OSH Code · Form XV (Form 15)
Form XV — Register for Wages, Overtime and Deductions
Form XV of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 72(1)(iii).
Rule: Rule 72(1)(iii) · Signed by: Manager
Register columns
- Name of Establishment
- Name of the Employer/owner
- PAN/TAN of the Employer
- Registration Number of the establishment (LIN)
- Wage Period from dd/mm/yyyy to dd/mm/yyyy (Monthly/Fortnightly/Weekly/Daily/Piece Rated)
- Serial Number
- Employee Code Number
- Name of the employee
- Designation
- Department
- Duration of Payment of wages (Monthly/Fortnightly/Weekly/Piece rated)
- Wage Period from- to
- Total number of days worked during the wage period
- Total overtime hours worked or overtime production in case of piece workers
- Rate of Wage - a) Basic
- Rate of Wage - b) DA
- Rate of Wage - c) Other allowance
- Amount of wages earned - Basic
- DA
- Allowances
- Overtime
- Total wages earned
- EPF
- ESIC
- Society
- Income Tax
- Insurance
- Advances
- Recovery of Fine
- Recovery on amount of damages/losses
- Total deductions
- Others
- Net Payment
- Date of Payment
- Receipt by employee/Bank Transaction ID
- Nature of acts and omissions for which fine imposed with date
- Amount of fine imposed
- Damage or loss caused to the employer by neglect or default of the employee
- Signature of Employer/Employer Representative
OSH Code Form XV is the 15th form of the Seventh Schedule, so it is also written OSH Code Form 15. Both refer to this same form: Register for Wages, Overtime and Deductions.
Part of the Seventh Schedule to the OSH & Working Conditions (Central) Rules 2026. View the official form layout in the gazette, or open Form XV in MedFactory.
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