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Annual Return

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....e of the Establishment     4. Email ID (employer)     5. Telephone No. (employer)     6. Mobile number (employer)     7. Premise name     8. Sub-locality     9. District     10. State     11. Pin Code     12. Geo Co-ordinates     B(a). Hours of Work in a day   B(b). Number of Shifts Number of hours in a shift   C. Details of Manpower Deployed Details Directly employed Employed through Contractor Grand Total Skill Category Highly Skilled Skilled Semi- Skilled Un- Skilled Highly Skilled Skilled Semi- Skilled Un- Skilled   (i) Maximum No. of employees employed in the establishment in any day during the year M/F/T M/F/T M/F/T M/F/T M/F/T M/F/T M/F/T M/F/T   (ii) Average No. of employees employed in the establishment during the year No. to be indicated M/F/T M/F/T M/F/T M/F/T M/F/T M/F/T M/F/T   (iii) Maximum number of Migrant W....

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....required to have data on occupational health.   F. The Industrial Relations: Instructions for filling 1. Is the Works Committee has been functioning.(Section 3 of IR Code, 2020) Yes/No and not applicable Industrial establishment in which 100 or more workers are employed (a) Date of its constitution.     2. Whether the Safety Redressal Committee constituted (Section 4 of IR Code, 2020) Yes/No and not applicable Industrial establishment employing 20 or more workers 3. Number of registered Unions in the establishments.     4. Whether any negotiation union exist(Section 14 of IR Code, 2020) Yes/No   5. Whether any negotiating council is constituted (Section 14 of IR Code, 2020) Yes/No   6. Number of workers discharged/dismissed, retrenched or whose services were terminated during the year:     Dismissed Retrenched Discharged /Terminated or Removed Grand Total   7. Man-days lost during the year on account of   Sl. No. Reasons Period /Date No. of man-days lost     (a) Strike   ....

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....) Belowground/ Opencast/ Aboveground/Mixed/OffShore/OnShore 8. Date of opening To be filled for first time 9 Mine Code To be filled for first time 10. Date of closing (if any) NA/ Calendar to be given 11. Date of reopening (if any) NA/ Calendar to be given 12. Depth of working in mts. Maximum Depth:            Minimum Depth:       B. Statutory personnel employed in the mine (as on 31^st December) Sl. No. Designation as per Code Number of Statutory Persons required Number of Statutory Persons employed 1.       C. Method of Working vis-a-vis Safety Parameters 1 Name of Method (Specify the name) (as per drop down menu)     2 Quantity of mineral Produced in Cu.m./Tonne     3 Quantity of Waste/overburden removed in Cu.m./Tonne     4 Stage of Working (as per drop down menu) Development/Extraction/Mixed   5 Permissible Void in Cu.m.   For extraction stage 6 Actual Void in Cu.m.   For extraction stage 7 A....

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....g   Imparted special Training   F. Details of Accident, Dangerous Occurrence and Occupational Diseases : (1) Details of Accidents and Dangerous Occurrences: Sl. No. Date of Accidents/Dangerous Occurrences No. of persons killed No. of persons received Serious Bodily Injury Number of persons injured (Excluding Serious Bodily Injury) and thereby prevented from working for a period of 48 hours or more Nature of Occurrence Mandays lost 1.             (2) Details of Occupational diseases: Sl. No Notified Disease No. of cases 1     G. Details of Safety Management Plan: (a) Safety Management Plan Prepared: (Yes/No/NA) (b) Date of Submission : Date (c) Last date of review of Safety Management Plan: Date (d ) Principal Hazards Identified: Sl. no. List of Principal hazards identified Principal hazard Mitigation date Principal hazard not mitigated till 31st December Reasons for failure to mitigate the same 1.         H. Mines Rescue Station: (For Belowground Mines O....

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....ntract labour employed Amount paid against wage bill (if applicable) to the contractor (including EPF, ESIC, Bonus etc.) Date of payment of wage bill (if applicable) Amount of the wages paid directly to the contract labour by Principal Employer (in case the contractor fails to pay) Date of payment of wages paid directly to the contract labour by Principal Employer (in case the contractor fails to pay) Remarks                                                                   Signature of the principal employer Date: PART IV (see rule 72(8)) Shram Shuvidha Portal Ministry of Labour and Employment Self-Declaration form for EPFO/ESIC Contribution           Year:___ PAN No: LIN:(Auto-Populated) EPF Code No. (Auto-Populated)(Editable): Branch Code Nos. (Auto- Populated)(Editable): ESI Code No.(Auto- Populated)(Editable): Sub Cod....