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5;
GOVERNMENT OF KARNATAKA
NOTIFICATION
TheKarnatakaStateSelfCertification-Cum-Integrated
PeriodicReturnsScheme-2015
3 . Definitions:-
-In this Scheme,unlessthecontextotherwiserequires,--
a) "Scheme" meaRs,the Karnataka State Self Certification-Cum-lntegrated
Periodic ReturnsScheme-2015
b) "Application Form" means the Form in which employer/entrepreneur
. submitshis intentionof entry into this Schemeas prescribedin Form-I.
.c) "Self Certification " means, a certificate submitted by the
emptroyer/entrepreneurto the notified authority, who optsto registerhis/her
esteblishmentunder.this.scheme to the effect that his/herestablishment
is in
full compliancewith the statutoryrequirementsunderapplicableenactments
' ineludedin this Schemeasprescribedin Fornr.-II.
d) "Integrated PeriodicReturn" meansa unified returnto be subnnitted under
this Scheme,asprescribed in Form-IItr.
e) "Employer's Manual" means the indicative sumrnary of statutory
requirements of the ernplbyerlentiepreneurunder the speiified Acts and
Rules of this Scheme,asprescribedin Forrn-IV.
A
Object of the Scheme:-The objeit of the Karnataka State Self-Certification-cum-
ConsolidatedPeriodic ReturnScherne-2015 is to bring spirit of voluntarycompliance
on the part of employer/entrepreneurand to reducemultiple visits by the Department
Officials for inspectionwithout compromisingthe serviceconditions,safety,health,
social securityand welfareof the workersas well as employeesandallow submission
of consolidatedPeriodic returnunderdifferent labour laws.
1 0 Period
. of Validity of Scheme:- Factulalinformationgivenin the prescribedformats
and returnsshallbe the sameas on the date of filing the Return.The Self-Certified
declaration/undertakingand affidavit to abide by all the laws as applicableto the
Industry/EstablishmenVShop/Cornmerciat Establishment/Factory concernedshall be
valid for a periodof next Gne)iear,i.e. between2&129'h Februaryto 31't March of
everyyear.
Onceoptedfbr the Scheme,the sameshall continuedto be valid for five years
provided year-on-yearthe enrptoyer / entrepreneurshall file annual return as
prescribed.After the successfulcompliance underthe Schemefor five years, the
employer/ entrepreneur shall haveoption eitherto remaincoveredunderthe Scheme
or opt out of the scheme.The option must be exercisedin writing to the notified
authority. In casethe employer / entrepreneursuccessfully completesfive years
underthe Schemeand during any inspection,carriedout, if no violationsof laws is
detectedthe amornt of secuiity so depositedshallbe refunded.No interestshall be
payableon the amountof securitydepositedto the employer/entrepreneur.
ll.Registration Fee and Amount of Securityto be Deposited :- Any Establishment
can opt to enroll for the Schemefor all the applicablelegislationsmentionedin
provision-3of the Scheme.Theemployer/entrepreneur shall pay registiation
feesand
depositamount of securityas prescribed
underthe Scheme.The registrationfeesand
securityamountprescribed undertheschemeshallbe as under:-
#{lt{,\r,ah
(s.N. RAMAKRTSHNA)\& ,l
\,
Under Secretaryto Government,
Labour Department
a,
ro, \,)t
The Cornpiler, KarnatakaGazatte,Bangalore- with a requelt to publish the aboveNotification in
the Extraordinary Gazettewith a requestto furnish 50 copies of the Notificationto the Under
Secretary to Government,Labour Departrnentand 50 copies to the Commissionerof Labour in
Karnataka, Karm ika Bhavana,BannerghattaRoad, Bangalore.
