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GOVERNMENT OF ANDHRA PRADESH
ABSTRACT
Unorganized Workers Social Security Act, 2008 (Act 33 of 2008) – Andhra
Pradesh State Unorganized Workers Social Security Rules, 2012 – Notification -
Issued.
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LABOUR EMPLOYMENT TRAINING AND FACTORIES (LAB.IV) DEPARTMENT
G.O.Ms.No. 20 Dated: 17.02.2012
Read:
1. Commissioner of Labour, Lr.No.R/2199/2002, dated 11.5.2011.
***
ORDER:
The following notification will be published in an Extraordinary Issue of
Andhra Pradesh Gazettee:
(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)
D.SREENIVASULU
SECRETARY TO GOVERNMENT
To
The Commissioner, Printing and Stationery Stores Purchases, Hyderabad for
publication of notification in the next Issue of Andhra Pradesh Gazette.
The Commissioner of Labour, Andhra Pradesh, Hyderabad.
All Collectors in the State.
All Departments of Secretariat.
All HODs in LET & F Department.
Copy to:
The P.S. to Chief Secretary.
The P.S. to Additional Secretary to CM.
The P.S. to Principal Secretary, Law Department.
The P.S. to Secretary, LET&F Department.
The P.A to Joint Secretary, LET&F Department.
The Law (B) Department.
Sf/Sc
//FORWARDED :: BY ORDER//
SECTION OFFICER2
NOTIFICATION
In exercise of the powers conferred by section 14 of the Unorganized
Workers’ Social Security Act, 2008 (Act 33 of 2008), the Governor of Andhra
Pradesh hereby makes the following rules namely:-
1. Short title and commencement - (1) These Rules may be called the
Andhra Pradesh Unorganized Workers’ Social Security Rules, 2012.
(2) They shall come into force on the date of their publication in the Official
Gazette.
2. Definition:- (1) In these rules, unless the context otherwise requires, -
(a) “Act” means the Unorganized Workers’ Social Security Act, 2008 (Act
No.33 of 2008);
(b) “Board” means the Andhra Pradesh State Social Security Board
constituted under section 6 of the Act.
(c) “Chairperson” means the Chairperson of the Board;
(d) “Government” means the State Government;
(e) “Member” means a member of the Board;
(f) “Section” means a section of the Act.
2. Words and expressions used and not defined in these rules but defined
in the Act shall have the meaning respectively assigned to them in the Act.
3. Andhra Pradesh State Social Security Board
(1) The Government by notification, constitute a Board to be known as
Andhra Pradesh State Social Security Board.
(2) The Board shall consist of the following members, namely:-
(a) Minister of Labour and Employment - Chairperson Ex-officio
(b) Principal Secretary / Secretary to Govt., - Member-Secretary Ex- Officio
LET & F Department
a nd
(c) Twenty eight members to be nominated by the Government, out of whom –
(i) Seven representing the Unorganised workers;
(ii) Seven representing employers of Unorganised workers;
(iii) Two representing Members of the Legislative Assembly;
(iv) Five representing eminent persons from Civil Society; and
(v) Seven representing State Government Departments concerned.
(3) The Chairperson and other members of the Board shall be from amongst the
persons of eminence in the fields of Labour Welfare Management, Finance, Law
and Administration:
Provided that adequate representation shall be given to persons belonging
to the Scheduled Castes, Scheduled Tribes, Minorities and Women.3
4. Term of office of members – (1) A member, other than an Ex-officio member,
shall hold office for a period not exceeding three years from the date of his
nomination.
(2) A member nominated under sub-clause (iii) of clause (c) of sub-
rule (2) of rule 3 shall cease to be a member of the Board if he ceases to be a
member of the Legislative Assembly.
(3) A member nominated under sub-clauses (i), (ii) and (iv) of clause (c) of sub-
rule (2) of rule 3 shall cease to be a Member of the Board if he ceases to represent
the category of interest from which he was so nominated.
Provided that out of seven persons nominated under sub-clause (i), of
clause (c) of sub-rule (2) of rule 3 one member each from the Scheduled Caste,
the Scheduled Tribe, the Minorities and the Women shall be represented.
(4) A Member shall be eligible for re-nomination.
