Application by an Inspector or Person
Permitted by the Authority or Authorised to Act
[See sub-sec. (2) of ss. 15 and 16 of the Payment of Wages Act]
In the Court of the Authority appointed under the Payment of Wages Act, for ……… area.
Application No. ………… of 19…………
Between ABC (designation ………… an Inspector under the Payment of Wages Act).
permitted by the authority
(or a person –––––––––––––––––––––– to act under sub-sec. (2) of
authorized.
s. 15) ……………………………
Applicant
And XYZ, the opposite party, is the person responsible under the Act for payment of wages to the following person(s):
(1) ……………………
(2) ……………………
(3) ……………………
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*
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2. His address for the service of all notice and processes is:
3. The wage of the said person(s) due in respect of the following wage
have not been paid
period(s) –––––––––––––––––––––––––––––––––––––––––––––––––––––
have been subjected to the following illegal deductions
4. The applicant estimates the value of the relief sought for the person(s) employed at the sum of Rs. ………….
5. The applicant prays that a direction may be issued under sub-sec. (3) of s. 15 for—
(a) Payment of the 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