15 Cooking Food Workers Schemes 2015 0

TAMIL NADU COOKING FOOD WORKERS SOCIAL SECURITY
AND WELFARE SCHEME 2015
In exercise of the powers conferred by Section 4 read with Section 3 of the Tamil
Nadu Manual Workers (Regulation of Employment and Conditions of Work) Act, 1982
the Governor of Tamil Nadu, hereby makes the following scheme for the employment in
Cooking Food, specified in item 19 in the schedule to the said Act:-
THE SCHEME
1. Short title, extent application and commencement:- (1) This Scheme may be
called the Tamil Nadu Cooking Food Workers’ Social Security and Welfare
Scheme 2015
(2) It extends to the whole of the State of Tamil Nadu.
(3) It shall apply to all manual workers engaged in cooking food, cutting
vegetables, serving food, cleaning utensils and also includes assistant cooks, helpers,
cleaners and the workers engaged in all other allied activities of cooking food.
(4) It shall come into force on 7th July 2015.
2. Definitions.- In this Scheme, unless the context otherwise requires:-
(a) ―Act‖ means the Tamil Nadu Manual Workers (Regulation of

Employment and Conditions of Work) Act, 1982 (Tamil Nadu Act 33
of 1982);
(b) ―Board‖ means the ―Tamil Nadu Cooking Food Workers’ Welfare
Board‖, established under section 6 of the Act;
(c) ―dependant‖ in relation to a registered manual worker means any of
the relatives of such deceased workman as specified below:-
(i) wife or husband, as the case may be;
(ii) children;
(iii) widow and children of the pre-deceased son; and
(iv) Parents.
(d) ―family‖ means-
(i) in the case of a male member, his wife, children whether married or
unmarried, dependent parents and the widow and children of a
deceased son of the member; and
(ii) in the case of a female member, her husband, children, dependant
parents and the widow and children of a deceased son of the
member;
(e)―Form‖ means the form appended to this Scheme.
(f)―Fund‖ means the Tamil Nadu Cooking Food Workers’ Social Security
and Welfare Fund established under the Scheme;
(g) ―manual worker‖ means any person who has completed 18 years of age but
has not completed 60 years of age and who is engaged to do any manual work in the
employment of cooking food, cutting vegetables, serving food, cleaning utensils and
also includes assistant cooks, helpers, cleaners and the workers engaged in all other
allied activities of cooking food specified in item 19 in the Schedule to the Act;
(h) ―Scheme‖ means the Tamil Nadu Cooking Food Workers’ Social Security and
Welfare Scheme, 2015;
(i) ―self employed person‖ means any person who has directly engaged himself in
laundries and washing clothes .
(j) ―self employed person‖ means any person who has directly engaged himself in
the employment of cooking food, cutting vegetables, serving food, cleaning utensils
and also includes assistant cooks, helpers, cleaners and the workers engaged in all
other allied activities of cooking food specified in item 19 in the Schedule to the
Act;
(k) words and expressions used in this scheme and not defined, shall have the
respective meaning assigned to them in the Act.
3. Powers, duties and functions of the Board:- (1) Subject to the other provisions of the
Act, the Board may take such measures, as it may consider necessary for implementing
the Scheme.
(2) The Board shall—
(a) maintain and administer the ―Tamil Nadu Cooking Food Workers‖ Social
Security and Welfare Fund‖ and collect the contributions towards that Fund;
(b) subject to the provisions of the Scheme, any property vested with
the Board shall be held and utilized by it only for the purpose of the
Scheme;
(c) have the authority to spend such sum, as it thinks fit for the
purposes of the Scheme from out of the Fund;
(d) keep proper accounts for all receipts and expenses under the
Scheme;
(e) submit annual budget to the Government for sanction;
(f) submit annual report to the Government on the working of the
Scheme as laid down under sub-section (5) of section 8 of the Act;
(g) submit to the Government copies of all proceedings of the meetings
of the Board;
(h) make all arrangements necessary for the annual audit of accounts
of the Board in accordance with the instructions issued by the Government;
(i) furnish information to the Government on such matters as the
Government may refer to it from time to time.
(3) The Board may—
(a) accept deposits from persons, authorities or establishments on
such conditions as it deems fit;
(b) borrow money with the previous permission of the Government in
order to augment the sources of Funds;
(c) specify Forms, records, registers and statements if so required, in
addition to such of those Forms, records, registers and statements
appended to this Scheme, for the administration of the Scheme and
revise any of such Forms, records, registers and also specify production of
additional certificates, records along with such forms, statement etc.;
(d) make recommendations to the Government about modifications which are
considered necessary in the Scheme.
4. Secretary of the Board—(1) The Chief Executive Officer of the Board shall be the
Secretary to the Board.
(2) The Secretary shall, with the approval of the Chairman of the Board, issue
notices to convene meetings of the Board and keep the record of minutes and shall
take necessary steps for carrying out the decisions of the Board.
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5. Appointment of Chief Executive Officer and other Officers and staff—(1) The
Government may appoint an officer of the Labour Department not below the rank of a
Labour Officer as the Chief Executive Officer of the Board.
(2) The Government may appoint a Chief Accounts Officer in the cadre of
Under Secretary, Finance Department or an Accounts Officer from the Treasuries and
accounts Department on foreign service terms and conditions.
(3) The Government may also appoint as many Officers, as may be
necessary, on deputation from the Labour Department or from any other departments
or undertakings or Corporations or Boards of the State Government or by direct
recruitment as Executive Officers for the purpose of implementation of the Scheme.
(4) The Government may also appoint as many Inspectors and staff, as
may be necessary, on deputation from Labour Department or from any other
departments or undertakings or Corporations or Boards of the State Government or by
direct recruitment for the purpose of implementation of the Scheme.
6. Chief Executive Officer of the Board, etc., to be public servants.—The Chief

