Application by employee to claim under Minimum Wages Act

In the court of Authority appointed under minimum wages 1948 for  ____________________ area.

Application No .  _____________________  of 20

1)   __________________________________

2)    ___________________________________Applicant’s.

3)    ______________________________________________

Through  __________________________an advocate  ______________________ official of __________________________ union which being a registered trade union.

Address ________________________________

Versus

1.   ____________________________________        opponents

2.    ____________________________________

The application/s named-above beg/s respectfully to submit as below:

                     i.        That _____________________________________

                    ii.        That ____________________________________

             The application’s has/have been paid less wages than the minimum  rate of wages.

             The applicant/s estimate /s the value of the relief sought by him/them at the sum of Rs _____

         The applicant/s pray/s that instruction may be issued under sub –sec(3) of s.28 for---

a.    Paying difference in wages due according to the minimum rate of wages fixed by government and wages actually paid, and

b.    Indemnification amonunting to Rs ___________________________________

The applicant/s beg/s leave to alter to or make amendments in application ,if any, and when compulsory.

Dated ___________________________

Signature or thumb impression of the employee/s or legal practitioner or officials of the registered trade union duly authorised.