendance, attendance by temporary as well as permanent employee should be counted, and all employees should be included, whether they are employed directly or under contractors. Attendance on separate shifts (e.g. night and day shifts) should be counted separately. Days on which the factory was closed for whatever cause, and days on which the manufacturing processes are not carried on should not be treated as working days. Partial attendance for less than half a shift on a working day should be ignored, while attendance for half a shift or more on such day should be treated as full attendance.

2. For seasonal factories, the average number of workers employed during the working season and the off-search should be given separately. Similarly the number of days worked and average number of manhours worked per week during the working and off-season should be given separately.

3. The average number of hours worked per week means the total actual hours worked by all workers during the year excluding the rest intervals but including overtime work divided by the product of total number of workers employed in the factory during the year and 52. In case the factory has not worked for the whole year, the number of weeks during which the factory worked should be used in place of the figure 52.

4. Every person killed or injured should be treated as one separate accident. If in one occurrence six persons were injured or killed, it should be counted as six accidents.

5. In item 24(a , the number of accidents which took place during the year should be given. In case of non-fatal accidents only these accidents which prevented workers from working for 48 hours or more, should be indicated.

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FORM - 30

Prescribed under Rule 125

HALF-YEARLY RETURN

For the half-year ending 30^th June, 19.…./31 December , 19.….

1. Registration number of factory :

2. Name of factory :

3. Name of occupier :

4. Name of manager :

5. District :

6. Postal address of factory :

7. Nature of industry :

8. Average number of workers

employed daily

(See explanatory note)

(a) Adults - i. Man :

ii. Women :

(b) Adolescents- i. Male :

ii. Female :

(c) Children - i. Male :

ii. Female :

9. Number of days worked during

the half-year ending 30^th June,

19…../31^st December , 19.... :

Signature of Manager :

Date :

Explanatory Note :-

The average daily number should be calculated by dividing the aggregate number of attendance on working days by the number of working days during the half-year. In reckoning attendance, attendance by temporary as well as permanent employees should be counted, and all employees should be included, whether they are employed directly or under contractors.

Attendance on separate shifts (e.g., night and day shifts) should be counted separately. Days on which the factory was closed, for whatever cause, and days on which the manufacturing processes were not carried on should not be treated as working days. Partial attendance for less than half a shift on a working day day should be ignored, while attendance for a half a shift or more on such day should be treated as full attendance.

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FORM - 31

Prescribed under Rule 129

MUSTER ROLL

Name of factory…………………………… Place …..……………. District………………..

Serial No.	Name of worker	Father’s Name	Nature of work	Daily attendance for month of ………………………... 19….. Dates														Remarks
				1	2	3	4	5	6	7	8	9	..	..	..	..	..

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FORM - 32

Prescribed under Rule 130

REGISTER OF ACCIDENTS AND DANGEROUS OCCURRENCES

Name of Injured person (if any)	Date of Accident or dangerous occurrence	Date of report (in Form 25) to Inspector	Nature of accident or dangerous occurrence	Date of return of injured Person to work	Number of days the injured Person was absent from work
1	2	3	4	5	6