Executive Officer and other officers and staff of the Board appointed under this
Scheme shall be deemed to be public servants within the meaning of section 21 of the
Indian Penal Code, 1860 (Central Act XLV of 1860).
7. Administrative and financial powers of the Chief Executive Officer.—(1) The Chief
Executive Officer of the Board may, without reference to the Board sanction
expenditure on contingencies, services and purchase of articles, subject to the limit up
to which he may be authorized to sanction expenditure with such restrictions imposed
by the Board with the approval of the Government.
(2) The Chief Executive Officer may also exercise such administrative and
financial powers other than those specified in sub-clause (1) above, as may be
delegated to him from time to time by the Board with the approval of the
Government.
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8. Opening of district and local offices.- The Board may with the approval of the
Government, open district and local offices, as it may consider necessary, for the
purpose of implementing the Scheme. It may also define the functions of such
Offices.
9. Registration of Manual workers.—(1) Any manual worker who has completed the
age of 18 years but not completed 60 years, may register his name with the Board
through the Labour Officer (Social Security Scheme) of the respective district to
become a member of the Scheme.
(2) Application for such registration shall be made in duplicate to the Labour
Officer (Social Security Scheme) of the respective district in the Form-I appended to
this Scheme together with a certificate of employment issued by any of the persons or
officers specified below:--
(a) Employer of any manual worker

**(b) President or the General Secretary of a trade union of the employment
concerned, registered under the Trade Unions Act, 1926 (Central Act XVI of 1926),
which has submitted the annual returns in Form E appended to the Tamil Nadu Trade
Unions Regulations, 1927, to the Registrar of Trade Unions, for three consecutive
years before the date of issue of certificate of employment or any other office – bearer
of such trade union authorised by the President or General Secretary of the said trade
union, in writing in this behalf;
(c) Any officer not below the rank of an Assistant Inspector of Labour in the
Labour Department or an officer not below the rank of an Assistant Inspector of
Factories in the Department of Inspectorate of Factories.;
(d) Village Administrative Officer and for Chennai District, the Revenue
Inspector concerned;
** G.O.(Ms) No.78,Labour and Employment (I1) Dept, Dt.15th May 2015.

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(3) (a) The registration of the name of the manual worker with the Board shall be
made by the Labour Officer (Social Security Scheme) of the respective district after
due verification by the respective Village Administrative Officer and for Chennai
district, by the Revenue Inspector concerned.
(b) The registration under this clause is valid for a period of five years or
until the registered manual worker attains the age of sixty years, whichever is
earlier‖]
(4) Every registered manual worker whose name has been registered under this
clause will be issued with an identity card in Form-II free of cost by the Labour
Officer (Social Security Scheme) of the respective district.
(5) In case of loss of the identity card, a duplicate Identity card will be issued by
the Labour Officer (Social Security Scheme) of the respective district on an
application made by the registered manual worker concerned and on payment of
twenty rupees.
(6) (a) Every registered manual worker shall furnish name, address, relationship
of the nominee to whom the benefits shall be payable in the event of his death in the
application.
(b) If a manual worker has a family at the time of making a nomination, the
nomination shall be made in favour of one or more members of his family. Any
nomination made by such employee in favour of a person who is not a member of his
family shall be void.
(c) If at the time of making a nomination the manual worker has no family,
the nomination may be made in favour of any person or persons.
(d) Where the nomination made is incomplete or becomes void, the assistance
shall be released to the legal heirs of the deceased registered manual worker;
(i) If the manual worker subsequently acquires a family such nomination
shall forthwith become invalid and the manual worker shall make within ninety days
of acquiring a family, a fresh nomination in favour of one or more members of his/her
family.
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(ii) If a nominee predeceases the manual worker, the interest of the nominee shall
revert to the manual worker who shall make a fresh nomination in respect of such
interest.
10. Suspension and cancellation of membership.— (1) The Labour Officer(Social

