Karnataka Cine And Cultural Activists (Welfare) Rules, 2025.

(cid:315)(cid:175)ೇಷ (cid:170)ಾಜ(cid:205) ಪ(cid:294)(cid:206)(cid:144)ೆ ¨sÁUÀ– 4J 24 2025 02 1947) . 627 Part – IVA BENGALURU, WEDNESDAY, 24 SEPTEMBER, 2025 AASHWAYUJA 02, SHAKAVARSHA 1947) No. 627 GOVERNMENT OF KARNATAKA NO: LD 386 LET 2023 Karnataka Government Secretariat, Vikasa Soudha, Dr. B.R. Ambedkar Veedhi Bangalore, dated:24/09/2025

NOTIFICATION The draft of the Karnataka Cine and Cultural Activists Social Security and Welfare Rules, 2025 which the Government of Karnataka proposes to make in exercise of the powers conferred by section 21 of the Karnataka Cine and Cultural Activists (Welfare) Act, 2024 (Karnataka Act 46 of 2024) is hereby published as required by sub-section (1) of the said section for the information of all the persons likely to be affected thereby and notice is hereby given that the said draft will be taken into consideration after the expiry of thirty days from the date of its publication in the Official Gazette.

Any objection or suggestion which may be received by the State Government from any person with respect to the said draft before the expiry of the period specified above will be considered by the State Government. Objections and suggestions may be addressed to the Secretary to Government, Labour Department, Vikasa Soudha, Dr B.R. Ambedkar Veedhi, Bengaluru-560001.

DRAFT RULES

1. Title, commencement and application.- (1) These rules may be called the Karnataka Cine And Cultural Activists (Welfare) Rules, 2025.

(2) They shall come into force from the date of their final publication in the Official Gazette.

(3) They shall apply to every undertaking as defined in clause (o) of section 2 of the Act.

2. Definition.- (1)In these rules, unless the context otherwise requires

(a) “Act” means the Karnataka Cine And Cultural Activists (Welfare) Act, 2024 (Karnataka Act 46 of 2024);

(1)2

(b) “Accident” means an event which is occurred suddenly without criminal intention and unforeseen act resulting in death or incapacitation leading to permanent or total or partial disablement;

(c) “Employer” means the person who employs directly or indirectly the Cine and Cultural Activist;

(d) “Chairperson” means the Chairperson of the Board;

(e) “Member” means a member of the Board; and

(f) “Section” means a section of the Act.

(2) All other words and expressions used but not defined shall have the same meaning as assigned to them in the Act.

3. Allowances of members:- (1) The travelling allowance of an official member of the Karnataka Cine And Cultural Activists’ Welfare Board shall be governed by the rules applicable to him for journey performed by him on official duties and shall be paid by the authority paying his salary.

(2) The non-official members of the Board shall be entitled to the payment of travelling and daily allowance as per the provisions of Payment of Travelling Allowance (to Non-official Members of Committees, Commissions or other Bodies) Rules, 2001, Annexure-A of Karnataka Civil Services Rules.

4. Meeting:- (1) The Board shall meet at such places and at such times as may be decided by the Chairperson but shall meet at least once in three months.

(2) Ordinarily, two weeks’ notice shall be given to the members of the

Board of a proposed meeting:

Provided that, the Chairperson, if he is satisfied that it is necessary so to do, may give notice of longer period not exceeding one month for such meeting.

(3) No business except which is included in the list of business for a meeting of the Board shall be considered at the meeting without the permission of the Chairperson.

(4) The Chairperson may at any time call a special meeting of the Board in case of urgency, after informing the members in advance about the subject-matter of discussion and the reason of urgency.

5. Quorum:- (1) No business shall be transacted at any meeting of the

Board unless fifty percent of the Board members are present in that meeting:

Provided that, if at a meeting, less than fifty percent of members are present, the Chairperson may adjourn the meeting to another date informing the members present and giving notice to the other members that he proposes to dispose off the business at the adjourned meeting whether there is quorum or not, and it shall there upon he can transact the business at the adjourned meeting irrespective of the number of members attending.3

(2) The State Government may prohibit any member, other than ex officio members, from taking part in the Meeting of the Board if,-

(a) The member absents himself from three consecutive meetings of the Board without written information and consent of the Chairperson; or

(b) The member in the opinion of the State Government has ceased to represent the interest which he purports to represent on the Board.

