Form IV

[Prescribed under Rule 18 of the Tamil Nadu Payment of Wages Rules, 1937]

WAGES AND DEDUCTIONS FROM WAGES
Return for the year ending {{ $report['period_end'] ?? '31-12-2024' }}

1. (a) Name of the Factory / Establishment and Postal Address	{{ $report['establishment_name'] ?? '' }}, {{ $report['address'] ?? '' }}
2. Number of days worked during the year	{{ $report['days_worked'] ?? '' }}
3. (a) Number of man-days worked during the year	{{ $report['man_days'] ?? '' }}
(b) Industry	{{ $report['industry'] ?? '' }}
(c) Average daily number of persons employed during the year Adults Children Total	{{ $report['adults'] ?? '' }} {{ $report['children'] ?? '' }} {{ $report['total_persons'] ?? '' }}

4. Gross amount paid as remuneration

Particulars	Amount (Rs.)
Persons receiving less than Rs. 1000 / month	{{ $report['gross_amount'] ?? '' }}

5. Total wages paid including deductions under Section 7(2) on the following account:

Particulars	Amount (Rs.)
a) Basic Wages	{{ $report['basic_wages'] ?? '' }}
b) Dearness Allowance	{{ $report['da'] ?? '' }}
c) Overtime wages & non-profit sharing bonus	{{ $report['ot_bonus'] ?? '' }}
d) Other allowances in cash	{{ $report['other_allowances'] ?? '' }}
e) Arrears of pay (previous year paid this year)	{{ $report['arrears'] ?? '' }}
Total	{{ $report['total_wages'] ?? '' }}

6. Deductions (for persons receiving less than Rs. 1000 / month)

Particulars	No. of Cases	Amount (Rs.)
a) Fines	{{ $report['fines_cases'] ?? '' }}	{{ $report['fines_amount'] ?? '' }}
b) Deductions for damage or loss	{{ $report['damage_cases'] ?? '' }}	{{ $report['damage_amount'] ?? '' }}
c) Deductions for breach of contract	{{ $report['breach_cases'] ?? '' }}	{{ $report['breach_amount'] ?? '' }}

7. Disbursements from the fines fund

Purpose	Amount (Rs.)
a)	{{ $report['disbursement_a'] ?? 'NIL' }}
b)	{{ $report['disbursement_b'] ?? 'NIL' }}
c)	{{ $report['disbursement_c'] ?? 'NIL' }}

8. Balance of fines in hand at the end of the year

{{ isset($report['fine_balance']) ? 'Rs.' . $report['fine_balance'] : 'NIL' }}

Date: {{ $report['date'] ?? '' }}

For {{ $report['establishment_name'] ?? '' }}

Signature

Designation: {{ $report['designation'] ?? '' }}

* This is the aggregate number of attendances during the year.

** The average daily number of persons employed during the year is obtained by dividing the aggregate number of attendances during the year by the number of working days.

*** Money value of concessions should be obtained by taking the difference between the cost price paid by the employer and the actual price paid by employees for supplies of essential commodities given free or at concessional rates.