1FORM D
Annual Return – Bonus paid to employees for the accounting year ending on the ……….
1. Name of the establishment and its complete postal address:
2. Name of industry:
3. Name of the employer:
4. Total number of employees:
5. Number of employees benefited by bonus payments:
Total amount payable Settlement, if any, reached Percentage of bonus
as bonus under section under section 18(1) of 12(3) declared to be paid
10 or 11 of the Payment of the Industrial Disputes
of Bonus Act, 1965 Act, 1947 with date
as the case may be
1 2 3
Total amount of bonus Date on which Whether bonus Remarks
actually paid payment made has been paid to
all the employees,
if not, reasons
for non-payment
4 5 6 7
Signature of the employer of his agent
1 Ins. by S.O. 251 dated 7th January,1984,(w.e.f. 21.1.1984)