6. Appointment of Registering Officers:- The Government may, by

order notify in the official gazette,-

(a) such persons, being officers of the Government not below the rank of labour inspectors in the Labour Department as it thinks fit, to be the Registering Officers to register cine and cultural activists for the purposes of this Act;

(b) define the limits within which a registering officer shall exercise the powers conferred on him by the Act or under this Rules.

(c) a digital portal shall be in place to carry out the registration process along with integration of digital data from such similar portals.

7. Registration of Cine and Cultural Activists.- (1) The Cine and Cultural Activists belonging to the age group of 18 to 60 years and categories mentioned in clause(e) of section 2 of the Act shall apply in Form I to the registering officers notified under clause (a) of rule 6 of along with his Address Proof, Aadhaar linked Bank Passbook or E-shram (UAN), employee I.D Card (If available) or employment certificate in Form II issued

by the employer:

Provided that, the Cine and Cultural Activist applying shall perform Cine and Cultural activity.

(2) The Registering Authority after satisfying that the applicant has complied with the provisions of clauses (e)&(f) of section 2 of the Act and register such Cine and Cultural activists as beneficiary of the schemes of the Board and shall issue him an unique ID card and a receipt for the same.

The ID card is valid for a period of three years.

(3) The registration shall be renewed for every three years. Cine and Cultural activists shall submit updated document regarding change of details if any in Form III.

(4) The registration of the Cine and Cultural activists shall be cancelled by the Registering Authority if such authority is satisfied that the registration has been obtained by false statement or declaration or by suppression of fact by fraud, after giving an opportunity of being heard to the affected Cine and Cultural activists by the Registering Authority to put4 forth his defense in the matter, before cancellation of his registration.

(5) The Registering Authority issues to every beneficiary an unique identity card with photo of beneficiary in Form IV.

8. Collection and Assessment of cess.- (1) Two percent cess on Cinema Tickets of all theatres including Multiplex Theatres.

(2) Two percent cess on total transaction of Television entertainment channels operating in the State of Karnataka.

(3) Levying, assessment and collection of cess from establishments notified by the Government from time to time will be done in such manner or such time and such intervals as notified by the Government in the official Gazette.

(4) The cess shall be collected by the Government and transferred to the Board quarterly.

9. Grants in Aid from the Government.- Government grants to be allocated for cultural activists other than cinema and Television channels activists.

10. Appointment of Collection Officer.- The Government may, by

notification in the official gazette,-

(a) appoint such persons, being officers of the Government not below the rank of labour officers in the Labour Department as it thinks fit, to be the Collecting Officers to collect the cess for the purposes of the Act and these rules;

(b) specify the limits within which a Collection Officer shall exercise the powers conferred on him by or under the Act and these rules; ( c) a digital portal shall be in place to carry out the collection process along with integration of digital data from such similar portals.

11. Claims Authority.- The Government may, by notification in the official gazette, appoint such officers of the State Government not below the rank of Labour Officers in the Labour Department as it thinks fit, to be the Claims Authority.

12. Accident Benefit to the Registered Cine and Cultural Activists in case of Death, Disability and Medical Reimbursement.- (1) the registered Cine and Cultural activists shall be eligible for accident benefit in case of death,

disability and medical reimbursement:

Provided that, the same benefit shall also available in case of cardiac arrest death (Heart attack) occurred while on duty.

(2) Every registered Cine and Cultural activists, who meets with an accident during the course of his employment or outside the course of his/her employment, shall be eligible for all accident benefits given by the Board under

these rules:5

Provided that, a registered Cine and Cultural activists shall not be eligible for accident benefits under these rules in following circumstances,-

(a) Natural Death.

(b) Payment of compensation in respect of death or injury as a consequences

of resulting from:-

(i) committing or attempting to commit suicide, intentional self injury;

(ii) whilst under the influence of intoxicating liquor or drugs;

(iii) committing any breach of law with criminal intent;

(3) Procedure for Claims shall be as follows, namely:-

(a) Every registered Cine and Cultural activists or his first living nominee who is eligible for accident benefit under sub-rule (2) shall apply to the Claims Authority notified under rule 13 for death in Form V and for accidental permanent disability or medical reimbursement in form VI along with FIR, Post mortem report, living member certificate of deceased and death certificate (in case of death), original medical bills and discharge summary for medical reimbursement and medical certificate issued by the taluk or district medical Board showing clearly the percentage of permanent total disablement (incapacitation) or permanent partial disablement suffered by the applicant due to the accident.

