15[(1) The employer of every mine or circus shall, on or before the 1st day of February in each year, upload a unified annual return in Form X online on the web portal of the Central Government in the Ministry of Labour and Employment, giving information as to the particulars specified, in respect of the preceding year:
Provided that during inspection, the inspector may require the production of accounts, books, register and other documents maintained in electronic form or otherwise.
Explanation. For the purposes of this sub-rule, the expression electronic form shall have the same meaning as assigned to it in clause (r) of Section 2 of the Information Technology Act, 2000 (21 of 2000).
(2) If the employer of a mine or circus to which the Act applies sells, abandons or discontinues the working of the mine or circus, then, he shall, within one month of the date of such sale or abandonment or four months of the date of such discontinuance, as the case may be, upload online, on the web portal of the Central Government in the Ministry of Labour and Employment, a further unified return in Form X referred to in sub-rule (1) in respect of the period between the end of the preceding year and the date of the sale, abandonment or discontinuance.]
*Form A
[See Rule 3]
Muster-roll
Name of 16[Mine or Circus]:
1. Serial Number.
2. Name of woman and her father's (or if married, husband's) name.
3. Date of appointment.
4. Nature of work.
5. Dates with month and year in which she is employed, laid off and not employed.
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No. of days employed |
No. of days laid off |
No. of days not employed |
Remarks |
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6. Date on which the woman gives notice under Section 6.
7. Date of discharge/dismissal, if any.
8. Date of production of proof of pregnancy under Section 6.
9. Date of birth of child.
10. Date of production of proof of delivery/miscarriage/17[Medical Termination of Pregnancy/Tubectomy Operation/death].
11. Date of production of proof of illness referred to in Section 10.
12. Date with the amount of maternity benefit paid in advance of expected delivery.
13. Date with the amount of subsequent payment of maternity benefit.
14. Date with the amount of bonus, if paid, under Section 8.
15. Date with the amount of wages paid on account of leave under Section 9.
18[15-A. Date with the amount of wages paid on account of leave under Section 9-A.]
16. Date with the amount of wages paid on account of leave under Section 10 and period of the leave granted.
17. Name of the person nominated by the woman under Section 6.
18. If the woman dies, the date of her death, the name of the person to whom maternity benefit and/or other amount was paid, the amount thereof and the date of payment.
19. If the woman dies and the child survives the name of the person to whom the amount of maternity benefit was paid on behalf of the child and the period for which it was paid.
20. Signature of the employer of 19[the mine or circus] authenticating the entries in the muster-roll.
21. Remarks column for the use of the Inspector.
Form B
[See Rule 4(1)]
This is to certify that I examined . wife/daughter of , a woman employee in . (name of 20[mine or circus]) on . found/cannot discover that she is pregnant and is expected to be delivered of a child within (month and/days) from the above-mentioned date/has undergone miscarriage or [medical termination of pregnancy or tubectomy operation]21 has been delivered of a child on (date) or suffering from (date) from illness arising out of pregnancy/delivery/premature birth of a child or miscarriage or [medical termination of pregnancy or tubectomy operation]22.
Signature, qualifications and designation
of Medical Officer/Medical
Practitioner
Date
Definitions of child and miscarriage as in the Maternity Benefit Act, 1961
1. Child includes a stillborn child.
2. Miscarriage means expulsion of the contents of a pregnant uterus at any period prior to or during the twenty-sixth week of pregnancy but does not include any miscarriage, the causing of which is punishable under the Indian Penal Code.
Form C
[See Rule 4(4)]
Certificate on death of a woman or a child
This is to certify that Smt , wife/daughter of employed in (name of 23[the mine or circus]) expired on . before/during/after confinement. The child died on /survives her.
Signature, qualifications and designation of
Medical Officer/Medical Practitioner.
Date .
Form D
[See Rule 4(5)]
Certificate from a registered midwife
This is to certify that I examined , wife/daughter of , a woman employed in (name of 24[mine or circus]) and found that she has been delivered of a child/has undergone miscarriage on .(date).
Signature of registered midwife
Date .
Definitions of child and miscarriage as in the Maternity Benefit Act, 1961
1. Child includes a stillborn child.
2. Miscarriage means expulsion of the contents of a pregnant uterus at any period prior to or during the twenty-sixth week of pregnancy but does not include any miscarriage, the causing of which is punishable under the Indian Penal Code.