5. Resignation – (1) A member of the Board, not being an ex-officio member, may
resign his office by a letter in writing addressed to the Chairperson.
(2) The seat of such a 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 at its next meeting.
6. Removal of Member – The Government may remove from office any member
of the Board, if, in its opinion, such a member has ceased to represent the interest
which he purports to represent on the Board.
Provided that no such member shall be removed unless a reasonable
opportunity is given to him of making any representation against the proposed
action.
7. Address of the Members:-
(1) Every Member shall furnish his or her Address to the Member-Secretary
of the Board who shall thereupon enter his address in the official records.
(2) If a Member changes his address, he shall furnish his new address to
the Member-Secretary of the Board who shall thereupon enter his new address in
the official records.
Provided that, if a member fails to furnish his new address, the address in
the official records shall for all purposes be deemed to be the member’s correct
address.
8. Manner of filling vacancies – When a vacancy occurs or is likely to occur on
completion of the term of the member in the membership of the Board, the
Member-Secretary shall submit a report to the State Government and on receipt of
such report, the Government may, by notification, nominate a person to fill the
vacancy:4
Provided, when a vacancy occurs or is likely to occur due to removal or
resignation of a member, the Member-Secretary shall submit a report to the
Government and on receipt of such report, the Government may, by notification,
nominate a person to fill the vacancy and the person so nominated shall hold
office for the remaining term of office of the member in whose place he is
nominated.
9. 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 provision of payment of travelling
allowance to non- official members of a Committee, as per Andhra Pradesh
Travelling Allowance Rules.
10. Disposal of business – Every matter which the Board is required to take into
consideration shall be considered at a meeting of the Board, or if the Chairperson
so directs, by sending the necessary papers to every member for opinion, and the
matter shall be disposed of in accordance with that decision of the majority.
Provided that where there is no opinion of majority on a matter and the
members of the Board are equally divided, the chairperson shall have a second or
a casting vote.
Explanation: The expression “Chairperson” for the purpose of the above proviso
shall include a member nominated or chosen under sub-rule (2) of rule 3 to
preside over a meeting.
11. Meetings:- (1) The Board shall meet at such places and at such times as may
be decided by the Chairperson and it shall meet at least once in four 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.
12. 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 expedient 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 reasons of urgency.
13. 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 of State Legislative Assembly:5
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 prescribed quorum or not, and
it shall there upon be lawful for him to dispose of the business at the adjourned
meeting irrespective of the number of members attending.
(2) The Government may prohibit any member other than ex-officio members,
from taking part in the Meeting of the Board if –
(a) he absents himself from three consecutive meetings of the Board without
written information and consent of the Chairperson:
[
or
(b) in the view of the Government, such member has ceased to represent the
interest which he purports to represent on the Board.
14. Functions of the Board
Functions of the Board shall be as follows:
(a) To recommend the Government in formulating suitable schemes for different
sections of the Unorganised Sector Workers;
(b) To advice the Government on such matters arising out of the administration of
the Act as may be referred to it;
(c) To monitor such social welfare schemes for Unorganized Workers as are
administered by the Government;
(d) To review the record keeping functions performed at the District level;
(e) To review the progress of registration and issue of cards to Unorganised
Sector Workers;
(f) To review the expenditure from the funds under various schemes; and
(g) To undertake such other functions as are assigned to it by the Government,
from time to time.
15. Creation of new posts:- (1) The Government may create new posts as it
considers necessary, from time to time, for effective monitoring of the schemes to
be implemented in the field level by the regular field officers of the departments
concerned in the Districts and Mandals, based on the proposals received from the
Member-Secretary to the Board.
(2) The posts if any created under sub-rule (1) above, shall be in the
respective departments in which such Social Security Schemes are being
implemented / introduced.
16. Minutes of the Meeting:- (a) The Secretary shall arrange for preparing the
minutes of the proceedings of each meeting of the Board showing inter alia the
names of the members present and shall forward a copy of such minutes to each
member of the Board as soon after the meeting as possible.
(b) The minutes of the proceedings of each meeting shall be confirmed with such
modification, if any, as may be decided upon at the next meeting of the Board and
signed by the Chairman at that meeting by way of authentication.6
(c) The minutes of the proceedings of each meeting of the Board authenticated by
the Chairman under clause (b) shall be kept in a separate minutes book and the
Secretary shall send a copy of such authenticated minutes of the proceedings of
each meeting to the Government for information as early as possible.