Security Scheme) of the respective district may, if he has any reasonable cause to
believe that the membership and or benefit under this Scheme has been secured by a
registered manual worker by making any statement in relation to, any application or
the registration, which is incorrect or false in any material particular or has
contravened any of the provisions of the Act, or any Rule or Scheme framed under
the Act, suspend such membership pending the completion of any enquiry against the
holder of such membership.
2) The Labour Officer (Social Security Scheme) of the respective district may, if
he is satisfied, after making such inquiry as he may think fit, that the holder of a
membership has made a false or incorrect statement of the nature referred to in sub-
clause (1), or has contravened any provision of the Act or any Rule or Scheme framed
under the Act, cancel such membership.
Provided that no such membership shall be cancelled unless the holder thereof has
been given a reasonable opportunity of showing cause against the proposed action
(3) Every person whose membership has been cancelled shall forfeit all his claims
under the Scheme.
(4) Any registered manual worker aggrieved by the orders passed by the authority
referred to in sub-clause (2) is entitled to prefer an appeal to the Chief Executive
Officer within thirty days from the date of receipt of such orders. The Chief
executive Officer may, for valid reasons to be recorded in writing allow preference of
appeal after a period of 30 days but not exceeding ninety days. On such preference of
appeal the Chief Executive Officer shall dispose of the appeal within a period of three
months from the date of filing of such appeal, after giving an opportunity to the
aggrieved manual worker. The orders passed by the Chief Executive Officer shall be
final.
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11. Maintenance of registers.—(1) Every employer shall maintain a Register of

