📍 When to use this template
- To record monthly or fortnightly wage payments for every single worker on the project.
- Must be updated for every wage cycle, typically by the 7th of the month for the previous month's wages.
- Filled by the Contractor's site accountant or HR representative, then verified and countersigned by the Principal Employer's (PMC/Client) representative.
Sections & fields
Preview of the template structure. Download Excel to fill on site.
1Header / Project Information6 fields
Project Name
_____________
Contractor Name & Address
_____________
Principal Employer Name & Address
_____________
Location of Work
_____________
Wage Period (e.g., Month & Year)
_____________
Date of Payment
_____________
2Worker Details & Attendance7 fields
Name of Workman
_____________
Father's/Husband's Name
_____________
Designation / Nature of Work
_____________
Serial No. in Register of Workmen (Form XIII)
_____________
No. of Days Worked
_____________
Units of Work Done (for piece-rated workers)
_____________
3Rate of Wages & Overtime4 fields
Rate of Daily/Monthly Wages
_____________
Rate of Piece-work Wages
_____________
Overtime Hours Worked
_____________
Rate of Overtime Wages
_____________
4Gross Wages Earned5 fields
Dearness Allowance (DA)
_____________
Overtime Wages
_____________
Other Cash Payments (specify nature, e.g., HRA, Conveyance)
_____________
Total Gross Wages Payable
_____________
5Deductions from Wages7 fields
Provident Fund (PF) Contribution
_____________
ESI Contribution
_____________
Deductions for Advances
_____________
Deductions for Fines
_____________
Deductions for Damage/Loss
_____________
Other Authorised Deductions (specify)
_____________
Total Deductions
_____________
6Net Payment & Acknowledgement4 fields
Net Amount Paid
_____________
Signature or Thumb Impression of Workman
_____________
Date of Payment to Workman
_____________
7Contractor's Certification4 fields
Name of Contractor/Authorised Representative
_____________
Signature of Contractor/Representative
_____________
Seal of the Contractor
_____________
💡 Sample filled excerpt
S.No: 25 | Name: Suresh Yadav | Designation: Shuttering Carpenter | Days Worked: 26 | Rate of Daily Wages: ₹850 | Gross Wages: ₹22,100 | PF: ₹1020 | ESI: ₹165.75 | Total Deductions: ₹1185.75 | Net Amount Paid: ₹20,914.25 | Signature: [Thumb Impression]
⚖ Compliance notes
- Mandatory under Rule 78(1)(a)(i) of the Contract Labour (Regulation and Abolition) Central Rules, 1971, which specifies maintaining a Register of Wages in Form XVII.
- Primary evidence for compliance with the Payment of Wages Act, 1936 and the Minimum Wages Act, 1948.
- Checked during statutory inspections by Labour Inspectors, PF/ESI officials, and used for BOCW cess calculations.
- Forms the basis for preparing the mandatory monthly Wage Slip (Form XIX) for each worker.