(d) The minutes book shall be kept in safe custody of the Officer authorized by the
Secretary who shall be responsible for recording the minutes of the meetings.
17. Budget of the Board:– The Secretary shall cause the budget estimates of the
fund containing estimated receipts and expenditure for every financial year to be
prepared and laid before the Board by 31st January every year and the Board will
approve the budget before the 15th March. The details of the all immovable and
movable assets of the Board including the Bank deposits, expenditure incurred on
Welfare Schemes, administration and other sub-heads against the current year’s
approved budget, and a detailed progress report on the functioning of the Board
during the current year, shall be placed before the Board as annexure to the
Budget. Thereafter, the budget copies shall be forwarded to the Central
Government and State Government.
18. Operation of the Bank Account:- (1) The Secretary of the Board shall open a
P.D. Account in a Nationalized Bank for depositing the subscriptions, etc., after
obtaining the prior permission of the Government.
(2) The Accounts shall be operated by the Secretary, who is the chief executive of
the Board.
(3) The Accounts with each of the Bank shall be reconciled once in every quarter
with the Cash Book of the Board. The consolidated debits and credits of Bank
Accounts shall tally with the Income and Expenditure of the Fund. A Bank
Reconciliation Statement shall be made as at the end of every quarter to explain in
inconsistencies between the fund Account maintained in the Board and the Bank
Accounts.
(4) The Secretary of the Board shall prepare, at the end of every quarter, an
estimated cash inflow and outflow statement for the next quarter and accordingly
invest the amounts lying to the credit of savings Bank accounts in fixed deposit for
appropriate period which yield higher rate of interest.
(5) In the contingency of non-availability of the Secretary and in case of
emergencies, for reasons to be recorded in writing and communicated to the Bank,
the accounts may be operated by another two officers of the Board or the State
Labour Department approved by the Board for this purpose on the
recommendations of the Commissioner of Labour. However, such transactions
shall be ratified by the Secretary, as soon as he is available, under intimation to
the concerned Bank.
19. Maintenance and Audit of Accounts of the Fund:- (a) The Board shall
maintain proper accounts and other relevant records and prepare annual
statement of accounts including statement of Income and Expenditure and
balance sheet, in such form as may be notified by the Government in consultation
with the Comptroller and Audit General of India.
(b) The accounts of the Board shall be balanced on the 31st March of each year.
(c) The Accounts of the fund shall be maintained by the Secretary of the Board
and shall be audited by the Comptroller and Auditor General of India.
(d) The Government may, also at any time, order special audit of the accounts of
the Board.7
(e) The expenses for the audit shall be as may be approved by the Government.
20. Annual report:- (a) The Secretary of the Board shall prepare an Annual
Report in a descriptive form explaining all the welfare and other activities of the
Board during the Financial Year and submit the same to the Central and State
Governments alongwith the Auditor’s Report and Balance Sheet, duly approved by
the Board, before the 15th July succeeding the Financial Year.
(b) The State Government shall cause the Annual Report and Auditor’s Report to
be laid, as soon as may be after they are received, before the State Legislature.
21. Appointment of Secretary, Other Officers, Clerical and other staff by the
Board and their service conditions:- (1) The Board may, create all posts and
appoint from among the existing Officers and Staff of the Labour Department of
the Government, a Secretary not below the rank of Joint Commissioner of Labour,
such number of other officers, clerical and other staff as may be necessary for
carrying out its functions under the Act, in the Head Office. The entire field work to
carry out the functions under this Act shall be done by regular staff and officers of
the Labour Department. All appointments shall be as per the allotment of officers
and Staff made by the Government in this regard. In case of clerical and other
subordinate staff, the Board may, depending on the exigencies of work, resort to
Contract appointments for a specific period in accordance with the Government
instructions in force. The Board shall obtain approval of the Government for
creation of posts, appointments and other matters incidental thereto.
(2) The salaries and other allowances of the Officers and other staff of the Board
shall be governed by the existing rules of the Government.
