Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Rules, 2024.

(cid:315)(cid:175)ೇಷ (cid:170)ಾಜ(cid:205) ಪ(cid:294)(cid:206)(cid:144)ೆ ¨sÁUÀ– 4J 29 2024 08 1946) . 313 Part – IV A BENGALURU, SATURDAY, 29, JUNE, 2024(ASHADHA, 08, SHAKAVARSHA, 1946) No. 313 GOVERNMENT OF KARNATAKA LD 274 LET 2023 Karnataka Government Secretariat, Vikasa Soudha, Bangalore, dated:29/06/2024 NOTIFICATION Whereas the draft of the Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Rules, 2024 was published in Notification No. LD 274 LET 2023, dated: 16.03.2024 in part IVA No 8803 of the Karnataka Gazette dated: 19.03.2024, as required by sub- section (1) of section 22 of the Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Act 2024 (Karnataka Act 13 of 2024) inviting objections or suggestions from all the persons likely to be affected there by within thirty days from the date of its publication in the official Gazette. And whereas the said Gazette was made available to the public on 19.03.2024. And whereas objections and suggestions received in this behalf have been considered by the State Government. Now, therefore, in exercise of the powers conferred by section 22 of the Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Act 2024 (Karnataka Act 13 of 2024), the Government of Karnataka hereby makes the following rules, namely:- RULES 1. Title, commencement and application.- (1) These rules may be called the Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Rules, 2024. (2) They shall come into force from the date of their publication in the Official Gazette. (3) They shall apply to every undertaking as defined in clause (f) and (g) of sub-section (1) of section 2 of the Act. 2. Definition.- (1) In these rules, unless the context otherwise requires, (a) “Act” means the Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Act 2024 (Karnataka Act 13 of 2024);“Chairperson” means the chairperson of the Board; (1)2 (b) “Member” means a member of the Board; and (c) “Section” means a section of the Act. (2) All other words and expressions used but not defined in these rules but defined in the Act shall have the same meaning as assigned to them in the Act. 3. Functions of the Board.- The Board shall perform the following functions, namely:- (1) ensure registration of motor transport and other allied workers; (2) make recommendations to the State Government for formulation, review and implementation of the schemes; (3) provide immediate assistance to a beneficiary in case of accident; (4) make payment towards funeral expenses due to natural death of the beneficiary; (5) give financial assistance for the education of children of the beneficiaries; (6) make payment of maternity benefit to the female beneficiary; (7) make payment of pension to the beneficiary who has completed the age of sixty years; (8) make provision for improvement of other welfare measures and facilities; and (9) send short message service (sms) to every beneficiary/applicant regarding status of his application. 4. Term of office of Members.- (1) A member, other than an Ex-Officio member, shall subject to the pleasure of the Government , hold office for a period not exceeding three years from the date of his nomination or till the reconstitution of the Board whichever is earlier. (2) A member nominated under sub clause (d) of sub-section (2) of section 3 shall cease to be a member of the Board if he ceases to represent the category, from which he was so nominated. (3) A member shall be eligible for re-nomination only on rotation basis. 5. Resignation.- (1) A member of the Board, not being a ex-officio member, may resign his office by a letter in writing addressed to the Chairperson. (2) The seat of such as member shall fall vacant from the date on which his resignation is accepted or on the expiry of thirty days from the date of receipt of intimation of resignation, whichever is earlier. (3) The power to accept the resignation of a member shall vest in the Chairperson who, on accepting the resignation, shall report to the Board in the next meeting. 6. Change of Address.- If a member changes his address, he shall notify his new address to the Member Secretary of the Board who shall there upon enter his new address in the official records: Provided that if a member fails to notify his new address, the address in the official records shall for all purpose be deemed to be the member’s correct address. 7. Manner of filling vacancies.- When a vacancy occurs or is likely to occur in the Membership of the Board, the Member-Secretary shall report to the State Government and on receipt of such report, the State Government may, by notification, nominate a person to fill the vacancy and the person so nominated shall hold office for the remainder of the term of office of the member in whose place he is nominated. 8. Allowances of members.- (1) The travelling allowance of an official member of the 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.3 9. Disposal of business.