Form E
[See Rule 5(1)]
Notice under Section 6 of the Maternity Benefit Act, 1961
. (name of 25[mine or circus])
I, ., (name of woman) wife/daughter of , employed as at (name of mine), hereby give notice that I expect to be confined within six weeks next following from the date of this notice/have given birth to a child on (date) and shall be absent from work from (date). I shall not work in any establishment during the period for which I receive maternity benefit.
2. For the purpose of Section 7, I hereby nominate (here enter name and address of the nominee) to receive maternity benefit and/or any other amount due to me under the Act in case of my death.
| Signature of an Attestor in case the woman is not able to sign and affixes thumb-impression. |
Signature or thumb-impression of woman. |
Date
Form F
[See Rule 5(3)]
Form of receipt of Maternity Benefit
To
. (name of 26[mine or circus])
I, , the undersigned, a *woman employee/the nominee of woman employee/legal representative of . woman employee deceased in (name of 27[mine or circus]) at in . district received maternity benefit and/or other amount due under the Maternity Benefit Act, 1961, from the employer of 28[the mine or circus] referred to above, as detailed below:
Rs. , being the first instalment of maternity benefit paid on .
Rs. , being the second instalment of maternity benefit after delivery paid on .
Rs. , being the medical bonus under Section 8 of the Act paid on .
Rs. ., being the wages for leave period from mentioned under Section 9 [, 9-A]29 or 10 .
*My/Her confinement/miscarriage, 30[medical termination of pregnancy or tubectomy operation] took place on . or I/she fell ill because of pregnancy, delivery, premature birth of a child or miscarriage or 31[medical termination of pregnancy or tubectomy operation] on . In consequence I, , her nominee/legal representative have received the aforesaid amounts prescribed in Sections 5, 8, 9 [, 9-A]32 and 10 of the Maternity Benefit Act, 1961.
Signature or thumb-impression of
*Woman employee or her nominee or legal representative.
Signature of an Attestor in case the
woman is not able to sign and
affixes thumb-impression.
Date .
* Strike out unnecessary portion.
Form G
[See Rule 9]
Appeal under S. 12(2)(b)
To
The Competent Authority
appointed under the Maternity Benefit Act, 1961
(Address)
Sir,
I, , the undersigned, woman employee of . (name of 33[mine or circus] and full address), having been wrongly deprived by the employer of maternity benefit or medical bonus or both (strike out unnecessary portion) for the reasons attached hereto, prefer this appeal under sub-section (2) of Section 12 and request that the said employer be ordered to pay the above-mentioned amount to me. A copy of the order of the employer in this benefit is enclosed.
Signature or thumb-impression of the woman.
Date
Signature of an Attestor in case the
woman is not able to sign and
affixes thumb-impression.
Full address of the nominee/legal
representative.
Form H
[See Rule 10]
Complaint under S. 17(1)
To
The Inspector,
(Under the Maternity Benefit Act, 1961).
Sir,
I, , (name of woman) employed in (name and full address of 34[mine or circus]) having fulfilled the conditions laid down in the Maternity Benefit Act, 1961 and the Rules thereunder am entitled to Rs being maternity benefit and/or Rs being the medical bonus and/or Rs being wages for leave due under Section 9 [or 9-A]35 or 10 but the same has been improperly withheld by the employer. He may, therefore, be directed to pay the amount to me.
Signature or thumb-impression of the woman
Date
Signature of an Attestor in case the
woman is unable to sign and affixes
thumb-impression.
Full address of the woman
Date
Form I
[See Rule 10]
Complaint under S. 17(1)
To
The Inspector,
(Under the Maternity Benefit Act, 1961).
I, ., (name), a person nominated under Section 6 by or a legal representative of . (name of woman) employed in (name and full address of mine) have to complain that the said woman having fulfilled the conditions laid down in the Maternity Benefit Act, 1961 and the Rules thereunder is entitled to Rs . being maternity benefit and/or Rs . being the medical bonus and/or Rs . being wages for leave due under Section 9 [or 9-A]36 or 10 but the same has been improperly withheld by the employer. He may, therefore, be directed to pay the amount to me.
Signature or thumb-impression of the
nominee/legal representative.
Date .
Signature of an Attestor in case the nominee/legal
representative is unable to sign and
affixes thumb-impression.