(3) The Board may outsource the operations such as Maintenance of Beneficiary
Accounts, Issuance of Identify Cards, receipt of contributions, registration fee,
Cess etc; and implementation of welfare measures, as a cost effective measure,
taking proper care about the safety of funds, control over implementation and such
other measures as are essential to effectively implement the provisions of the Act,
However, such proposals shall be approved by the Government, before they are
implemented.
22. Government’s Authority to investigate into the matters of the Board/
Funding:- The Government shall have power to investigate into the matters of the
functioning of the Board and its funding at any time, as it feels necessary.
(1) The Government may at any time appoint any person to investigate or enquire
into the working of the Board or any scheme and submit a report to the
Government in that behalf.
(2) The Board shall give to the person so appointed all facilities for the proper
conduct of the investigation or inquiry, and furnish to him such documents,
accounts or information in possession of the Board as he or she may require.
(3) Any person so appointed to investigate or inquire into the working of any Board
or scheme may also exercise all the powers of an Inspector appointed under this
Act.
23. (1) If the Government on consideration of the report referred to in sub-rule (a)
of Rule 19 is of the opinion, -
(a) that the Board is unable to perform its functions; or8
(b) that the Board has persistently made default in the discharge of its
functions or has exceeded or abused its powers, the Government may, by
notification, supersede the Board in question and reconstitute it in the
prescribed manner.
(2) When the Board is superseded, the following consequences shall follow:-
(a) All the members of the Board shall, from the date of publication of the
notification vacate their office.
(b) The Vehicle, furniture, stationery or other movable or immovable
property under the control or custody of the Chairman or Members
of the Board shall immediately be restored to the Secretary under proper
acknowledgement.
24. The Government may give directions to the Board as to the carrying into
execution of any provisions of the Act and Rules, schemes and notifications issued
and the Board shall be bound by such directions. The Government is competent to
call for any records, reports or other particulars pertaining to the functioning of the
Board and the Secretary shall furnish such information with reasonable diligence.
25. The Andhra Pradesh Social Security Board may formulate welfare schemes for
Un-organized workers in furtherance of the functions mentioned in Section 6 (8) of
the Act. The Board may also adopt such procedures, forms and registers etc., as
are required for carrying out the said functions. Such schemes, procedure, forms
and registers etc., shall be approved by the Government, before they are
implemented.
26. Registration of beneficiaries:- (1) The Government shall by notification,
appoint any officer of the Labour Department, as Registering Authority for the
purpose of Registration of the Unorganized Workers.
Provided that, the officers already authorized by different departments in
the State for registration of beneficiaries in the unorganized sector falling under
their departments under various welfare schemes shall continue to be the
Registering Authorities.
(2) The Registering authority shall take up registration of unorganized
workers.
(3) If the Registering Authority is satisfied that, the registration was obtained
by mis-representation, fraud or suppression of any material fact, the registering
authority may be revoke, suspend or cancel the registration.
(4) Renewal of the registration shall be done by the registration authority.
(5) Every unorganized worker who has completed fourteen years of age,
but has not completed sixty years of age, and who has been engaged in any
unorganized sector work shall be eligible for registration as a beneficiary under the
Act/Rules.
(6) An application for registration shall be made in Form-I to the Officer as
notified by the Government in this behalf.
(7) Every application under sub-rule 6 shall be accompanied by such
documents together with such fee as may be prescribed.9
(8) If the Registering Authority is satisfied that the applicant has complied
with the provisions of the Act and Rules made there under, he shall register the
name of the unorganized worker as a beneficiary under the Act/Rules.
(9) Every registration made under sub-rule 8 shall be renewed for a period
of 1 (one) year or for such number of years as may be prescribed commencing
from the date of its expiry. The renewal of registration shall be made in Form-II so
as to reach the Registering Authority not later than 30 days before the date of its
expiry. Any of renewal registration made after the date shall not be entertained.
(10) The fee for registration of worker shall be Rs.30/- and fee for renewal
shall be Rs.20/- and fee for any change of nominations and for issue of duplicate
Identity Cards shall be Rs.10/-(excluding Photo of the beneficiary).
Provided that an application for registration / renewal shall not be rejected
without giving the applicant an opportunity of being heard.