(b) The Claims Authority shall examine every application for accident benefit in accordance with the provisions of the act and these rules and may accept

or reject the claim:

Provided that, the Claim Authority in this behalf shall, before rejecting a claim for accident benefit, give the applicant a reasonable opportunity of making the representation.

(c) The amount of compensation in case of death, permanent total disablement and permanent partial disablement in proportion to the percentage of disablement or hospital expenditure reimbursement shall be as specified by the Government by notification.

13. Natural Death Assistance (Inclusive of Funeral expenses).- (1) If a registered Cine and Cultural activists dies naturally, the Claims Authority shall pay such amount as notified by the Government by notification from time to time to the nominee of the deceased registered Cine and Cultural activists inclusive of funeral expenses of the deceased registered Cine and Cultural activists.

(2) The application for claiming the amount specified in sub-rule (1) shall be in Form VII and shall be accompanied by the death certificate of the deceased registered Cine and Cultural activists Living member certificate issued by revenue department, Aadhaar linked bank pass book and the original identity card issued to the deceased Cine and Cultural activists or registration number of the beneficiary for verification of validity and correctness by the Board in case of non availability of original identity card.6

14. Education Assistance to Children’s of registered Cine and Cultural Activists.- (1) The Claims Authority may, on an applications made by a registered Cine and Cultural activists in form-VIII, sanction every year for their dependent children not exceeding two children, annual educational assistance for the courses specified in the table.

Table SL.

Educational Courses No.

01 12th or equivalent 02 Bachelor Degree or equivalent 03 LLB/Para Medical/B.Pharma/Nursing and other professional courses, as specified by the State Government 04 MBBS/BE/B.Tech and Post Graduation courses

(2) The Claims Authority shall pay such amount as notified by the Government by notification.

(3) Educational Assistance shall be available for the current enrolment and only for the students enrolled in regular courses in institutions recognized by the

Government:

Provided that, Educational Assistance benefit shall not be available for Distance Education Courses, Home Study Courses, Online Courses, etc.

15. Education assistance to the children of the deceased/total permanent disabled registered Cine and Cultural Activist’s due to accident.-

(1) The Claims Authority may every year sanction annual educational assistance for dependent children, not exceeding two children of the deceased Cine and Cultural activists who succumbed to accidental death or permanent total disablement for the courses specified in the table.

Table SL.

Name of Educational Courses No.

01 1st Standard to Degree and equivalent 02 LLB/Para Medical/ B.Pharma/ Nursing and other professional courses etc., 03 MBBS/BE/B.Tech and Post Graduation courses

(2) The Claims Authority shall pay such amount as notified by the by the Government by notification from time to time.

(3) The amount under sub rule (1) shall be sanctioned only if the following conditions are fulfilled, namely:-7

(a) A minimum of one year shall have lapsed from the date of registration of the applicant to the date of his application.

(b) Only two children of a registered deceased or totally permanent disabled Cine and Cultural activists.

(4) The application for claiming the amount specified in sub-rule (1) shall be in Form – IX.

(5) Educational Assistance shall be available for the current enrolment and only for the students enrolled in regular courses in institutions recognized by the

Government:

Provided that, educational assistances shall not be available for Distance Education Courses, Home Study Courses, Online Courses, etc.

(6) Benefit provided under rule 14 shall not be applicable to these beneficiaries.

16. Maternity benefit to registered woman Cine and Cultural activists:-

(1) The Claims Authority on an application in form-X shall sanction such amount as notified by the Government by notification, only for first two deliveries, to the female registered Cine and Cultural activists on producing proof of delivery of a child.

(2) The amount shall be sanctioned, only if the following conditions are fulfilled, namely;-

(a) A minimum of one year shall have lapsed from the date of registration of the applicant as a Cine and Cultural activists with the Board, to the delivery of the child;

(b) A registered woman Cine and Cultural activists can get this assistance only twice and that second claim application shall be accompanied by an affidavit stating that the claim is for second delivery;

(c) The registered woman Cine and Cultural activists shall have no dues payable to the Board; and

(d) The registered woman Cine and Cultural activists shall not be given this assistance if she already has two living children.

17. Pension Scheme, eligibility, procedure and sanction of pension.- The conditions regarding eligibility, procedure and sanction of pension as may be specified by the State Government.

18. Time limit for submission of applications.- Time limits for submission of applications for different claims shall be as follows, namely:- Sl. Rule Benefits Time Limit No. No.