Contribution in Form-III.
(2) Every employer shall maintain an Inspection Register in which the
Inspector appointed for the purpose of the Scheme may record his remarks regarding
any defects that may come to light at the time of his inspections.
(3) The records relating to a calendar year shall be preserved until the end of the
subsequent three years.
4) The Board and the Labour officer (Social Security Scheme) of the respective
district shall maintain a Register of Members in Form IV.
12. The Tamil Nadu Cooking Food Workers’ Social Security and Welfare Fund:-
(1) There shall be constituted a fund called the ―The Tamil Nadu Cooking Food
Workers’ Social Security and Welfare Fund‖ to which shall be credited:--
(a) all contributions received by the Board from the Government as grant;
(b) all contributions received by the Board under the Scheme;
(c) all moneys received by the Board by way of sale or disposal of Properties and
other assets;
(d) interest on investments in securities and deposits and rents;
(e) all moneys received by way of interest charged for the delayed payment of
contribution under clause 27 of the Scheme; and
(f) all moneys received by the Board in any other manner or from any other
source.
(2) All moneys received by the Board and forming part of the Fund shall be kept
in Current Account of any of the Nationalised Banks or any of the Co-operative
Banks under the control and supervision of Tamil Nadu State Co-operative Bank or
any other bank as may be specified by the Board from time to time. Such account
shall be jointly operated by the Secretary of the Board and another Officer authorized
by the Secretary of the Board.
13. Contributions.—(1) The contribution payable under this Scheme shall comprise
contribution payable to the Board by an employer (hereinafter referred to as the
―employer’s contribution‖), and the grant made to the Board by the Government,
from time to time as contribution to the Fund which shall form part of the Fund.
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(2) All remittances payable to the fund shall be rounded off to the nearest rupee.
(3) Every employer shall pay to the Board a sum equivalent to 3% of the wages
payable by him to the manual workers, employed by him, before the 15th day of every
month by means of a demand draft drawn in favour of the ―Secretary, Tamil Nadu
Cooking Food Workers’ Welfare Board‖, Payable at Chennai accompanied by a
statement in Form V.
14. Renewal of Registration:-- (1) Every manual worker whose name has been
registered under Clause 9, shall renew his registration before the expiry of the period
of five years specified in that Clause.
(2) A registered manual worker who fails to renew his registration shall cease to
be member automatically. No specific orders on the cessation of membership need be
issued under this provision.
(3) A registered manual worker whose membership ceased under sub-clause (2)
may be re-admitted by the Labour Officer (Social Security Scheme) of the respective
district, after due verification.
(4) Notwithstanding his re-admission under sub clause (3), he shall not be eligible
to claim any benefits that may become due during the period of non renewal.
15. Intimation about change of employer, employment, place etc:-- Every registered
manual worker who leaves or changes his service under an employer, or changes his
scheduled employment to another, or migrates from one place to another place shall,
within thirty days of such change intimate the Labour Officer (Social Security
Scheme) of the respective district by a letter sent by registered post or delivered in
person.
16. Utilisation of Fund:-- (1) The Fund of the Scheme shall vest in and be held and
applied by the Board as Trustees subject to the provisions and for the purposes of this
scheme.
(2) It shall be lawful for the Board to invest the moneys in any Government
Financial Institutions, Co-operative Banks, Nationalised Banks, or Corporations
authorized by the Government which offers the highest rate of interest as on the date
of such investment.
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17 Personal Accident Relief:-- (1) All registered manual workers who met with the
accident are eligible for Personal Accident Relief and where the accident results in
death, their nominees are eligible for Personal Accident Relief.
Explanation:- For the purpose of this clause ―Accident‖ means any bodily injury or
death or loss of limbs or loss of sight resulting solely and directly from accident
arising out of and in the course of his employment or death but does not include any
intentional self injury, suicide, attempted suicide, injury caused while under the
influence of intoxicating liquor or drugs or resulting from the injured worker
committing any breach of the Law or rules, regulations or instructions applicable
from time to time
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(2) The risk covered by the Scheme and the amount of compensation payable
shall be as follows:
( a ) Death .. Rs.1,00,000
( b ) Loss of actual physical separation or total and irrecoverable loss of use of:-
(i) both hands; or
(ii) both feet; or .. Rs.1,00,000
(iii). one hand and one foot; or
(iv). total and irrecoverable loss of
sight in both eyes
(c) Loss of actual physical separation of or total and irrecoverable loss of use of:-
(i) one hand; or
(ii) one foot; or .. Rs.50,000
(iii) total and irrecoverable loss of sight in one eye.
(d) Permanent total disablement from injuries other than
those specified in items (b) and (c) above .. Rs.25,000
(e) Permanent partial disablement as At the rate the specified in the

specified in column (1) of the Table corresponding Entry in column (2) of the Table
appended hereunder below
THE TABLE
Compensation in percentage
Nature of disablement
(to be applied on Rs.1,00,000/-)
(2)
(1)
PERCENT
1. Loss of toes All 20

Great both phalanges 5
Great One phalanx 2
Other than great, If 1
More than one toe lost each
2. Loss of hearing Both ears 50
3. Loss of hearing one ear 15
4. Loss of four fingers and thumb of one 40
hand
5. Loss of four fingers 35
6. Loss of thumb Both Phalanges 25
7. Loss of index finger Three Phalanges 10
Two Phalanges 8
One Phalanx 4
8. Loss of middle finger Three Phalanges 6
Two Phalanges 4
One Phalanx 2
9. Loss of ring finger Three Phalanges 5
Two Phalanges 4
One Phalanx 2
10. Loss of little finger Three Phalanges 4
Two Phalanges 3
One Phalanx 2
11. Loss of Metacarpal (additional) 3
1st or 2nd (additional) 2
3rd 4th or 5th
12. Any other Permanent Partial Percentage as
disablement assessed by the Doctor
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1[“(2-A) In case of disablement due to accident, the registered manual