Date
Full address of the nominee/legal representative
Form J
[See Rule 11]
Appeal against the decision of the Inspector
To
Sir,
Shri , Inspector, having directed under sub-section (2) of Section 17 to pay the maternity benefit or other amount being . (nature of amount) to which (name of woman) is said to be entitled, I prefer this appeal under sub-section (3) of Section 17. In view of the fact mentioned in the memorandum attached hereto and other documents filed herewith it is submitted that the woman is not entitled to the maternity benefit or the said amount and hence the decision of the Inspector in this behalf, copy of which is enclosed, may be set aside.
Signature of aggrieved person
Full address
Date
Form K
[See Rule 15]
(Abstract of the Maternity Benefit Act, 1961, and the rules made thereunder.)
1. No employer shall knowingly employ a woman during the six weeks immediately following the day of her delivery or miscarriage or [medical termination of pregnancy]37 and no woman shall work in any establishment during the said period.
2. No pregnant woman shall, on a request being made by her in this behalf, be required by her employer to do during the period of one month immediately preceding the period of six weeks before the date of her expected delivery and also for any period during this period of six weeks for which she does not avail of leave of absence, any work which is of an arduous nature or which involves long hours of standing, or which in any way is likely to interfere with her pregnancy or the normal development of the foetus, or is likely to cause her miscarriage or otherwise to adversely affect her health.
3. 38[(1) Subject to the provisions of the Act, every woman who has actually worked in an establishment of the employer from whom she claims maternity benefit for a period of not less than eighty days, including the days during which she was laid off, shall be entitled to, and her employer shall be liable for the payment of maternity benefit at the rate of her average daily wages, or the minimum rate of wage fixed or revised under the Minimum Wages Act, 1948 or ten rupees a day, whichever is the highest, for the period of her actual absence not exceeding six weeks immediately preceding the day of delivery and the remaining period immediately following that day:
Provided that the qualifying period of eighty days aforesaid shall not apply to a woman who has immigrated into the State of Assam and was pregnant at the time of the immigration:
Provided further that where a woman dies during the period for which maternity benefit is payable to her, the benefit shall be payable only for the days up to and including the day of her death. However, where the woman having been delivered of a child, dies during her delivery or during the remaining period of maternity benefit leaving behind in either case the child, the employer shall be liable for the payment of maternity benefit for the entire period of maternity benefit following the day of her delivery but if the child also dies during the said period, then, for the days up to and including the day of the death of the child].
(2) The amount of maternity benefit for the period preceding the date of her expected delivery shall be paid in advance by the employer to the woman on production of a certificate in Form B stating that she is pregnant and is expected to be delivered of a child within six weeks of the date of production of the certificate, and the amount due for the subsequent period shall be paid by the employer to the woman within forty-eight hours of production of the certificate in Form B or Form D stating that she has been delivered of a child or production of certified extract from a Birth Register maintained under the provisions of any law for the time being in force.
4. (1) Any woman employed in an establishment and entitled to maternity benefit under the provisions of this Act may give notice in writing in Form E to her employer, stating that her maternity benefit and any other amount to which she may be entitled under this Act may be paid to her or to such person as she may nominate in the notice and that she will not work in any establishment during the period for which she receives maternity benefit.
(2) In the case of a woman who is pregnant, such notice shall state the date from which she will be absent from work, not being a date earlier than six weeks from the date of her expected delivery.
(3) Any woman who has not given the notice when she was pregnant may give such notice as soon as possible after the delivery.
(4) On receipt of the notice, the employer shall permit such woman to absent herself from the establishment until the expiry [of the remaining period of maternity benefit]39 after the day of her delivery.
5. (1) Every woman entitled to maternity benefit under the Act shall also be entitled to receive from her employer a medical bonus of [two hundred and fifty rupees]40, if no prenatal confinement and postnatal care is provided for by the employer free of charge. The medical bonus shall be paid along with the second instalment of the maternity benefit.
(2) In case of miscarriage, a woman shall, on production of a certificate in Form B or Form D be entitled to leave with wages at the rate of maternity benefit, for a period of six weeks immediately following the day of her miscarriage. The wages shall be paid within 48 hours of production of the certificate in Form B or Form D .
41[(2-A) In case of medical termination of pregnancy, a woman shall, on production of a certificate in Form B , be entitled to leave with wages at the rate of maternity benefit for a period of six weeks immediately following the day of her Medical Termination of Pregnancy. The wages shall be paid within 48 hours of production of the certificate in Form B ].
(3) A woman suffering from illness arising out of pregnancy, delivery, premature birth of child or miscarriage or 42[medical termination of pregnancy or tubectomy operation] shall, on production of a certificate in Form B , be entitled, in addition to the period of absence allowed to her on account of maternity or miscarriage or 43[medical termination of pregnancy or tubectomy operation], as the case may be, to leave with wages at the rate of maternity benefit for a maximum period of one month. The wages for the leave period shall be paid within 48 hours of the expiry of that period.
6. Every woman delivered of a child who returns to duty after such delivery shall, in addition to the interval for rest allowed to her, be allowed in the course of her daily work two breaks of 15 minutes' duration for nursing the child until the child attains the age of fifteen months. An extra sufficient period depending upon the distance to be covered, shall be allowed for the purpose of the journey to and from the creche or the place where the children are left by woman while on duty, provided that such extra period shall not be less than 5 minutes and more than 15 minutes' duration.
7. (1) When a woman absents herself from work in accordance with the provisions of the Act, it shall be unlawful for her employer to discharge or dismiss her during or on account of such absence or to give notice of discharge or dismissal on such a day that the notice will expire during such absence, or to vary to her disadvantage any of the conditions of her service.
(2) (a) The discharge or dismissal of a woman at any time during her pregnancy, if the woman but for such discharge or dismissal would have been entitled to maternity benefit or medical bonus shall not have the effect of depriving her of the maternity benefit or medical bonus:
Provided that where the dismissal is for one or more of the following acts, the employer may, by order in writing communicated to the woman, deprive her of the maternity benefit or medical bonus or both for
(i) wilful destruction of employer's goods or property;
(ii) assaulting any superior or co-employee at the place of work;
(iii) criminal offence involving moral turpitude resulting in conviction in a court of law;
(iv) theft, fraud, or dishonesty in connection with the employer's business or property; and
(v) wilful non-observance of safety measures or rules on the subject or wilful interference with safety devices or with fire-fighting equipment.
(b) Any woman deprived of maternity benefit or medical bonus or both, may within sixty days from the date on which the order of such deprivation is communicated to her, appeal in Form G to 44[the Competent Authority and his decision] on such appeal whether the woman should or should not be deprived of maternity benefit or medical bonus or both, shall be final.
8. If a woman works in any establishment after she has been permitted by her employer to absent herself under the provisions of the Act, she shall forfeit her claim to the maternity benefit for such period.
9. (1) Any woman claiming the maternity benefit or any other amount to which she is entitled under the Act and any person claiming that payment due has been improperly withheld may make a complaint to the Inspector in writing in Form H or I as the case may be.
(2) The Inspector may, of his own motion or on receipt of a complaint in Form H or I make an inquiry or cause an enquiry to be made and if satisfied that payment has been wrongfully withheld, may direct the payment to be made in accordance with his orders.
(3) Any person aggrieved by the decision of the Inspector may, within thirty days from the date on which such decision is communicated to such person, appeal to 45[the Chief Inspector of Mines.]
(4) The decision of 46[* * *] [the Competent Authority]47 where an appeal has been preferred to him or of the Inspector where no such appeal has been preferred, shall be final.
10. (a) The employer shall supply to every woman employed by him at her request free of cost copies of Forms B , C , D , E , F , G , H and I .
(b) The failure to submit a notice, appeal or complaint in the prescribed form will not affect the right of a woman entitled to receive maternity benefit or any other amount due under the Act. Where a notice, appeal or complaint has been received in a form other than the prescribed form, the authority concerned shall within fifteen days of the receipt of such notice, appeal or complaint, require the woman to submit the notice, appeal or complaint, as the case may be, in the prescribed form.
11. (a) (1) The employer of 48[every mine or circus] in which women are employed shall prepare and maintain a muster-roll in Form A and shall enter therein particulars of all women workers in 49[the mine or circus].
(2) All entries in the muster-roll shall be made in ink and maintained upto date and it shall always be available for inspection by the Inspector during working hours.
(b) The employer of 50[every mine or circus] shall on or before the 21st day of January in each year submit to 51[* * *] 52[the Competent Authority] a return in each of the Forms L , M , N and O giving information as to the particulars specified in respect of the preceding year.