01 12 Accident Benefit to the Within One year from the Registered Cine and date of accident.

Cultural Activists in case of Death, Disability and Medical Reimbursement.8 02 13 Natural Death Assistance Within six months from the (Inclusive of Funeral date of death. expenses).

03 14 Education Assistance to Within 6 months from the Registered Cine and date of admission.

Cultural Activists Children.

04 15 Education assistance to Within 6 months from the the children of the date of admission. deceased/total permanent disabled registered Cine and Cultural Activists due to accident.

05 16 Maternity benefit to Within nine months from the registered woman date of delivery beneficiary.

06 17 Pension Scheme. As notified

19. Appeal.- (1) A registered Cine and Cultural activists aggrieved by an

order passed by the Registering Officer may appeal against such order to the Appellate Authority not below the rank of Assistant Labour Commissioners as notified by the Government within thirty days of from the date of order passed.

(2) A registered Cine and Cultural activists aggrieved by the rejection of claims by the Claims Authority or any grievance regarding claims may appeal against such order to the Appellate Authority as notified by Government within sixty days from the date of rejection of such claims.

(3) The Appellate Authority, upon inquiries, dispose the said petition by passing an order of redressed and may also issue a direction to the Registering or

Claims Authority:

Provided that, the Appellate Authority may admit the appeal after the expiry of the said period of days if it is satisfied that the appellant was prevented by sufficient cause from filing the appeal in time.

(4) The Appellate Authority shall dispose of the appeal with in the period of ninety days from the date of receiving the appeal.

20. Maintenance of Audit and Accounts.- (1) The accounts of the Board shall be prepared and maintained by the Board and shall be audited by the Auditors appointed by the Board once a year.

(2) As soon as may be after the receipt of the report of the auditor, the Board shall send a copy of the annual statement of accounts, together with the copy of the report of auditor to the State Government.

(3) The State Government may, after perusal of the report of the auditor, give such directions, as it thinks fit, to the Board and the Board shall comply with such directions.9

21. Annual Reports.- The Board shall submit to the Karnataka State Legislature as soon as may be after the 1st of April every year and not later than 31st day of December, an Annual Report in Form XI, a soft and hard copies as may be required on the working of the Board during preceding year ending on 31st march of the year along with audited copies of Accounts together with an auditor’s report.

22. Books of accounts, register and other records:- (1) The Board shall maintain cash register, assets register and all the books of accounts.

(2) The Board shall maintain required books of accounts for the purpose specified in rules 20 and 21.

(3) The Board shall maintain all the database of registration and claims in electronic format securely.

(4) The Board may maintain such records and registers as it considers necessary.

(5) The Registering Authority and Claims Authority shall maintain all the records submitted by applicant or Cine and Cultural activists and produce those records whenever required by higher authority. ****** FORM –I [See sub-rule (1) ofrule7] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Application for registration with “Karnataka Cine and Cultural Activists Welfare Board.

To, Registering Officer 01 Name as Per Aadhaar:

02 Father/Spouse Name:

03 Permanent Address: __________________Taluk_____________ District____________State___________ PIN___________ 03(A) Assembly Constituency 04 Present Address __________________Taluk_____________Distri ct____________State___________ PIN___________ 05 UAN No. (e-Shram registration No.) 05(A) Aadhaar No.

05(B) Ration Card Type and No. APL/BPL and No.

06 Gender Male/Female/Transgender10 07 Date of Birth DD/MM/YYY 08 Religion Hindu/Muslim/Christian/Other 08(A) Caste SC/ST/OBC/Gen 10 Educational Qualification Illiterate/Primary School/Secondary School/10th/12th/ITI/Diploma/Degree/P ost Graduate 11 Nature of Work As per List identified by the Board.

12 Experience in Work at the Year and Month time of registration 13 Working with The Cine Yes/No and Cultural Activist/ Organization 13(A) If Yes a) Name of the The Cine and Cultural Activist b)Address with contact No.

c)Daily Wage. d)Monthly Wage.

14 Nominee Details Sl. No:

Name:

Gender:

Relation:

Father/Mother/Spouse/Son/Daughter.

Age:

Marital Status:

15 Aadhaar Linked Bank Account No.

I hereby declare that all the above information and documents submitted are true and collect to the best of my knowledge and belief. I also realize that it is an offence to furnish false information to a public authority and that if any information is found false, I may be prosecuted for the same.