(11) Any person aggrieved by the decision under sub-rule (8) & (9) may, within 30
days from the date of such decision, prefer an appeal to the appellate authority.
Even if the appeal is barred by the limitation of the time, the appellate authority
can entertain such an appeal if he is satisfied that the unorganized worker was
prevented by sufficient cause from filing the appeal in time.
(12) The appellate authority shall cause to maintain such registers of appeals as
may be prescribed.
27. Identity Cards:-
(1) The Registering Authority shall issue Identity Cards in Form–V
to every unorganized worker/beneficiary with his/her photograph duly
affixed thereon.
(2) A beneficiary who has been issued an identity card under this rule shall
produce the same whenever demanded by any Authorized officer of the
Government.
(3) In case of loss of identity card, destroyed or defaced by the worker a
duplicate identity card will be issued in Form–VI by the issuing Officer
on an application made to him by the registered unorganized worker on
payment of such fee as may be prescribed.
28. Register of beneficiaries:- The authority of issuing Identity Cards shall cause
to maintain a register in such form as may be prescribed showing the particulars of
the beneficiaries (Form-IV).
29. Nomination:-
(1) Every unorganized worker shall at the time of making the application for
his/her registration with the Department, make a nomination, for the
purpose of delivery of benefits in case of death of the worker (Form-III).
(2) An Unorganized worker may, in his/her nomination, distribute the
amount payable under the Act amongst one or more dependents.
(3) If an unorganized worker has a family at the time of making a
nomination, the nomination shall be made in favour of one or more
members of his family, and any nomination made by such unorganized
worker in favour of a person who is not a member of his family shall be
void.10
(4) Dependents shall have the same meaning assigned to it under Section
2(1) (d) of the Workmen’s Compensation Act, 1923 (Act No. of 1923).
When there are no dependents to the unorganized worker, others may
be nominated.
(5) A nomination may be modified by an unorganized worker in Form-III at
any time after giving a written notice of his/her intention to do so to the
concerned Notified Officer of the area.
(6) If a nominee predeceases the unorganized worker, such worker shall
submit a fresh nomination in Form-III.
All the departments concerned who are implementing welfare measures to
the Unorganized Workers falling under their departments, shall suitably modify the
forms prescribed in the rules in tune with the provisions of the Act and these
Rules, to have uniformity.
30. Dual Membership & Dual Benefits:
(1) No unorganized worker shall be entitled to more than one same or
similar benefit under this Act, Rules or the Scheme or any other Act
conferring the same or similar benefit.
(2) The unorganized worker shall be entitled to continue as a beneficiary
under one Scheme only depending upon his prime occupation.
However, he may transfer his membership from one Scheme to the
other and the contribution remitted by him along with employer’s
matching contribution, if any, should also be transferred to the latter
Scheme.
31. Scheme Implementing Machinery: (1) Each department/agency
implementing a Social Security Scheme for a particular segment of Unorganised
Sector shall continue to implement such scheme for such workers.
(2) The Labour Department shall deal with the matters of registration of the
workers and implementation of the Social Security Scheme to those segments
who are not covered by any other department.
(3) The respective Administrative Department shall issue notifications for
registration of the workers and implementation of the Social Security Schemes for
effective implementation of the law as and when funds are provided by the
respective departments/agencies.
32. Appointment of Chief Inspector and Inspectors:- The Government may, by
notification, appoint a Chief Inspector and such number of Inspectors as may be
necessary for the purposes of this Act and fix the local limits of their jurisdiction.
33. Power and duties of Chief Inspectors:- The Chief Inspector may exercise
and perform in addition to the powers and duties conferred and imposed on him by
or under this Act, all the powers and duties of an Inspector under this Act. The
Chief Inspector and every Inspector shall be deemed to be public servants within
the meaning of Section 21 of the Indian Penal Code (45 of 1860).
34. Powers and duties of Inspectors: - An Inspector may within the local limits,
for which he is appointed, -
(a) Enter at all reasonable hours in any premises / place where workers in
the Organized / Unorganized Sector are engaged.11
(b) Exercise such other powers necessary for carrying out of the purposes
of the Act.
(c) Ensure inspection of the premises and record the names of unorganized
workers on the spot or otherwise evidence of such persons, as he may
deem necessary in the manner prescribed.
