Individual Application Deed Format

Individual Application

Individual Application Deed Format

[See sub-sec. (2) of s. 15 of the Payment of Wages Act]

In the Court of the Authority appointed under the Payment of Wages Act (IV of 1936) for ………… area.

Application No. ………… of ………… 19………

Between ABC …………

(through a legal practitioner)                                                    Applicant

an official of ………… which is a

registered trade union And XYZ ………                            Opposite Party

1. ABC  is a person employed in/or the …………………………

Factory

……………………………………

Railway                                                                         entitled ………… and

……………………………………

industrial establishment

resides at …………….

The address of the applicant for the service of all notices and processes is:

2. XYZ, the opposite party, is the person responsible for the payment of his wages under s. 3 of the Act and his address for the service of all notices and processes is:

3. (1) The applicant’s wages have not been paid for the following wage period(s) (give date). Or

A sum of Rs. ……………… has been unlawfully deducted from his wages of (amount) for the wage period(s) which ended on [give date(s)].

(2) Here give any further claim or explanation.

4. The applicant estimates the value of the  relief sought by him at the sum of Rupees ………….

5. The applicant prays that a direction may be issued under sub-sec. (3) of s. 15 for—

(a)        Payment of his delayed wages as estimated or such greater or lesser amount as the authority may find to be due. Or

                                    Refund of the amount illegally deducted.

(b)        Compensation amounting to …………

The applicant certifies that the statement of facts contained in this application is to the best of his knowledge and belief accurate.

Signature or thumb impression of the employed person, or legal practitioner or official of a registered trade union duly authorized.

Individual Application Deed Format

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