Place:

Date: Signature/LTI of Applicant

Documents to be upload:  Photo  Employee ID/Employment Certificate (If working in an organisation).11 Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for registration with “Karnataka Cine and Cultural Activists’ Welfare Board. The application and supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer Sanction/Rejection Order The Application No.………………Date……………… registration with “Karnataka Cine and Cultural Activists’ Welfare Board and documents are satisfactory. So, I registered the Cine and Cultural Activists with “Karnataka Cine and Cultural Activists’ Welfare Board.

Place :

Date : Signature of the registration authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:……………………………… Date:………………………… for registration with “Karnataka Cine and Cultural Activists’ Welfare Board.

1.

2.

3.

Place :

Date : Signature of the registration authority12 FORM –II [See sub-rule (1) of rule 7] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Employment Certificate Shri/Smt./Kum__________________________C/o___________________ residing at _________________________________________________, is working as _____________________________ in our organisation since___________ months __________years. He/She is receiving Rs._________as daily/monthly wages.

Our Organisation details are as follows:

1. Name of Organisation/The Cine and Cultural

Activist:__________________________________

2. Address of Organisation/The Cine and Cultural Activist: ________________________ _____________________________________________________________

3. Name and Phone/Mobile No of Contact person:______________________

4. Employee ID (If available) and Date of Joining our

organisation:____________________________

Place:

Date:

Signature and seal of the Cine and Cultural Activist/organisation FORM –III [See sub-rule (3)of rule7] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Application for renewal of registration with “Karnataka Cine and Cultural Activists Welfare Board.

To, Registering Officer Tick Which is to be updated in registration details 01 Registration No. and Date of registration 02 Previous registering officer details 01 Name as Per

Aadhaar:

02 Father/Spouse

Name:

03 Permanent __________________Taluk_____________District____________St

Address: ate___________ PIN___________13 03 Assembly

(A) Constituency 04 Present Address __________________Taluk_____________District____________St ate___________ PIN___________ 05 UAN No. (eShram Can not registration No.) changed 05 Aadhaar No. Can not changed

(A) 05 Ration Card APL/BPL and No.

(B) Type and No.

06 Gender Can not Male/Female/Transgender changed 07 Date of Birth Can not DD/MM/YYY changed 08 Religion Can not Hindu/Muslim/Christian/Other changed 08 Caste Can not SC/ST/OBC/Gen changed

(A) 09 Educational Illiterate/Primary School/Secondary Qualification School/10th/12th/ITI/Diploma/Degree/Post Graduate 10 Nature of Work As per List identified by the Board.

11 Experience in Year and Month Work at the time of registration 12 Working with The Yes/No Cine and Cultural Activist/Organisat ion 12 If Yes a) Name of the The Cine and Cultural Activist

(A) b)Address with contact No. c)Daily Wage. d)Monthly Wage.

13 Nominee Details Sl.No:

Name:

Gender:

Relation: Father/Mother/Spouse/Son/Daughter.

Age:

Marital Status:

14 Aadhaar Linked Bank Account No.

I hereby declare that all the above information and documents submitted are true and collect to the best of my knowledge and belief. I also realise that it is an offence to furnish false information to a public authority and that if any information is found false, I may be prosecuted for the same.

Place:

Date: Signature/LTI of Applicant

Documents to be upload:  Photo  Employee ID/Employment Certificate (If working in an organisation).14 Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for renewal of registration with “Karnataka Cine and Cultural Activists Welfare Board. The application and supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer Sanction/Rejection Order The Application No.………………Date……………… renewal of registration with “Karnataka Cine and Cultural Activists Welfare Board” and documents are satisfactory. So, I re-registered the Cine and Cultural Activists with “Karnataka Cine and Cultural Activists Welfare Board.

Place :

Date : Signature of the registration authority ………………………………………………………………………………………………………… ………………………………………………………………………………………………………F or the following reasons I have rejected the application No.:……………………………… Date:………………………… for renewal of registration with “Karnataka Cine and Cultural Activists Welfare Board.

1.

2.

3.

Place :

Date : Signature of the registration authority15 FORM –IV [See sub-rule (6) of rule7] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Identity Card Govt. of Karnataka : Department of Labour Karnataka Cine and Cultural Activists Welfare Board, Bengaluru Identity card Registration No. :

Photo with date of registration and expiry

Name :

Father/Spouse :

Name

G ender :

Date of Birth :

Occupation

Address :

Mobile No. :

Workers signature /LTI Registration authority signature Terms and Conditions Contact Details16 FORM –V [See sub-rule (3) of rule 12] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Application for Accidental Death Claim to Registered Cine and Cultural Activists

Application No:

To, Registered Claim Authority, Applicant/ Workers Nominee Photo (if Photo available) Applicant's/Nominee Personal Details:

1. Name as per Aadhar

2. Date Of Birth & Age

3. Aadhar Number

4. Relationship with Registered Cine and Cultural Activists

5. Address Permanent Present

6. Mobile Number

7. Date of accident.

8. Date of Death

Registration Details of Cine and Cultural Activists:

1. Name

2. Registration Number:

3. Father/Spouse Name

4. Date Of Birth & Age:

5. Occupation:

Bank Details of Applicant/Nominee  Bank Name  Branch Name  Aadhaar linked Account Number  IFSC Code List of Documents

Submitted:(All Attested copy’s) Yes/No17

1. Original registration Identity Card of Cine and Cultural Activists

2. Employment Certificate

3. FIR copy (Attested by respected Police Station).

4. Post Mortem report (Attested by respected Police station or Hospital)

5. Death Certificate of Cine and Cultural Activists

6. Aadhar card copy of Applicant/Nominee and deceased

7. Ration card (If available)

8. Living Member Certificate of deceased (Issued by Revenue Department)

9. Copy of Applicant/Nominee Aadhaar linked bank passbook I hereby declared that the details furnished above are true and correct to the best of my knowledge. In case any of above information is found to be false or untrue. I am aware that I may be held liable for it.

Place :

Date : Signature/Thumb impression of the Nominee Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for accidental benefit.

The application for accidental death benefit and supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer18 Sanction/Rejection Order The Application No.………………Date……………… for accidental death benefit and documents are satisfactory. So, I paid Rs. ……………………………… under accidental death benefit for the ……………….. year.

Place :

Date : Signature of the Claim authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:………………………………

Date:………………………… for accidental death benefit.

1.

2.

3.

Place :

Date : Signature of the claim authority FORM –VI [See sub-rule (3) of rule12] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Application for Accidental Permanent Disability /Medical Reimbursement to Registered Cine and Cultural Activists

Application No:

To, Registered Claim Authority, Workers Photo 1 Applicant/Registered Cine and Cultural ActivistsPersonal Details:

1. Name as per Aaadhaar

2. Registration Number:

3. Occupation:

4. Registration Number:

5. Date Of Birth & Age

6. Aadhar Number

7. Address Permanent Present

8. Mobile Number19

9. Date of accident.

10. Claim type Medical Permanent Disability

11. If disability, Disability certificate No. issued by medical board.

12. Percentage of Disability.

2 Bank Details of Applicant/Registered Cine and Cultural Activists  Bank Name  Branch Name  Aadhar linked bank account Number  IFSC Code 3 List of Documents Submitted: (All Attested copy’s) Yes/No

1. Registration Identity Card

2. Employment Certificate

3. FIR copy (Attested by respected Police Station).

4. Disability certificate issued by medical board

5. Original Bills and Cash Paid Receipts of Hospital (Original copy).

6. Discharge Summary (Original copy).

7. X-Ray Copies (Original copy).

8. Aaadhar card copy of applicant/registered Cine and Cultural Activists

9. Copy of Applicant/registered Cine and Cultural Activists Bank Passbook I hereby declared that the details furnished above are true and correct to the best of my knowledge. In case any of above information is found to be false or untrue. I am aware that I may be held liable for it.

Place :

Date :

Signature/Thumb impression of the Applicant/registered Cine and Cultural Activists20 Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for accidental permanent disability /medical reimbursement benefit. The supporting documents are subject to verification.

Place :

Date : Signature and seal of the office Sanction/Rejection Order The Application No.………………Date……………… for accidental permanent disability /medical reimbursement benefit and documents are satisfactory. So, I paid Rs.

……………………………… under accidental permanent disability /medical reimbursement benefit for the ……………….. year.

Place :

Date : Signature of the Claim authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:……………………………… Date:………………………… for accidental permanent disability /medical reimbursement benefit.

1.

2.

3.