worker shall also be eligible to claim wheel chair or artificial limbs, in
addition to the amount of compensation”.]
(3) Claim:- (a) Immediately upon the happening of any accident while in pursuit of
his employment resulting in death or loss of limbs or loss of sight, the employer shall
send a report to the Labour Officer (Social Security Scheme) of the respective district
and to the Police in Form VI, within three days of such occurrence of the accident. In
any other case the report of the accident may be sent to the Labour Officer (Social
Security Scheme) of the respective district either by the injured worker or the
nominee of the deceased worker or a representative of a trade union of the
employment concerned. The Labour Officer (Social Security Scheme) of the
respective district shall investigate the accident occurred, in the work place either on
the report of the accident received from the employer or the injured worker or the
nominee of the deceased worker or a representative of a trade union of the
employment concerned.
(b) In the case of injury or loss of limbs or loss of eyesight specified in items (b)
to (e) of sub-clause (3), the claim shall be made by the registered manual workers
concerned, in the event of death of a registered manual workers, the claim shall be
made by his nominee in Form VII.
(c) In case of death of a registered manual worker due to accident, death
certificate and post-mortem certificate issued by an authority who is competent to
issue such certificate shall be produced by the claimant. If there is delay for more
than thirty days in getting the post-mortem certificate, the certificate given by the
Tahsildar in this regard shall be produced.
(d) In case of loss of limbs or loss of eyesight or, partial disablement due to
accident, the claimant should produce a medical certificate issued by a medical
officer not below the rank of a Civil Assistant Surgeon.
1 Inserted by G.O.Ms.No.64,Labour and Employment (I1) Dept, Dt.01.03.2016

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(e) The Labour Officer (Social Security Scheme) of the respective district shall
after due verification, sanction the compensation in addition to provide artificial limbs
or wheel chair to the claimant.
(f) The Labour Officer (Social Security Scheme) of the respective district shall
after due verification, sanction the compensation to the claimant.
18. Pension Scheme.- (1) Eligibility – Every registered manual worker who has
completed 60 years of age is eligible for pension.
Provided that a manual worker who has not completed 60 years of age but
registered with the Board is also eligible for pension, if he has become disabled due to
sickness and incapacitated from normal work.
(2) Claim.- (a) Every registered manual worker who is eligible for pension under
sub-clause (1) shall apply to the Labour Officer (Social Security Scheme) of the
respective district in form VIII & VIII-A as applicable.
Provided that a disabled manual worker who is eligible for pension under the
proviso to sub-clause (1) should produce to the Labour Officer (Social Security
Scheme) of the respective district a certificate of proof of his disability issued by a
Medical Officer not below the rank of a Civil Surgeon.
(b) The Labour Officer (Social Security Scheme) of the respective district
shall examine every application for pension in accordance with the provisions of this
clause and may accept or reject the claim. The decision of the Labour Officer (Social
Security Scheme) of the respective district shall be final;
Provided that the Labour Officer (Social Security Scheme) of the respective
district shall, before rejecting a claim for pension, give the applicant a reasonable
opportunity of making his representation.
(3) Amount of pension.- The quantum of pension shall be Rs.1000/- (Rupees Four
hundred only).
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19. Assistance to meet the funeral expenses of a registered manual worker:-- (1) If a
registered manual worker dies, the Labour Officer (Social Security Scheme) of the
respective district, after due verification 1[shall sanction a sum of Rs.5,000
(Rupees Five Thousand only)] to the nominee of the deceased registered manual
worker to meet the funeral expenses of the deceased registered manual worker.