53[Form X
[See Rule 16(1)]
Unified Annual Return
A. General Part:
Particulars:
| (a) Name of the establishment |
| Address of the establishment. House No./Flat No.Street/Plot No. TownDistrictStatePin Code |
| (b) Name of the employer |
| Address of the employer House No./Flat No.Street/Plot No. |
| Town |
District |
State |
Pin Code |
| E-mail ID |
Telephone Number |
MobileNumber |
| (c) Name of the manager or person responsible for supervision and control of establishment
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| Address House No./Flat No.Street/Plot No. |
| Town |
District |
State |
Pin Code |
| E-mail IDTelephone NumberMobile Number |
B. Employer's Registration/License number under the Acts mentioned in column (2) of the table below:
| Sl. No. |
Name |
Registration |
If yes (Registration No.) |
| (1) |
(2) |
(3) |
(4) |
| 1. |
The Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996 |
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| 2. |
The Contract Labour (Regulation and Abolition) Act, 1970 |
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| 3. |
The Inter-State Migrant Workmen (Regulation of Employment and Condition of Service) Act, 1979 |
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| 4. |
The Employees Provident Funds and Miscellaneous Provisions Act, 1952 |
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| 5. |
The Employees' State Insurance Act, 1948 |
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| 6. |
The Mines Act, 1952 Notice of opening under Regulation 3 of Coal Mines Regulation, 1957 or Regulation 3 of Metalliferous Mines Regulation, 1961 |
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| 7. |
The Factories Act, 1948 |
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| 8. |
The Motor Transport Workers Act, 1961 |
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| 9. |
The Shops and Establishments Act (State Act) |
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| 10. |
Any other Law for the time being in force |
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C. Details of Principal Employer, Contractor and Contract Labour:
| 1. |
Name of the principal employer in the case of a contractor's establishment |
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| 2. |
Date of commencement of the establishment |
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| 3. |
Number of Contractors engaged in the establishment during the year |
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| 4. |
Total Number of days during the year on which Contract Labour was employed |
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| 5. |
Total number of man-days worked by Contract Labour during the year |
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| 6. |
Name of the Manager or Agent (in case of mines) |
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| 7. |
Address House No./Flat No. |
Street/Plot No. |
Town |
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District StatePin Code |
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E-mail IDTelephone NumberMobile No. |
D. Working hours and weekly rest day:
| 1. |
Number of days worked during the year |
| 2. |
Number of man-days worked during the year |
| 3. |
Daily hours of work |
| 4. |
Weekly day of rest |
E. Maximum number of persons employed in any day during the year:
| Sl. No. |
Males |
Females |
Adolescents (between the age of 14 to 18 years) |
Children (below 14 years of age) |
Total |
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F. Wage rates (Category Wise):
| Category |
Rates of Wages |
No. of workers |
| Regular |
Contract |
| Male |
Female |
Children |
Adole-scent |
Male |
Female |
Children |
Adole-scent |
| Highly Skilled |
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| Skilled |
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| Semi-skilled |
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| Un-skilled |
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G. (a) Details of Payments:
| Gross wages paid |
Deductions |
New wages paid |
| In cash |
In kind |
Fines |
Deductions for damage or loss |
Others |
In cash |
In kind |
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(b) Number of workers who were granted leave with wages during the year:
| Sl. No. |
During the year |
Number of workers |
Granted leave with wages |
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H. Details of various welfare amenities provided under the statutory schemes:
| Sl. No. |
Nature of various welfare amenities provided |
Statutory (specify the statute) |
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I. The Maternity Benefit Act, 1961, Maternity Benefit (Mines and Circus) Rules, 1963:
(a) Details of establishment, medical and paramedical staff:
| 1. |
Date of opening of establishment |
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| 2. |
Date of closing, if closed |
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| 3. |
Name of Medical Officer |
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| 3(i) |
Qualification of Medical Officer |
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| 3(ii) |
Is Medical Officer at (the mines or circus)? |
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| 3(iii) |
If a part time, how often does he/she pay visit to establishment? |
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| 3(iv) |
Is there any Hospital? |
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| 3(v) |
If so, how many beds are provided? |
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| 3(vi) |
Is there a lady Doctor? |
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| 3(vii) |
If so, what is her qualification? |
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| 3(viii) |
Is there a qualified mid-wife? |
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| 3(ix) |
Has any cr che been provided? |
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(b) Leave Granted under the Maternity Benefit Act, 1961 Maternity Benefit (Mines and Circus) Rules, 1963/Employees' State Insurance Act, 1948:
| 1. |
Total number of female employees in the establishment |
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| 2. |
Total number days of leave granted |
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| 3. |
Number of employees granted maternity leave/benefited by ESI |
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DECLARATION
It is to certify that the above information is true and correct and also I certify that I have complied with the all provisions of Labour Laws applicable to my establishment.