Place :

Date : Signature of the claim authority21 FORM –VII [See sub-rule (2)of rule 13] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Application for Natural Death Claim to Registered Cine and Cultural Activists

Application No:

To, Registered claim authority. Applicant/ Workers Nominee Photo (If Photo available) 1 Applicant/Nominee Personal Details:

1. Name as per Aadhar

2. Date Of Birth & Age

3. Aadhaar Number

4. Relationship with Registered Cine and Cultural Activists

5. Address Permanent Present

6. Mobile Number 2 Registration Details of Cine and Cultural Activists:

1. Name

2. Registration Number:

3. Father/Spouse Name

4. Date Of Birth & Age:

5. Occupation:

6. Date of Death:

3 Bank Details of Nominee  Bank Name  Branch Name  Aadhaar linked bank account number  IFSC Code 4 List of Documents

Submitted: (All Attested copy’s) Yes/No

1. Original registration Identity Card of Cine and Cultural Activist

2. Death Certificate of Cine and Cultural Activist22

3. Aadhaar card copy of Applicant/Nominee and deceased

4. Employment Certificate

5. Living member certificate issued by revenue department.

6. Ration card (if available)

7. Copy of Applicant/Nominee Aadhaar linked Bank Passbook I hereby declared that the details furnished above are true and correct to the best of my knowledge. In case any of above information is found to be false or untrue. I am aware that I may be held liable for it.

Place :

Date : Signature/Thumb impression of the Nominee Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for natural death benefit. The application and supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer Sanction/Rejection Order The Application No.………………Date……………… for natural death benefit and documents are satisfactory. So, I paid Rs. ……………………………… under natural death benefit for the ……………….. year.

Place :

Date : Signature of the Claims Authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:……………………………… Date:………………………… for natural death benefit.

1.

2.

3.

Place :

Date : Signature of the Claims Authority23 FORM –VIII [See sub-rule (3) of rule 14] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Education Assistance For Registered Cine and Cultural Activists Children

Application No:

To, Claim Authority, Student Photos 1 Cine and Cultural Activists Personal Details:

1. Name as per Aadhaar

2. Registration Number:

3. Date Of Birth & Age

4. Aadhar Number

5. Occupation

6. Postal Address

7. Mobile Number 2 Education Details of Beneficiary Children:

Sl. Student Date The Aaadhaar School Name, No Name Of class Number Address & Birth being Contact studied Number 3 Bank Details of Student:  Bank Name:  Branch Name:  Account Number:  IFSC Code:

4 List of Documents Submitted:

1. Registration card

2. Current Year Study Certificate24

3. Previous Year Passed Marks Card

4. Aadhaar card copy of Applicant & Student

5. Copy of student aadhaar linked bank Passbook I hereby confirm that the information given above is correct to the best of my knowledge and belief and that not more than two children have received similar facility.

Place :

Date : Signature/Thumb impression of the Applicant Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… An application has been submitted for Educational Financial Assistance. The application and supporting documents including signatures are subject to verification.

Place :

Date : Signature and seal of the office Sanction/Rejection Order The Application No.………………Date……………… for Educational Financial Assistance and documents are satisfactory. So, I paid Rs. ……………………………… under Educational Financial Assistance Facility in the ……………….. year ……………………… to the student of ………………..

Place :

Date : Signature of the claim authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:………………………………

Date:………………………… for Educational Financial Assistance Facility.

1.

2.

3.

Place :

Date : Signature of the claim authority25 FORM –IX [See sub-rule (4) of rule15] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Education Assistance For Deceased/Permanent Disabled Registered Cine and Cultural Activists due to accident

Application No:

To, Claim Authority. Student Photo 1 Registered Cine and Cultural Activists personal Details:

1. Name as per Aadhaar

2. Registration Number:

3. Order No. benefits claimed under Rule ().

4. Date Of Birth & Age

5. Aadhaar Number

6. Relationship with Registered Cine and Cultural Activists

7. Postal Address

8. Mobile Number 2 Details of registered Cine and Cultural Activists Children’s:

Sl. Student Date The Aadhaar School Name, No Name Of class Number Address & Birth being Contact studied Number 1 2 3 Bank Details of Students  Student Name as per bank passbook.  Bank Name  Branch Name  Account Number  IFSC Code 4 List of Documents Submitted:

1. Identity Card

2. Current Year Study Certificate26

3. Previous Year Passed Marks Card

4. Order Copy of benefits claimed under Rule ()

5. Aadhaar card copy of registered Cine and Cultural Activist& Student

6. Copy of student aadhaar linked bank passbook I hereby confirm that the information given above is correct to the best of my knowledge and belief and that not more than two children have received similar facility.