(2) The application for claiming the amount specified in sub-clause (1) shall be in
Form IX and shall be accompanied by the death certificate of the deceased registered
manual worker and the original identity card issued to the deceased worker.
20. Assistance on the natural death of a registered manual worker:-- (1) If registered
manual worker dies naturally, the Labour Officer (Social Security Scheme) of the
respective district, after due verification 2[shall pay a sum of Rs.20,000/- (Rupees
Twenty Thousand only)] to the nominee of the deceased registered manual worker.
(2) The application for claiming the amount specified in sub-clause (1) shall be in
Form-IX and shall be accompanied by the death certificate of the deceased registered
manual worker and the original identity card issued to the deceased worker.
21. Assistance for education of the son or daughter of a registered manual worker. –
(1)The assistance for the education of the Children of a registered manual worker
shall be sanctioned by the Labour Officer (Social Security Scheme)of the respective
district, after due verification as specified in the Table below:
_____________________________________________________________
1,2 vide G.O.Ms.No.196, Labour and Employment department, dated 17.11.2017
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THE TABLE
Serial
Form Course of study Day scholar Hosteller
number
Boys Girls Boys Girls
Rs. Rs. Rs. Rs.
1 XI 10th Std., studying – Girl children - 1,000 - -
only
2 X 10th Std. passed 1,000 1,000 - -
3 XI 11th studying – Girl children only - 1,000 - -
4 XI 12th studying – Girl children only - 1,500 - -
5 X 12th Std. passed 1,500 1,500 - -
6 XII Studying regular Bachelor Degree 1,500 1,500 1,750 1,750
course(Every academic year)
7 XII Studying regular Post Graduate 4,000 4,000 5,000 5,000
course(Every academic year)
8 XII Studying regular Profession Course 4,000 4,000 6,000 6,000
in Law, Engineering, Medicine,
Veterinary Science and allied
courses (Every academic year)
9 XII Studying regular Post Graduate 6,000 6,000 8,000 8,000
Professional Course in Law,
Engineering, Medicine, Veterinary
Science and allied courses (Every
academic year)
10 XII Studying ITI or Polytechnic 1,000 1,000 1,200 1,200
course(Every academic course)
(2) The amount shall be sanctioned only if the following conditions are fulfilled,
namely. -
(a) only two children of a registered manual worker shall be given this assistance;
and
(b) the registered manual worker shall have no dues payable to the Board.
(3) The application for assistances specified in Serial numbers 2 and 5 in column
(1) of the Table in sub- clause (1) shall be in Form X to be submitted after passing of the
course, the application for assistances specified in serial numbers 6 to 10 in column (1 )
of the said Table shall be in Form XII to be submitted before completion and passing of
the course and the application for the assistances specified in serial numbers 1, 3 and 4
shall be in Form XI to be submitted before completion and passing of the course;
(4) Where both husband and wife have applied for assistance under this clause,
one of them alone shall be eligible for such assistance.
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22. Assistance for marriage. - (1) The Labour Officer (Social Security Scheme) of the
respective district shall, on an application from a registered manual worker, after due
verification sanction a sum of Rs.3,000/- (Rupees three thousand only) for men and
Rs.5,000/- (Rupees five thousand only) for women as assistance to meet the marriage
expenses of the registered manual worker or of the son or daughter of the registered
manual worker, as the case may be ;
namely. –
(a) the family of a registered manual worker can avail this assistance only twice;
(b) the registered manual worker shall have no dues payable to the Board; and
(c) the registered manual worker or the person for whose marriage the assistance is
sought for, as the case may be, shall have attained the age prescribed by law for marriage;
(3) Where both husband and wife have applied for assistance to the marriage of his/her
son or daughter under this clause, one of them alone shall be eligible for this assistance.
(4) The application for assistance under this clause shall be in Form-XIII.
23. Assistance for delivery or miscarriage of pregnancy or the termination of pregnancy