- Every matter which the Board is required to take in to consideration shall be considered at a meeting of the Board, or if the Chairperson so directs, by circulation of resolution among the members and shall be passed by a simple majority of votes, where there is no consensus on a matter and the members of the Board are equally divided, the Chairperson shall have the deciding vote. Explanation.—The expression “Chairperson” for the purpose of the above provision shall include a member nominated or chosen under sub-rule (2) of rule 10 to preside over a meeting. 10. 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) The Chairperson shall preside over every meeting of the Board in which he is present and in his absence he may nominate a member of the Board to preside over such meeting in his place and in the absence of such nomination by the Chairperson, the members of the Board present in such meeting may choose one member from amongst themselves to preside over the meeting. 11. Notice of meetings and list of business.- (1) 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. (2) 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. (3) 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. 12. Quorum.- (1) No business shall be transacted at any meeting of the Board unless at least six members are present in that meeting, which shall include at least one member each from sub-clause (i) and (ii) of clause (d) of sub-section (2) of section 3. Provided that if at a meeting, less than six 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. (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. 13. Collection and Assesment of cess under certain circumstances.- Levying, assessment and collection of cess from establishments which are carrying the business of transport of persons or goods will be done in such manner or such time and intervals through notification in the official Gazette. 14. Registration of motor transport and other allied workers.- (1) The workers belonging to the age group of 18 to 60 years and categories mentioned in clause (f) of section 2 of the Act shall4 apply in Form I to the registering officers notified under clause (a) of section 10 of the Act, along with his Address Proof, Aadhaar linked Bank Passbook, Driving License for drivers, Conductor license for conductors, employee I.D Card (If available) or employment certificate in Form II issued by the employer or if he is running own work/business submit any registration certificate issued by the local authority to run business under e-Shram (UAN) portal along with proof of Birth. (2) The worker applying under sub-rule (1) shall comply with the provisions of clause (f) of sub-section (1) of section 2. (3) The registering authority shall satisfy that the applicant has complied with the provisions of clause (f) of sub-section (1) of section 2 and he shall collect registration fee of Rs.50/- from the worker and register such worker as beneficiary of the schemes of the Board and shall issue him an ID card and a receipt for the same. (4) The registration shall be renewed for every three years with the renewal fee of Rs.50/-. Worker shall submit updated documents regarding change of details if any in Form III. (5) The registration of the worker shall be cancelled by the Registering Authority if such authority is satisfied that the registration has been obtained by false statement/declaration or by suppression of fact, after giving an opportunity of being heard to the affected worker by the registering authority to put forth his defense in the matter, before cancellation of his registration. (6) The Registering Authority issue to every beneficiary an identity card with photo of beneficiary in Form IV. 15. Accident Benefit to the Registered Workers in case of Death, Disability and Medical Reimbursement.- (1) Accident means an event which is sudden without criminal intent and unforeseen resulting in death or incapacitation permanent, total or partial disablement; Provided that same benefit is also available in case of cardiac arrest death (Heart attack) occurred while on duty. (2) "Eligibility" Every registered worker, who meets with an accident during the course of his employment or outside the course of his/her employment, assistance under this rule shall be given by the Board excluding the following cases. (a) Natural Death. (b) Payment of compensation in respect of death or injury as a consequences of resulting from:- i. committing or attempting suicide, intentional self injury; ii. whilst under the influence of intoxicating liquor or drugs; iii. committing any breach of law with criminal intent; 16. Manner of Claims.