Bonus* — AMENDING ACT — Roop's Law Assist Statutes

17. Bonus* (a) Number of employees eligible for bonus : (b) Percentage of bonus declared and number of employees who were paid bonus: (c) Amount payable as bonus : (d) Total amount of bonus actually paid and date of payment : Place: Date: ANNEXURE I * ANNEXURE II (See Item No. 6) * Delete, if not applicable. Signature of the Manager/Employer with full name in capital letters. FORM II [See section 4(1)] REGISTER OF PERSONS EMPLOYED -CUM-EMPLOYMENT CARD Name of the establishment, address, telephone number, FAX number and e-mail address _____________ Location of work_________________________________________________________ ________________ Name and address of principal employer if the employer is a contractor_______________ ________________ _________________________________________________________________________ _______________ Name of workman/employee___________________________________________ ____________________ Father’s/Husband’s name_____________________________________________ _____________________ Address: (i) Present________________________________________________________ _____________________ (ii) Permanent______________________________________________________ ____________________ Name and address of the nominee/next of kin______________________________ _____________________ Designation/Category________________________________________________ ______________________ Date of Birth/Age___________________________________________________ ______________________ Educational qualifications_____________________________________________ _____________________ Date of entry_________ ___________________________________________________________________ Worker’s ID No./ESI/EPF/L.W.F. No._____________________ ___________________________________ If the employed person is below 14 years, whether a certificate of age is maintained_______________ ____ Sex: Male or Female_______________________________________________ ______________________

Section 17