Copy to:
1. The Commissioner of Labour in Karnataka, Karmika Bhavana, Bannerghatta
Road,Bangalore-560029
2. The P.S.to Hon. Ministerfor Labour Depaftment,Vidhana Soudha,
3. P.S.to AdditionalChiefSecretaryto Governrnent,Labour Departrnent
-
4. P.A. to DeputySecretary 1, Labour Department.
5. S.G.F/SpareCopies.
TheKarnataka
StateSelfCertification-Curn-lntegrated
PeriodicReturnsScheme-2015
Form-l
Form)
{Application
From
To.
The Notified Authority,
Departmentof Labour
Governmento:fKarnataka
you'
Thanking
Yoursfaithfuily,
Acknowledeement
Slip
This is to acknowledgethat an applicationin respect of the KarnatakaState Self
Certification-Cum-lntegratedPeriodic ReturnsScheme-2015. under labour laws has been
receivedby the undersignedfrom M/s.... ....(Fulladdressin Capitaland
the samehas been entered in the officereceiptRegisterat Sl. No........... Dt...................
Any
furthercorrespondence in favour in this regardmaybe done by statingthis Sl. No.....................
AuthorizedSignatory
ForDepartmentof Labour
Governmentof Karnataka
The KarnatakaState SelfCertification-€unr'tntegrated
PeriodicReturnsScheme-2ol5
L]STOF DOCUMENTS
TO BEATTACHEDWITH FORM-I
SL ENCLOSED,
DOCUMENTS
NO YESOR NO
RegistrationCertifrcateunder.KarnatakaShops and CcimmercialAct 1961
and Karnataka rutes 1963 / Licence obtained under Factories Act 1948 I
1
Registration Certificateof PrincipalEmp]oyer'fL'leence'of Contractorunder
ContractLabourAct whicheveris applicabh.
v ESIC Challani EPFResistration Certificate/ Chatlan
3 Details of Feesand SecurityDepositpaid dccunrents.
Permarrcnt and Postal Address & ID Proof of Proprietor / Partners
4
DirectorsI Occupiers.
5 Rent ,Agireement / OwnershipDeed/ LeaseDeed.
Copy'of. Memorandum"of'Assobiation and Article s of A ssociation;in caseof
6
Pvt. Ltd., Publiccompanies... .
7 PartnershipDeed in caseof PartnershipFirm.
Registration/ Licenceobtainedunder any Central I State Govt. Agencies
8 (TIN RegistrationCertificate,if RegisteredI VAT Registration/ServiceTax
/ Licence Obtainedfrom Indugriesand CornmerceDepartmentl
9 Declaration regardingnon-employmentof child Labour.
Lahd line. Mobile number,E-mail IDs Proprietor / Partners/ Directors/
10
Occupiers/ Contractor/ Ernployerfor cornrnunication.
t 1 Any otherrelatedDocuments.
4
(.7
SELFCERTIFICATION
liWe .
Slo/DlolWlo;...
Managerof IWs.
PLACE:
(Name,Designation
and FullAddress)
,.i
INFORMATIONFORM OF SELFCERTIFICATION
UNDERTHESCHEMh
PhoneNo.l e-Mail/Fax/website
2 . Proprietor/FartnerlDirector of
EstahFi$rnent
PhoneNo./ e:MaitiFaxlWebsite
3. Registrationll icenceno. (Which
ever Labour Act appticable)
4. Nature of Business
b) Contract
c) Daily Wages .
6. Weeklv holidav
Yoursfaithfully,'
Form-]tl
( IntegratedPeriodicReturn)
Year Ending:-
2. F*tPostat Address :
--i
'
Lrcation Ad&ess Telephone Fax E-rnail
1)Shop/Establishment/Enterpris{Factory :
Occupier (o)
(R)
Manager (o)
(R)
T.Particulars of
No.of Persons No.ofPersons No. of Man No of man Total amout of
on roll ason on roll ason days hoursworked salary/wagespaid
l-l-20 (year 3l-12-20(year worked includingO.T. includingO.T.
commenceme commencemen during the duringthe wagesand
nt date) t date) Year year ailowances(in Rs)
i) Women
l.Canteen
2.Creches
3.Shelters.RestroomsandLunchRoom
4.TransportFacility
T
13
9. Materni{r Benefits :-
Delivery
..b)After
. i
i)
ti)
v)
Name and Period Nature Maximum No. of days No. of man Total Amount Arnount of
Address of of No. of worked days worked of salary/ displacement
of the Contract Work workers Wagespaid allowance
Contractor employedby includingO.T paid
each ' wagesand
contractor allowances
(Rs)
Signature.of Ernployer
/OccupierlN{anager
Dated:
Plme:
Name
Designation
,
+l
' a 16
i
Form-lV
Employer's
Manual
R E S P O N S I B I L I TO
I EFT
SH EE M P L O Y E RUSN D E RD I F F E R E N T
I
I
a
LABOURLAWS
(The provisions of different labourlaws to be complied given below are illustrative
and not exhaustiveand are meantfor generalguidance.for detailspleaserefer to
respectiveAct and Rules.)
1. Payment of Wages Act, 1936 and Karnataka rules framed
thereunder.
The employerhasto:
1'FixthewagesperiodwhichwiIlnof.exceedone'month....
2. Pay .the..wages.tothe employed'persons on or before 7th (employingleSsthan
1000persons)lOth (employingmorethan 1000persons)of everymonth.
3. Pay the wagesin currentcoins/currency noteV Bank Account
4. Deduct from the wages of an emplo-,ved person wages as per provisionsafter
following the due procedureonly.
5. Display the notice containingtheabstractof the Act and the rulesmadethereunder
in English, Hindi, Kannadaand in languagesof the majority of the employed
persons.
6. Maintain the following registers
- Registerforfines;
- Registerlor deductionsfor damageor loss;
- Registerof wages.
7. Pleasereadthe Act andRules
1.. Ensure that no woman is being employedknowingly during the six weeks
immediately f'ollowing the day of her delivery. Miscarriage or medical
termiqationof pregnancy.
2. Ensurethat the Maternity benefitat the rate of avbragedaily wage for the period
of her actualabsencefor deliveryor twelveweekswhicheveris less,is beingpaid
to the women employees,and in caseof her deathbefore receiving the maternity
benefit,the sameshall be givento thepersonnominatedby the saidwomen.
3. Ensurethat a medical bonusof two hundredand fifty rupeesis also beinggivento
the female employeesin casethe free of chargepre natal confinementand post
natalcareis not provided by the establishment.
4. Ensurethat a six weeks leavefor miscariageor medicalterminationof pregnancy
is also being given to the affectedwomenemployee.
5. Ensurethat leave with wagesfor two weeksfor tubectomy operationis given to
womenemployees.
6. Ensurethat every woman who hasdelivereda child who returnsto duty shall be
alfowedin the courseof her daily work two breaksof twenty minutesdurationfor
nursingthe child until the child attainsthe ageof fifteen months.
7. Maintainthe recordof womenemployeeof the establishmentin PrescribedForm
8. Exhibit an abstractof the Act andthe rulesthere under in PrescribedForm in the
languageof the locality at a conspicuous placein every part where the womenare
ernployed.
9. Pleasereadthe Act and Rules
19
1,. Mai*tain in Fornr "A" the record in respect of computation of the 'Available
Surplus'in respectofany accounting vear.
2. Maintain the Set on andSetoff of allocablesurplus in Form-B
3. Maintain the recordaf theborus paid to ernployeesfor any accountingyearForr*-
C
4. Stlbmit Annual ReturninForun-D
5;'Pay the'bohus to the emf,oyeeswithin'8'mbntFn of the close of the accounting.
_..:.yemi ..
l. Employer has to pay remunerationat equalratesto men & women workers for
performingsameor similar natureof work.
3. Please
readthe Act and Rules
7.Submittheprescribedannua[returnswithinthestipu}atedtirrre.
9.InterStateMigrant.Workmen(Regu|ationofEmp|oymentand
Conditions of Service) Act, 1979 and Karnataka ru.l€s framed
thereunder.
The Employer has.to
3. The employerhas to give holiday with wageson the polling day for House of
Peopleor to the StateLegisl.ativeAssembly.
4. Please
readtheAct and Rules
5. Everychildemployedin an establishment
hasbeenalloweda weeklyholiday.
6. The notice to inspector as required u/s 9(2) of the Act has been given
containingthe inforrnationas per section9(1) of theAct;
7. Therecordin prescribedForm hasbeen/shallbe maintained.
f . - 73
t? 8. The notice containing abstractof section3 and 14 has bean displayed at the
t
I
!
placeof work in local languageandin Englishlanguage.
'Welfare
l2.*furn#*ka- L,aheur Fund Act 1965 and Karnataka rules
framed thereunder.
ANNEXURE
FORMFORSEIFCERTIFICATION
ANDCONSOLIDATED
ANNUAL
RETURN
TOBESUBMITTED
BY
2.The Paymentof WagesAct. 1936 and the karnatakaRules made there under as
amendedfrom time to time.
3.The Minimum WagesAct, 1948 and karnatakaRules madethere under as amended
from tinid to time.
4.The Contract Lalrour (R.egulation& Abofition) Act, 1970and kamataka Rules made
-'..' there underasamendedfrom time to time.
'
5.The MaternityBenefitAct, 1961 and karnatakaRules madethere under as amended
from time to time.
6.The Paymentof BonusAct, 1965 and karnatakaRules madethereunder as dmended
from time to tirne.
7-The Paymentof GratuityAct, 1972 and karnatakaRulesmadethereunder as amended
from time to time.
8.The EqualRemuneration Act, 1976 and karnatakaRulesmadethereunderas amended
from time to time.
9-.TheIndustrialEmployment(Standing Orders) Act, I 946 andkarnatakaRules made
there underasamended from time to time.
10.TheBeedi and Cigar Workers (Conditions of Employment)Act, 1966and karnataka
Rulesmadethereunderas amendedfrom time to time.
I 1.The Inter StateMigrant Workmen (Regulationof Employmentand Conditionsof
Service) Act, 1979and karnatakaRules made there underas amendedfrom time to
time.
l2.The Motor TransportWorkersAct, 1961 and karnatakaRulesmadethere under as
amendedfrom time to time.
t
II t
t -
I t. NameandAddressof Establishment:
TeleNo. Mobile No. FaxNo. E-mail
address.
2. Nanreardresidentialaddressof the
Emp&uyer/contractor: .
TeleNo. Mobile No. Fax No. fudl
address
5. Nature of Btrsfures$activity:
EmplolrnentPortal Reg-No.. Whethervacancyuploaded:Y/N
6. Numberof Employeesemployed:
(inctudingcontractworkers)
/.et\
rto,/*i" r,q'i
Governmentof Karnatakr Departmentof Labour
- fiffi.,';
{')- -{+.7'{tl:'}
a a a a a a a a a a a a a a
.. ...t-q..r-......lalaa.......rrrrrrrr.r....rrr
Date:
Form-V
Certificateissuedby the NotifiedAuthority for the Establishment
for
having admitted.underThe.Karnatakastate self certif:ication-c
um-
lntegiated Periodic Returns Scheme-2015
PhoneNo./ e-Mail/Fax/website
2. Name of Proprietor/
Partner/Directorof
Establishment
PhoneNo./ e-Mail/Fax/Website
3 . Registration/Licence
no. (Which
everLabourAct applicable)
4 . Natureof Business
b) Contract
c) Daily Wages
5. Weeklvholidav
The above establishmenthas been admitted for the Karnataka State Self Certification-Cum-
Integrated Periodic ReturnsScheme-2015. The following Labour Laws are applicableto the
abovesaid establishment.This certificateis valid for five (5) yearsfrom the dateof issue.
* 27
Dated:
Place: