LEFT JOIN LEFT JOIN

875 OPEN /BAL TOTAL 192 OPEN /BAL TOTAL

May-21 Jun-21 May-21 Jun-21
AD 33 2 31 AD 13 13
PR 57 10 1 48 PR 32 4 28
CH 105 61 44 CH 1 1
TW 24 14 10 TW 0 0
TOTAL 219 87 1 133 TOTAL 46 4 0 42

MANOJ KUMAR P.F. STATEMENT FOR THE MONTH OF SEPTEMBER 2004

UNIT DEPT EMPL SALARY V.P.F. P.F. TOTAL 3.67% 8.33%

875 ----> TW 10 26125 0 3135 3135 959 2176

AD 31 90506 780 10861 11641 3322 7539
PR 48 63490 780 7618 8398 2330 5288
CH 44 34985 0 4193 4193 1281 2912
133 215106 1560 25807 27367 7892 17915

STRENGTH A/C 1 12%+3.67% 27367 7892 35259

A/C 2 1.1 % 2366 2366
OPEN May-21 219 A/C 10 8.33 % 17915 17915
JOINING Jun-21 1 A/C 21 0.5 % 1076 1076
LEFT May-21 87 A/C 22 0.01% 22 22
CLOSING 133 27367 29271 56638

192 ----> AD 13 32398 3887 3887 1189 2698

PR 28 86636 690 10395 11085 3182 7213
CH 1 3825 459 459 140 319
42 122859 690 14741 15431 4511 10230

STRENGTH A/C 1 12%+3.67% 15431 4511 19942

A/C 2 1.1 % 1351 1351
OPEN May-21 46 A/C 10 8.33 % 10230 10230
JOINING Jun-21 0 A/C 21 0.5 % 614 614
LEFT May-21 4 A/C 22 0.01% 12 12
CLOSING 42 15431 16718 32149

STRENGTH A/C 1 12%+3.67% 42798 12403 55201

A/C 2 1.1 % 3717 3717

OPEN 265 A/C 10 8.33 % 28145 28145

JOINING 1 A/C 21 0.5 % 1690 1690

LEFT 91 A/C 22 0.01% 34 34

CLOSING 175 42798 45989 88787

Total of 875 & 192 175 337965 2250 40548 42798 12403 28145

MANOJKUMAR E.S.I. STATEMENT FOR THE MONTH OF SEPTEMBER 2004

UNIT DEPT EMPL SALARY 1.75% 4.75% TOTAL

875 -------> AD 25 78821 1379.60

PR 37 107951 1889.55
CH 43 112440 1968.10
TW 10 26125 457.45
115 325337 5694.70
SUS. ALLW.
ARR (-)
0.00 0.00
115 325337.00 5694.70 15453.55 21148.25
ROUND-OFF 0.75
115 325337 5694.70 15454.30 21149.00

192 -------> AD 13 39465 690.85

PR 20 69758 1221.05
CH
33 109223 1911.90 5188.1 7100.00
ROUND-OFF 0.00
33 109223 1911.90 5188.10 7100.00

Total of Unit -- 875 & 192 148 434560 7606.60 20642.40 28249.00

Please make cheque for P.F. Rs. 88787 /- E.S.I. Rs. 28249 /-
 kuldeep singh

love

Page 2
 MONTHYEAR EM'EE WAGES 12% 3.67% 1.1% 8.33% 0.5% 0.01% open join left close
9 0 9 0 7 591 1408176 170571 51804 15490 117207 7041 140 424 181 14 591
10 1 0 0 7
11 1 1 0 7
12 1 2 0 7
1 0 1 0 7
2 0 2 0 7
arr1 1 0 0 7
3 0 3 0 7
4 0 4 0 7
5 0 5 0 7
6 0 6 0 7
7 0 7 0 7
8 0 8 0 7
0 9 0 7
1 0 0 7
1 1 0 7
1 2 0 7
 BANK CHEQUE DT OF CHEQUE DATE OF REMITANCE MONTH
STATE BANK OF INDIA 439997 10/13/2003 10/17/2003 SEPTEMBER ' 2003
OCTOBER ' 2003
NOVERMBER ' 2003
DECEMBER '2003
JANUARY ' 2004
FEBURARY ' 2004
ARR OF OCTOBER' 2003
MARCH ' 2004
APRIL ' 2004
MAY ' 2004
JUNE ' 2004
JULY ' 2004
AUGUST ' 2004
SEPTEMBER ' 2004
OCTOBER ' 2004
NOVERMBER ' 2004
DECEMBER '2004
 MONTH ESI STRENGH ESI-WAGE E'EE CONTRI E'ER CONTRI TLT-CONTRI

DECEMBER '2007 247 670910 11744.55 31869.45 43614.00

1 JANUARY ' 2007
2 FEBURARY ' 2004
3 MARCH ' 2004
4 APRIL ' 2004
5 MAY ' 2004
6 JUNE ' 2004
7 JULY ' 2004
8 AUGUST ' 2004
9 SEPTEMBER ' 2004 0.00
10 OCTOBER ' 2004 0.00
11 NOVERMBER ' 2004 0.00
DECEMBER '2004 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CHEQUE NO Dt. Of Cheque bank

80321 1/10/2004 State Bank of India

 COMBINED CHALLAN OF A/C No. 1,2,10,21 & 22 Original / Duplicate / Triplicate / Quadruplicate
STATE BANK OF INDIA

EMPLOYEE'S PROVIDENT FUND ORGANISATION

(USE SEPARATE CHALLAN FOR EACH MONTH)

ESTABLISHMENT CODE NO. HR / FD / 10381 ACCOUNT GROUP NO ………...…… PAID BY CHEQUE / CASH ……………..………

Employees Share 0 8 0 7 D D M M Y Y
DUES FOR THE MONTH OF:
Employer Share 0 8 0 7 DATE OF PAYMENT 27 7 2021

TOTAL NO. OF SUBSCRIBERS 0 0

A/c 1 A/c 10 A/c 21
TOTAL WAGES DUE 0 0

SL. PARTICULARS A/C No. 1 A/C No 2. A/C No. 10 A/C No. 21 A/C No.22 TOTAL
…………….……. AMOUNT (IN RUPEES) ………...…………

1 EMPLOYER'S SHARE OF CONT. 0

2 EMPLOYEE'S SHARE OF CONT. 0

3 ADM. CHARGES 0

4 INSP. CHARGES

5 PENAL DAMAGES

6 MISC. PAYMENT (PAST

ACCUMULATIONS ONLY)
TOTAL 0 0 0 0 0 0

(AMOUNT IN WORDS) Rs. Only

[FOR BANK'S USE ONLY]
NAME OF ESTABLISHMENT: MANOJ KUMAR AMOUNT RECEIVED Rs……...………..………..
FOR CHEQUES ONLY….………………………..
ADDRESS: DATE OF PRESENTATION………....……….…..
GURGAON, HARAYANA. DATE OF REALISATION ……………..………….
NAME OF DEPOSITOR ……………………………..…………………………………. BRANCH NAME …….……...…….…...…………..
SIGNATURE OF THE DEPOSITOR ………………...………………………………… BRANCH CODE NO………….….………………..

(TO BE FILLED IN BY EMPLOYER)

NAME OF THE BANK ------------- ### -------- CHEQUE NO -------------------------- DATE

Original / Duplicate / Original / Duplicate /
Triplicate / Quadruplicate E.S.I.C. Challan No. …….. Triplicate / Quadruplicate E.S.I.C. Challan No. ……..
EMPLOYEE'S STATE INSURANCE FUND ACCOUNT NO.01 EMPLOYEE'S STATE INSURANCE FUND ACCOUNT NO.01
PAY-IN-SLIP FOR CONTRIBUTION PAY-IN-SLIP FOR CONTRIBUTION
STATE BANK OF INDIA STATE BANK OF INDIA

Station :Dundahera, Udyog Vihar, Gurgaon Date 7/27/2021 Station :Dundahera, Udyog Vihar, Gurgaon Date 7/27/2021

Particulars of Cash / Cheque Rs. P. Particulars of Cash / Cheque Rs. P.

Cheque No. /- Cheque No. /-

TOTAL /- TOTAL /-

Paid into the credit of the employee's State Insurance Fund A/c No.01 Rs. /- Paid into the credit of the employee's State Insurance Fund A/c No.01 Rs. /-
Rupees: Rs. Only Rupees: Rs. Only

in Cash / by Cheque (on realisation) for Payment of Contribution as per details given below under in Cash / by Cheque (on realisation) for Payment of Contribution as per details given below under
the Employee's State Insurance Act,1948 for the Month of :AUGUST ' 2004 the Employee's State Insurance Act,1948 for the Month of :AUGUST ' 2004

Employer's Code No : 13 / 24431 / 23 Employer's Code No : 13 / 24431 / 23

Name & Address of Factory / : MANOJ KUMAR Name & Address of Factory / : MANOJ KUMAR
Establishment Deposited By Establishment Deposited By
UDYOG VIHAR, GURAON - 122016 UDYOG VIHAR, GURAON - 122016

No. of Employee's : No. of Employee's : 0

Total Wages : /- Total Wages : /-

Employee's Contribution Rs. Employee's Contribution Rs. 0.00

Employer's Contribution Rs. Employer's Contribution Rs. 0.00

Total Contribution Rs. Total Contribution Rs. 0.00

(For use in Bank) (To be filled by depositor) (For use in Bank) (To be filled by depositor)
ACKNOWLEDGEMENT ACKNOWLEDGEMENT
Received Payment by Cash / Cheque / Draft No. Dated: 30-12-1899 for Rupees. /- ( Rs. Received Payment by Cash / Cheque / Draft No. Dated: 30-12-1899 for Rupees. /- ( Rs.
Only ) Only )

drawn in in favour of Employee's drawn in in favour of Employee's

State Insurance Fund Account No.01 Sl. No. in Bank's Scroll ……… State Insurance Fund Account No.01 Sl. No. in Bank's Scroll ………

Authorised Signatory Authorised Signatory

Dated: ………………… of the receiving Bank Dated: ………………… of the receiving Bank
Only for Un-Exempted Establishments FORM 12 - A ( REVISED) (To be filled in by the EPFO)
Employees' Provident Fund and Miscllaneous Provisions Act, 1952 Establishment Status
Employees' Pension Scheme
[Paragraph 20(4)] Group Code. .
Currency Period from 1 April 2004 to 31 March 2005
st st

Statement of contributions for the month of AUGUST ' 2004

Statutory rate of contribution - 12%
Name & Address of the Establishment
M/s MANOJ KUMAR
Code No. HR / FD / 10381
GURGAON, HARYANA - 122016

Amount of Contribtion Amount of contribution Remitted

Wages on which Amount of Amount of Date of Remittance
PARTICULARS Contributions are Administrative Administrative (Enclose Triplicate
Payable Recovered from Payable by the Employer's Charges Due Charges Remitted copies of Challan)
Worker's Share
the Workers Employer Share

E.P.F. A/c No.01 0 0 0

Pension Fund A/c No. 10 0 NIL NIL 0 NIL NIL 12/30/1899

D.L.I. A/c No. 21 0 NIL NIL 0 0 12/30/1899

Total No. of Employee's Name & Address of State Bank of India

the Bank in which the
(a) Contract 5 Security Guards covered under code no. DL-5431 amount is remitted Dundahera, Gurgaon
M/s S.D.S. Security Pvt. Ltd.
(b) Rest 0 Harayana - 122016

(c) Total 5

Pension
Details of Subscribers E.P.F. E.D.L.I.
Fund
No. of subscribers as per last month 0 0
No. of New subscribers (Vide Form 5) 0 0
No. of subscribers left service (Vide Form 10) 0 0
(Nett.) Total No. of Subscriber 0 0 0 Signature of the Employer with official (Seal)
 COMBINED CHALLAN OF A/C No. 1,2,10,21 & 22 Original / Duplicate / Triplicate / Quadruplicate
STATE BANK OF INDIA

EMPLOYEE'S PROVIDENT FUND ORGANISATION

(USE SEPARATE CHALLAN FOR EACH MONTH)
Vide your Letter no HR / GGN / Circle: 1 / HR / 10381 / CA / 8050 Dt. 19-11-2003 under section 7Q and 14B
ESTABLISHMENT CODE NO. HR / FD / 10381 ACCOUNT GROUP NO ………...…… PAID BY CHEQUE / CASH ……………..………

Employees Share D D M M Y Y
DUES FOR THE MONTH OF:
Employer Share DATE OF PAYMENT 26 11 2003

TOTAL NO. OF SUBSCRIBERS

A/c 1 A/c 10 A/c 21
TOTAL WAGES DUE

SL. PARTICULARS A/C No. 1 A/C No 2. A/C No. 10 A/C No. 21 A/C No.22 TOTAL
…………….……. AMOUNT (IN RUPEES) ………...…………

1 EMPLOYER'S SHARE OF CONT. 0

2 EMPLOYEE'S SHARE OF CONT. 0

3 ADM. CHARGES 0

4 INSP. CHARGES 0

5 PENAL DAMAGES 129 4 8 69 0 210

6 MISC. PAYMENT (PAST 0 0

ACCUMULATIONS ONLY)
TOTAL 129 4 8 69 0 210

(AMOUNT IN WORDS) Rs.

[FOR BANK'S USE ONLY]
NAME OF ESTABLISHMENT: MANOJ KUMAR AMOUNT RECEIVED Rs……...………..………..
FOR CHEQUES ONLY….………………………..
ADDRESS: DATE OF PRESENTATION………....……….…..
GURGAON, HARAYANA. DATE OF REALISATION ……………..………….
NAME OF DEPOSITOR ……………………………..…………………………………. BRANCH NAME …….……...…….…...…………..
SIGNATURE OF THE DEPOSITOR ………………...………………………………… BRANCH CODE NO………….….………………..

(TO BE FILLED IN BY EMPLOYER)

NAME OF THE BANK ------------- ### -------- CHEQUE NO -------------------------- DATE