- (1) Every registered worker or his first living nominee who is eligible for accident benefit under sub-rule (2) of rule 14 shall apply to the Claims Authority notified under section 13 in Form V for death and Form V(1) for medical and disability 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/district medical board showing clearly the percentage of permanent total disablement (incapacitation) or permanent partial disablement suffered by the applicant due to the accident occurred to. (2) The Claims Authority shall examine every application for accident benefit in accordance with the provision 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. (3) The Claims Authority may grant benefit through Direct Benefit Transfer (DBT), a sum of Rs.5.00 lakh (Rupees Five Lakh only) for first living nominee in case of death, Rs.2 lakh (Rupees Two Lakh only) for permanent total disablement and Rs.1 lakh (Rupees One Lakh only) in case of5 permanent partial disablement in proportion to the percentage of disablement or hospital expenditure reimbursement. 17. Natural Death Assistance (Inclusive of Funeral expenses.- (1) If a registered worker dies, the Claims Authority shall pay a sum of Rs. 25,000/- (Rupees Twenty Five Thousand only) to the nominee of the deceased registered worker inclusive of funeral expenses of the deceased registered worker. (2) The application for claiming the amount specified in sub-rule (1) shall be in Form VI and shall be accompanied by the death certificate of the deceased registered worker, Living member certificate issued by revenue department, Aadhaar linked bank pass book and the original identity card issued to the deceased worker or registration number of the beneficiary for verification of validity and correctness by the Board in case of non availability of original identity card. 18. Education Assistance to registered worker’s children.- (1) The Claims Authority may, on an application from a registered worker, sanction every year for their dependent children not exceeding two children, annual educational assistance, as under,- Table Annual Educational SL. Educational Courses Assistance No. (in Rupees) 01 12th or equivalent 3000/- 02 Bachelor Degree or equivalent 5500/- 03 LLB/Para Medical/B.Pharma/Nursing and other 8000/- professional courses, as specified by the State Government 04 MBBS/BE/B.Tech and Post Graduation courses 11000/- (2) The application for claiming the amount specified in sub-rule (1) shall be in Form - VII. (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. Distance Education Courses, Home Study Courses, Online Courses, etc. are not eligible to avail this benefit. 19. Education assistance to the children of the deceased/total permanent disabled registered workers due to accident.- (1) The Claims Authority may sanction every year for dependent children not exceeding two children of deceased worker who succumbed to accidental death or permanent total disablement, annual educational assistance, as under,- Table SL. Annual Educational Name of Educational Courses No. Assistance 01 1st Standard to Degree and equivalent Rs.10,000/- 02 LLB/Para Medical/ B.Pharma/ Nursing and Rs.20,000/- other professional courses etc 03 MBBS/BE/B.Tech and Post Graduation Rs.25,000/- courses (2) The amount under sub rule (1) 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 to the date of his application: (b) Only two children of a registered deceased/totally permanent disabled worker shall be given this assistance; and6 (3) The application for claiming the amount specified in sub-rule (1) shall be in Form – VIII. (4) Educational Assistance shall be available for the current enrolment and only for the students enrolled in regular courses in institutions recognized by the Government. Distance Education Courses, Home Study Courses, Online Courses, etc. are not eligible to avail this benefit. (5) Benefit provided under rule 16 shall not be applicable to these beneficiaries. 20. Maternity benefit to registered women beneficiary.- (1) The Claims Authority, shall on an application, sanction a sum of Rs. 10,000 (rupees five thousand only), only for first two deliveries, to the female registered beneficiary 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 worker with the Board, to the delivery of the child; (b) A registered worker 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 worker shall have no dues payable to the Board; and (d) The registered woman worker shall not be given this assistance if she already has two living children. (3) The application for claiming the amount specified in sub-Rule (1), shall be in Form – IX. 21. Pension Scheme, eligibility, procedure and sanction of pension.- The conditions regarding eligibility, procedure and sanction of pension shall be notified by the State Government. 22. Appeal.- (1) A registered worker aggrieved by an order passed by the registering officer may appeal against such order to the Appellate Authority as notified by the Government within thirty days of from the date of order passed. (2) A registered worker 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 / 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. 23. Time limit for submission of applications.-Time limits for submission of applications for different claims shall be as follows:- Sl. Rule No. Benefits Time Limit No. 01 15 Accident Benefit to the Registered Within One year from the Workers in case of Death, Disability date of accident. and Medical Reimbursement. 02 17 Natural Death Assistance (Inclusive of Within six months from the Funeral expenses). date of death 03 18 Education Assistance to Registered As Notified by the Board Workers Children.7 04 19 Education assistance to the children of As Notified by the Board the deceased/total permanent disabled registered workers due to accident. 05 20 Maternity benefit to registered women Within nine months from the beneficiary. date of delivery 06 21 Pension Scheme. As notified 24. 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. 25. 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 X, 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. 26. 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 22 and 23. (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 consider necessary. (5) The Registering Authority and Claims Authority shall maintain all the records submitted by applicant/beneficiary and produce those records whenever required by higher authority. FORM – I [See sub-rule (1) of rule 14] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Application for registration with “Karnataka Motor Transport and Other Allied Workers Social Security and 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_____________District ____________State___________ PIN___________ 05 UAN No. (eShram registration No.) 05(A) Aadhaar No. 05(B) Ration Card Type and No. APL/BPL and No. 06 Gender Male/Female/Transgender8 07 Date of Birth DD/MM/YYY 08 Religion Hindu/Muslim/Christian/Other 08(A) Caste SC/ST/OBC/Gen 10 Educational Qualification Illiterate / PrimarySchool / Secondary School / 10th / 12th / ITI / Diploma / Degree / Post Graduate 11 Nature of Work As per List identified by the Board. 12 Experience in Work at the time Year and Month of registration 13 Work Specified registration No. (i.e., If driver DL No., If conductor License No. etc.) 14 Working with Yes/No Employer/Organisation 14(A) If Yes a) Name of the Employer b)Address with contact No. c)Daily Wage. d)Monthly Wage. 15 Nominee Details Sl.No: Name: Gender: Relation: Father/Mother/Spouse/Son/Daughter. Age: Marital Status: 16 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). Acknowledgment Smt./Mr.…………………………… Application No. …………………………… Date:…………………… an application has been submitted for registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. The application and supporting documents are subject to verification. Place : Date : Signature and seal of the officer9 Sanction/Rejection Order Application No.………………Date……………… registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board and documents are satisfactory. So, I registered the worker with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. Place : Date : Signature of the registration authority ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………… For the following reasons I have rejected the application No.:……………………………… Date:………………………… for registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. 1. 2. 3. Place : Date : Signature of the registration authority FORM –II [See sub-rule (1) of rule 14] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND 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/Employer:__________________________________ 2. Address of Organisation/Employer: ________________________ _____________________________________________________________ 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 employer/organisation10 FORM –III [See sub-rule (4) of rule 14] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Application for renewal of registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. To, Registering Officer Tick Which is to be updated in registration details Registration No. and Date of registration Previous registering officer details Name as Per Aadhaar: Father/Spouse Name: Permanent __________________Taluk_____________District________ Address: ____State___________ PIN___________ 03(A Assembly Constituency Present Address __________________Taluk_____________District________ ____State___________ PIN___________ UAN No. Can not (eShram change registration No.) d 05(A Aadhaar No. Can not change d 05(B) Ration Card APL/BPL and No. Type and No. Gender Can not Male/Female/Transgender change d Date of Birth Can not DD/MM/YYY change d Religion Can not Hindu/Muslim/Christian/Other change d 08(A Caste Can not SC/ST/OBC/Gen change d Educational Illiterate / Primary School / Secondary School / 10th / 12th / ITI Qualification / Diploma / Degree / Post Graduate Nature of Work As per List identified by the Board. Experience in Year and Month Work at the time of registration11 Work Specified Can not registration No. change (i.e., If driver d unless DL No., If occupat conductor ion License No. change etc.) d Working with Yes/No Employer/Organ isation 14(A If Yes a) Name of the Employer b)Address with contact No. c)Daily Wage. d)Monthly Wage. Nominee Details Sl.No: Name: Gender: Relation: Father/Mother/Spouse/Son/Daughter. Age: Marital Status: 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). Acknowledgment Smt./Mr.