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Form M Rule

20(4) Register of

Name of the employer or the establishment :

Name of the employee :

Description of the department (if applicable)
: Date of entry into service :

Accumulation of leave Leave Payment for leave made on Refusal of Payment for leave on discharge of an
allowed leave employee quitting employment if admissible
Leave due No. of days Fro To Balance of 1st 2nd a D Am Dat Da Signat Signature Rem
On m leave carried Moi moiet p at ount e of te ure or or thumb arks
over ety y pl e of disc an left impression
ic of leav harg d hand of
at re e e am thumb employee
io fu refu ou impres in receipt
n s sal nt sion of of Leave
al pai emplo Book in
d yee Form N
and Date.
1 2 3 4 5 6 7 8 9
3103.15 05 XX 05
31.03.16 17 17
31.03.17 29 29