by registered manual female worker:- 1[(1) The Labour Officer (Social Security
Scheme)of the respective district, shall, on an application from a registered
female manual worker, sanction the assistance as indicated below, after
due verification of the proof produced by her of her pregnancy or delivery
of child by her or the miscarriage of her pregnancy or the termination of
pregnancy:-
(i) Pregnancy - Rs. 6,000/-
(Rs. 3000/- shall be paid between seventh
month to ninth month of pregnancy period
and remaining Rs.3000/- shall be paid from
two to five month after the delivery of the child).
(ii) Miscarriage of pregnancy - Rs. 3,000/-.
(iii) Termination of pregnancy - Rs. 3,000/-
(2) The amount shall be sanctioned, only if the following conditions are fulfilled,
namely:-
(a) registered female manual worker can get this assistance only twice;
(b) registered female manual worker shall have no dues payable to the Board; and
1 substituted by G.O.Ms.No.230, Labour and Employment Department, dated 01.12.2016

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(c) registered female manual worker shall not be given this assistance if she already
has two children.
(3) The application for claiming the amount specified in sub-clause (1) shall be in Form
XIV.
24. Assistance for purchase of spectacles by a registered manual worker.-
(1) The Labour Officer (Social Security Scheme)of the respective district, shall on an
application Form XV from a registered manual worker, after due verification sanction a
sum not exceeding Rs.500/- (Rupees five hundred only) as an assistance towards
reimbursement of cost of spectacles.
(2) 1[***].
namely. -
(a) This assistance shall be given to a registered manual worker only once.
(b) The registered manual worker applying for assistance shall have no dues
payable to the Board.
25. Eligibility to avail the benefits. - A registered manual worker will be eligible to avail
the benefits under this Scheme only if he has not availed similar benefits of any other
Schemes of the Government.
26. Penalty. - (1) If any employer who, for the purpose of avoiding any payment to be
made by him under the Act or under this Scheme or if any person who, for the purpose of
enabling an employer to avoid such payment, knowingly makes or causes to be made any
false statement or false representation shall be punishable with fine which may extend to
five hundred rupees or with imprisonment for such term which shall not exceed three
months and for the second or subsequent offence with fine which may extend to one
thousand rupees or with imprisonment which shall not exceed a term of six months.
(2) If an employer who contravenes or makes default in complying with any of the
provisions of this Scheme shall for such contravention or noncompliance, be punishable
with fine which may extend to five hundred rupees or with imprisonment for such term
which 2[“shall not exceed a term of six months or with both imprisonment and fine
and if the contravention is continued after conviction, with a further fine which may
extended to one hundred rupees for each day on which the contravention is so
continued”.]
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1 [***] Omitted by G.O.Ms.No.90,Labour and Employment (I1) Dept, Dt.2thJune 2015.
2 Substituted by G.O.Ms.No.168,Labour and Employment (I1) Dept, Dt.09.10.2015
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27. Mode of recovery of amount from employers. - Any amount due from the employer in
pursuance of the scheme shall, without prejudice to any other mode of recovery, be
recoverable on behalf of the Board as an arrear of land revenue together with interest at
such rate as may be notified by the Government.
28. Power to remove difficulties. - If in the opinion of the Board any difficulty or doubt
arises as to the Interpretation of any of the provisions of the Scheme or in the
implementation of the Scheme, the Board shall refer the question to the Government and
the decision of the Government shall be final and binding.
29. Construction of reference to the registration, contribution etc., under the Tamil Nadu
Manual Workers Social Security and Welfare Scheme,….- The contribution made by any
manual worker and the contribution made by an employer after registration and the
consequential benefits accrued to any manual worker under the Tamil Nadu Manual
Workers Social Security and Welfare Scheme, …… shall be construed as contribution
made and the benefits accrued under this Scheme.
for Form I, the following Form shall be substituted, namely :-
FORM – I
[See clause 9(2)]
APPLICATION FOR REGISTRATION
To
The Labour Officer (Social Security Scheme),
……………..district. Affix
Registration No………… Passport
(to be filled in by the Registration Authority) Size
1[“1.(a) Name of the worker : Photograph
(b) Sex :
(c) Religion :
(d) Caste :
(e) Category SC ST MBC BC OC : “;]
2.Name of the Father/Husband :

3.Date of Birth :
(enclose Xerox Copy of evidence Day Month Year
in proof duly attested by a Group A or Group B officer)*
4.Marital Status
(Whether married, unmarried, widow/widower) :
5.Permanent address :
6.Present address :
7.State whether self-employed or employed :
8.If employed, furnish the name and address
of the established and also the name and
address of the employer/ contractor :
9.Nature of work :
10.Number of years engaged in the employment
as on the date of application :
11.Particulars of the member of the family :
Sl. No Name Age Relationship Marital status
(1) (2) (3) (4) (5)
12. (a) Whether the wife/husband is employed ? :
(b) If so furnish details
13. Nomination for receipts of Natural Death/Accidental
Death Assistance :
Name and address ** Nominee’s Relationship Age of the

Percentage of
amount to be paid
of the nominee/nominees with the worker nominee to each nominee
________(1) ____________ _____(2) ______________ (3) ____________ (4) _____________
____________________________________________________________________________
*(i) Birth Certificate or (ii) School Certificate or (iii) Driving License or (iv) Ration Card or
(v)Voter’s identity card or(vi) Certificate from Registered Medical Practitioner not below the rank
of Civil Surgeon of a Government Hospital in the prescribed format duly signed by the worker.
**Nominees shall be Dependant Family Members.
Signature/Thumb impression of the manual worker

(Left hand thumb impression to be attested by the
Registering Authority)

DECLARATION BY THE APPLICANT***
In declare that I am not registered as a member in any other Manual workers welfare board or
Boards constituted by the Government of Tamil Nadu or under any other Government scheme.
Signature or left hand thumb impression of the manual worker.

(Left hand thumb impression to be attested by the Registration authority)
***Any false declaration/certification will entail legal action

_________________________________________________________________________
CERTIFICATE OF EMPLOYMENT***
Certified that the particulars furnished by Thiru/Thirumathi/Selvi……………………………

regarding employment as a manual worker in the application for registration are true to the best of my
knowledge and belief.
Place:
Date :
Signature and name of the person/

Officer issuing the certificate
***Any false declaration/certification will entail legal action