35. Penalty for obstructing Inspector, etc:- Any person who willfully obstructs
an Inspector in the exercise of any power conferred on him by or under this Act or
any person lawfully assisting such inspector in the exercise of such power, or who
fails to comply with any lawful direction made by such Inspector, shall be
punishable with fine as may be prescribed and/or imprisonment for a term which
may extend to three months or with both.
36. Procedure for trial of offence:- No court shall take cognizance of a
complaint against any person for an offence under rule–35 on a complaint made
by or with the previous sanction in writing of an Inspector under this Act within 6
months from the date on which the offence or contravention is alleged to have
been committed.
37. These rules shall be adopted by all the administrative departments/agencies
which are implementing the Social Security Schemes to the Unorganised Sector
Workers.
38. Powers to remove difficulties:- If any difficulty arises in giving effect to the
rules of this Act, the State Government may, by order published in the Official
Gazette, make such rules, not inconsistent with the provisions of this Act, as may
appear to it to be necessary for removing the difficulty.
D. SREENIVASULU
SECRETARY TO GOVERNMENT
//FORWARDED :: BY ORDER//
SECTION OFFICER12
FORM-I
[see rule 26 (6)]
Name of the unorganized worker: ……………………………………………...
Father’s / husband’s name: ……………………………………………….........
Occupation: ………………………………………………………………………
Address: ………………………………………………………………………......
Present:……………………………………………………………………
……………………………………………………………………..
Permanent:………………………………………………………………..
………………………………………………………………..
Dependents: ……………………………………………………………………...
(a) Father: …………………………………………………………………
(b) Mother: ………………………………………………………………..
(c) Dependent children: …………………………………………………
(d) Others: ………………………………………………………………...
Signature of the unorganized worker13
FORM - II
See Rule 26 (9)
Application for renewal of membership
1. Registration No:-------------------------------------------------
2. Name of the worker:--------------------------------------------
3. Age and Date of Birth:------------------------------------------
4. Name of Father’s / Husband’s name:-----------------------
5. Permanent address:---------------------------------------------
6. Present address:-------------------------------------------------
7. Present place of work:------------------------------------------
8. Nature of Employment: ----------------------------------------
9. Bank / Post Office Account No, ------------------------------
Name of the Bank / Post Office
Signature of the unorganized worker14
FORM – III
(See Rule 29(1)(5) and (6)
NOMINATION FORM / CHANGE OF NOMINATION
I am here by nominate person / persons / change nomination as shown
below to receive the claims or amount is due to me under the Unorganized
Workers Act, 2008 or the Andhra Pradesh Unorganized Workers Rules, 2012 or
the schemes made there under; in the event of my death any amount due to me
becomes payable to.
Name and Relationship of Age of the Share of the
address of the nominee with the nominee amount to each
Nominee (S) regd. worker nominee to be
paid
Signature or left-hand thumb – Impression
of the Unorganized Worker15
FORM – IV
(See Rule 28)
REGISTER OF BENEFICIARIES
Sl. Name of the Name and Date of Date of Registration Remarks
No. unorganized address of application Registration No. and initials
worker the estt. In of
which Registering
employed officer
(not
applicable
in case of
self-
employed
worker) of
the
unorganized
worker
1 2 3 4 5 6 716
FORM – V
(See Rule 27)
IDENTITY CARD
Registration Number :
Photo :
Application Number :
Ration Card Number or any ID proof :
1. Name of the Worker :
2. Name of the Father / Husband :
3. Age :
4. Address :
5. Nature of Employment
Home based worker / wage worker :
6. Bank / Post Office Account No. & Address :
Signature:
Name & Designation of the issuing Officer
Date:
Bar Code:17
FORM – VI
(See Rule 27(3))
APPLICATION FOR DUPLICATE IDENTITY CARD
To
The -------------------
-------------------------
-------------------------
(Notified Officer)
I was issued Identity Card under the Unorganized Workers Social Security
Act, 2008 with the Number ---------------------------- . But I have lost the same in the
following circumstances:
I, therefore request that I may be issued a Duplicate Identity Card for --------
---------------------------------- Scheme. I will surrender, if, the original is restored to
me.
Station: Signature
Date: Name of the Unorganized Worker