FORM C
[See Sec. 4(l) proviso (b) (i)]
Muster Roll to be maintained by small establishments

Name of establishment ……………………….. Name and address of the employer
Address (Local)……………………………….         …………………………………
(Permanent) ………………………………….. Wage period……………………

Serial Number	Name   of the employee	Date of employment	Permanent address	Age or date of birth
1	2	3	4	5

Father’s husband’s name	For the period ending Number of units of work done during	Total attendance	Total overtime worked	Total production in case of piece-rated workers
6	7	8	9	10

Compensatory rest
Brought Inspector forward from previous wage period	Given during the wage period	Signature of with date	Remarks
11	12	13	14

NOTES: 1. In the case of daily-rated workers, the extent of overtime done on each occasion has to be reflected against each concerned date, such as, “P/I” meaning “Present with one hour’s overtime”, “P/1-2” meaning “Present with one and a half hour’s overtime”, and so on.
2. The number of units of work done by a piece-rated worker has to be noted for each day in the Register. In case of employment of any child/adolescent, the employer shall indicate the hours worked each day with intervals of rest.
3. The Compensatory Test availed by the worker has to be marked in the Register in red ink as “CR”.
4. Column 7 to be filled up on each working day and the remaining columns to be completed within seven days of the expiry of the wage period.
Signature of the employer with full name in capitals.
Date……………..
Place………………