Form Xix Wage Slip

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FORM XIX WAGE SLIP (Vide Rule 78 (1)(b) of Contract Labour (R. & A.) Central & A.P.

Rules, 1971) Name and Address of the contractor


: M/S. PREMIER TRAVELS(INDIA ) PVT.LTD H.No.2-4-69/147,Fort View ColonyPlot Upperpalli,Pillar No.191, Rajendra Nagar,R.R.Dist

Name and fathers/ Husbands Name of the Workman

Nature and Location of Work

: Transport Services M/S.ADP PVT. LTD 6-3-1019/C/1/FORTUNE-9, RAJBHAVAN ROAD at SOMAJIGUDA,HYDERABAD-82 : MARCH.2013

For the week/Fortnight/month ending

1. No. of Days worked 2. No. of units worked in case of Piece rate workers 3. Rate of Monthly wage /: 4. Amount of Overtime wages 5. Gross wages payable 6. Deduction, if any 7. Net amount of wages paid

: : N.A

: : : :

Nil

Initial of the Contractor or his representative.

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