____________________________________________________________________________
VERIFICATION CERTIFICATE
After due verification it is certified that the particulars furnished in the application and the proof
of age are found to be correct and recommended for registration.
Place:
Date :
Village Administrative Officer/
Revenue Inspector(for Chennai district)
____________________________________________________________________________
Office Note:-
Application and proof verified. The recommendation of the ……………………is accepted and the
applicant is registered as member of the Tamil Nadu………………………Welfare Board.
Application for membership rejected(In case of rejection, reason should be clearly mentioned).
Labour Officer (Social Security Scheme)

…………………….District
__________________________________________________________________________
ACKNOWLEDGEMENT SLIP
Received from Selvi/Thiru/Tmt………………………….residing at
…………………………application for registration as manual worker in the Tamil Nadu
…………….Welfare Board.
Office Seal: Labour Officer (Social Security Scheme)
District with date :
Name:
Designation :
______________________________________________________________________
21
FORM – II
[See Clause 9 (4)]
IDENTITY CARD
TAMIL NADU
............................
WELFARE
BOARD
LABOUR
STATUE
IDENTITY CARD
22
SCHEME ASSISTANCES OF THE BOARD

1. Accident Insurance Scheme Rs.
(a) Accidental Death 1,00,000/-
(b) Accidental Disability Based on Extent of Disability
2. 2[Natural Death Assistance 20,000/-
3. Funeral Expenses Assistance 5,000/-]
4. Educational Assistance:-
(a) Girl Children studying 10th 1,000/-
(b) 10th Passed 1,000/-
(c) Girl Children studying 11th 1,000/-
(d) Girl Children studying 12th 1,500/-
(e) 12th Passed 1,500/-
(f) Regular Degree Course 1,500/-
with hostel facility 1,750/-
(g) Regular Post Graduate Course 4,000/-
with hostel facility 5,000/-
(h) Professional Degree Course 4,000/-
With Hostel Facility 6,000/-
(i) Professional PG Course 6,000/-
(j) I.T.I. or Polytechnic 1,000/-
5. Marriage Assistance For Women- 5,000/-
For Men -3,000/-
6. Maternity Assistance 6,000/-
1[Rs.3000/- seventh month to
ninth month of pregnancy &
Rs.3000/- Second to fifth
months after the delivery]
7. Reimbursement of Cost of Spectacles Upto 500/-
8. Pension 1000/- per month
1 vide G.O.(D) No.230, Labour and Employment Department dt.01.12.2016

2 vide G.O.(D) No.196, Labour and Employment Department dt.17.11.2017
23
TAMIL NADU
............................
WELFARE
BOARD
Affix
Passport
Size
Photograph
Registration No. :
Date :
[ 1 (a) Name of the worker
1 “ . :
(b) Sex :
(c) Religion :
(d) Caste :
(e) Category SC ST MBC BC OC : “;]
2. Father / Husband :
3. Date of Birth / Age :
4. Employment :
Registration should be renewed before ...................................................

24
1. Permanent Address :
2. Present Address :
3. Marital Status :
4. Details of Nominees :
5. Registration Number if
Member of Trade Union :
Signature of the Worker Signature of the Officer

Labour Officer
(Social Security Scheme)
…………….District
25
Details of Scheme Assistance provided to the worker
Sl. No. Name of the 1 [Name of File No. Amount Signature of

Assistance the Person] and Date distributed the Officer
provided
1 substituted by G.O.Ms.No.122, Labour and Employment (I1), 24 th October 2008.

26
Renewal details
Date of Renewal Receipt No. and Next Renewal Signature of the

Date Date Renewing Officer
with seal
27
GENERAL INSTRUCTIONS
 The Registering individual should have completed 18 years of age and

below 60 years of age.
 No Registration / Renewal Fee.
 Registration should be renewed once in five years.
 In case of loss of Identity Card, Duplicate Identity Card may be collected
from the Labour Officer (Social Security Scheme) of the respective district
by remitting Rs. 20/-
 In case of change of Residence new address should be intimated to the
Labour Officer (Social Security Scheme) of the respective district.
 After Marriage of the worker, application should be made to the Labour
Officer (Social Security Scheme) of the respective district for change of
nominee in the Original Registration Application Form.
 In the event of death of the worker, the original identity card should be
surrendered to the Labour Officer (Social Security Scheme) of the
respective district along with the application for Natural Death Assistance.
 The Original identity card should be enclosed along with claim application
each time when the Assistance is sought for.
 1[All assistances should be extended to the beneficiary through “RECS”
system of Banking services]
1 vide G.O.(D) No.102, Labour and Employment (I-1) Department,dated 8.11.2011.
28
UZHAIPPOM
UYARVOM
G. 133, