1

[FORM No. 9

[See Rule 107]

REGISTER OF OVERTIME AND PAYMENT
Form No. 9 under Rule 107 of Karnataka Factories Rules, 1969.
Form No. XIII under Rule 78(1) (a)(iii) of Contract Labour (Regulation and Abolition) Karnataka Rules, 1974.
Form No. IV under Rule 28(2) of Karnataka Minimum Wages Rules, 1958.
Name and Address of the
Factory/Establishment :

Name and Address of the

Principal Employer :

Name and Address of the

the Contractor (if any) :

Month/Year

Place of Work :

Sl.
No.

Employee
Name
Father/Husba
nd Name

Sex

Designatio
n/Employm
ent No.

Particulars of
OT Work
Date

Hour
s
6

Normal
rate of
wages
per hour

Overtim
e wages
per
hour

Norma
l piece
rate of
wages

OT
piece
rate of
wages

Total OT
earning
s

Date of
payme
nt

Signatur
e/Thumb
impressi
on of the
Employe
e

10

11

12

13

Signature of the Occupier/Principal Employer/Contractor