Place :

Date :

Signature/Thumb impression of the Applicant/ registeredCine and Cultural Activists/student Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… An application has been submitted for educational assistance for deceased/permanent disabled registered Cine and Cultural Activistsdue to accident. The application and supporting documents including signatures are subject to verification.

Place :

Date : Signature and seal of the office Sanction/Rejection Order The Application No.………………Date……………… for educational assistance for deceased/permanent disabled registered Cine and Cultural Activists due to accident and documents are satisfactory. So, I paid Rs.……………………………… under educational assistance for deceased/permanent disabled registered Cine and Cultural Activists due to accident in the ……………….. year.

Place :

Date : Signature of the Claims Authority For the following reasons I have rejected the application No.:………………………………

Date:………………………… for educational assistance for deceased/permanent disabled registered Cine and Cultural Activistsdue to accident.

1.

2.

3.

Place :

Date : Signature of the Claims Authority27 FORM –X [See sub-rule (3) of rule 16] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Maternity Benefit for Registered Female Cine and Cultural Activist

Application No:

To, Claims Authority, Worker Photo 1 Cine and Cultural Activists Personal Details:

1. Name as per Aadhar

2. Registration Number:

3. Date Of Birth & Age

4. Aadhar Number

5. Occupation

6. Address Permanent Present

7. Mobile Number 2 Maternity Details of a Cine and Cultural Activists:

1. Date of Delivery

2. Gender of Child

3. Place of birth

4. Whether claiming for First/Second child 3 Bank Details of registered Cine and Cultural Activists:  Bank Name:  Branch Name:  Account Number:  IFSC Code:

4 List of Documents Submitted:

1. Registration Card

2. Tayi card

3. Birth Certificate of Child

4. Copy of aadhaar linked bank Passbook28

5. Affidavit stating previously not claimed for any children/claiming for second children I hereby confirm that the information given above is correct to the best of my knowledge and belief and I have not more than two children have received similar facility.

Place :

Date :

Signature/Thumb impression of the registered Cine and Cultural Activist Acknowledgment Smt./Mr.…………………………… Application No. ……………………………

Date:…………………… an application has been submitted for maternity benefit.

The application and supporting documents are subject to verification.

Place :

Date : Signature and seal of the office Sanction/Rejection Order The Application No.………………Date……………… for maternity benefit and documents are satisfactory. So, I paid Rs. ……………………………… under maternity benefit for the ……………….. year.

Place :

Date : Signature of the Claims Authority ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… ………… For the following reasons I have rejected the application No.:……………………………… Date:………………………… for maternity benefit.

1.

2.

3.

Place :

Date : Signature of the Claims AuthorityR.N.I. No. KARBIL/2001/47147 POSTAL REGN. No. RNP/KA/BGS/2202/2017-19 Licensed to post without prepayment WPP No. 297 29 FORM –XI [See rule 21] THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD Annual Report for the Year ___________.

Sl.No. Particular Information 01 Name of the Board 02 Date of Constitution 03 Name of Chairperson 04 Members of the Board 05 Regional Office (If any) 06 No. of Staff of the Board with grade wise (Including regional office) 07 No. of beneficiaries registered with the Board.

08 No. of beneficiaries registered during the Year.

09 State the number of meetings held with dates during the year and copy of proceedings to be attached.

10 Audit identifications during the year.

11 Compliance taken for previous year audit identifications 12 Internal audit report to be attached along with financial statements 13 Recommendations by Internal auditor during previous year and compliances.

14 Cash and Bank balance at the end of 31st March. (If more than one bank account, mention separately).

15 Movable and immovable property details.

16 Receipts during the year as per section 14 of the act.

17 Expenditure as per section 15 of the act. (mention Scheme wise and other expenditure details).

18 Court Case details if any.

19 Proposals sent during the year to Govt.

By order and in the name of Governor of Karnataka, Suma.S Under Secretary to Government, Labour Department. ಮುದ(cid:206)ಕರು (cid:178)ಾಗೂ ಪ(cid:206)(cid:144)ಾಶಕರು:- ಸಂಕಲ(cid:163)ಾ(cid:297)(cid:144)ಾ(cid:312)ಗಳ(cid:133), ಕ(cid:163)ಾ(cid:143)ಟಕ (cid:170)ಾಜ(cid:205)ಪತ(cid:206), ಸ(cid:144)ಾ(cid:143)(cid:312) (cid:144)ೇಂದ(cid:206) ಮುದ(cid:206)(cid:158)ಾಲಯ, (cid:166)ೆಂಗಳ(cid:136)ರು