…………………………… Application No. …………………………… Date:…………………… an application has been submitted for renewal of registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. The application and supporting documents are subject to verification. Place : Date : Signature and seal of the officer12 Sanction/Rejection Order The Application No.………………Date……………… renewal of registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board and documents are satisfactory. So, I registered the worker with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. Place : Date : Signature of the registration authority ……………………………………………………………………………………………………………… …………………………………………………………………………………………………For the following reasons I have rejected the application No.:……………………………… Date:………………………… for renewal of registration with “Karnataka Motor Transport and Other Allied Workers Social Security and Welfare Board. 1. 2. 3. Place : Date : Signature of the registration authority13 FORM –IV [See sub-rule (6) of rule 14] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Identity Card Govt. of Karnataka : Department of Labour Karnataka Motor and Other Allied Workers Social Security and Welfare Board, Bengaluru Id entity card Photo Registration No. : with date of registration and expiry Name : Father/Spouse : Name Gender : Date of Birth : Occupation Address : Mobile No. : Workers signature /LTI Registration authority Terms and Conditions Contact Details14 FORM –V [See sub-rule (1) of rule 16] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Application for Accidental Death Claim to Registered Workers Application No: To, Registered Claim Authority, Applicant/ Workers Nominee Photo (if Photo available) Applicant's/Nominee Personal Details: Name as per Aadhar Date Of Birth & Age Aadhar Number Relationship with Registered Worker Address Permanent Present Mobile Number Date of accident. Date of Death Registration Details of Transport Workers: Transport Worker Name Registration Number: Driving/Conductor License Number (In Case Drivers/Conductor) Father/Spouse Name Date Of Birth & Age: 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/No Original registration Identity Card of worker Valid Driving/Conductor license Copy (In case of Drivers/Conductor)15 FIR copy (Attested by respected Police Station). Post Mortem report (Attested by respected Police station or Hospital) Death Certificate of worker Aadhar card copy of Applicant/Nominee and deceased Ration card (If available) Living Member Certificate of deceased (Issued by Revenue Department) 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 officer Sanction/Rejection Order 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 authority16 FORM –V(1) [See sub-rule (1) of rule 16] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Application for Accidental Permanent Disability /Medical Reimbursement to Registered Workers Application No: To, Claim Authority, Registered . Workers Photo Applicant/Registered worker Personal Details: 9. Name as per Aaadhaar 10. Registration Number: 11. Occupation: 12. Driving License Number (In Case Drivers/Conductor) 13. Date Of Birth & Age 14. Aadhar Number 15. Address Permanent Present 16. Mobile Number 17. Date of accident. 18. Claim type Medical Permanent Disability 19. If disability, Disability certificate No. issued by medical board. 20. Percentage of Disability. Bank Details of Applicant/Registered worker  Bank Name  Branch Name  Aadhar linked ban account Number  IFSC Code List of Documents Submitted: (All Attested copy’s) Yes/No 1. Registration Identity Card 2. Valid Driving/Conductor license Copy (In case of Drivers/Conductor) 3. FIR copy (Attested by respected Police Station). 4. Disability certificate issued by medical board17 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 worker 9. Copy of Applicant/registered workers 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 worker Acknowledgment Smt./Mr.…………………………… Application No. …………………………… Date:…………………… an application has been submitted for accidental permanent disability /medical reimbursement benefit. The and 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 authority18 FORM –VI [See sub-rule (2) of rule 17] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Application for Natural Death Claim to Registered Workers Application No: To, Registered claim authority. Workers Applicant/ Photo (If Nominee available) Photo Applicant/Nominee Personal Details: 21. Name as per Aadhar 22. Date Of Birth & Age 23. Aadhaar Number 24. Relationship with Registered Worker 25. Address Permanent Present 26. Mobile Number Registration Details of Transport Workers: 7. Transport Worker Name 8. Registration Number: 9. Driving /Conductor License Number (In Case Drivers/Conductor) 10. Father/Spouse Name 11. Date Of Birth & Age: 12. Occupation: 13. Date of Death: Bank Details of Nominee  Bank Name  Branch Name  Aadhaar linked bank account number  IFSC Code List of Documents Submitted: (All Attested copy’s) Yes/No 10. Original registration Identity Card of worker19 11. Death Certificate of worker 12. Aadhaar card copy of Applicant/Nominee and deceased 13. Valid Driving/Conductor license Copy (In case of Drivers/Conductor) 14. Living member certificate issued by revenue department. 15. Ration card (if available) 16. 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 Authority20 FORM –VII [See sub-rule (2) of rule 18] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Education Assistance For Registered Transport Workers Children Application No: To, Claim Authority, Student Photos Transport Worker's 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 Education Details of Beneficiary Children: Sl. Student Name Date The Aaadhaar School Name, Address No Of class Number & Contact Number Birth being studied Bank Details of Student  Bank Name:  Branch Name:  Account Number:  IFSC Code: List of Documents Submitted: 1. Registration card 2. Current Year Study Certificate 3. Previous Year Passed Marks Card21 4. Aadhaar card copy of Applicant & Student 5. Copy of student aadhaar linker 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 authority22 FORM –VIII [See sub-rule (3) of rule 19] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Education Assistance For Deceased/Permanent Disabled Registered Workers due to accident Application No: To, Claim Authority. Student Photo Registered worker personal Details: 27. Name as per Aadhaar 28. Registration Number: 29. Order No. benefits claimed under Rule (). 30. Date Of Birth & Age 31. Aadhaar Number 32. Relationship with Registered Worker 33. Postal Address 34. Mobile Number Details of registered worker Children’s: Sl. Student Name Date The Aadhaar School Name, Address No Of class Number & Contact Number Birth being studied 1 2 Bank Details of Students  Student Name as per bank passbook.  Bank Name  Branch Name  Account Number  IFSC Code List of Documents Submitted:23 17. Identity Card 18. Current Year Study Certificate 19. Previous Year Passed Marks Card 20. Order Copy of benefits claimed under Rule () 21. Aadhaar card copy of registered worker & Student 22. 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/ registered worker/student Acknowledgment Smt./Mr.…………………………… Application No. …………………………… Date:…………………… An application has been submitted for educational assistance for deceased/permanent disabled registered workers due 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 workers due to accident and documents are satisfactory. So, I paid Rs. ……………………………… under educational assistance for deceased/permanent disabled registered workers 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 workers due to accident. 1. 2. 3. Place : Date : Signature of the Claims Authority24 FORM –IX [See sub-rule (3) of rule 20] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Maternity Benefit for Registered Female Transport Worker Application No: To, Claims Authority, Worker Photo Transport Worker's Personal Details: 8. Name as per Aadhar 9. Registration Number: 10. Date Of Birth & Age 11. Aadhar Number 12. Occupation 13. Address Permanent Present 14. Mobile Number Maternity Details of Transport Workers: 1. Date of Delivery 2. Gender of Child 3. Place of birth 4. Whether claiming for First/Second child Bank Details of registered worker  Bank Name:  Branch Name:  Account Number:  IFSC Code: List of Documents Submitted: 6. Registration Card 7. Tayi card 8. Birth Certificate of Chaild 9. Copy of aadhaar linked bank Passbook25 10. 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 worker 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 26 FORM –X [See rule 25] THE KARNATAKA MOTOR TRANSPORT AND OTHER ALLIED WORKERS SOCIAL SECURITY AND WELFARE BOARD Annual Report for the Year ___________. Sl.No. Particular Information Name of the Board Date of Constitution Name of Chairperson Members of the Board Regional Office (If any) No. of Staff of the Board with grade wise (Including regional office) No. of beneficiaries registered with the Board. No. of beneficiaries registered during the Year. State the number of meetings held with dates during the year and copy of proceedings to be attached. Audit identifications during the year. Compliance taken for previous year audit identifications Internal audit report to be attached along with financial statements Recommendations by Internal auditor during previous year and compliances. Cash and Bank balance at the end of 31st March. (If more than one bank account, mention separately). Movable and immovable property details. Receipts during the year as per section 14 of the act. Expenditure as per section 15 of the act. (mention Scheme wise and other expenditure details). Court Case details if any. Proposals sent during the year to Govt. By Order and in the name of the 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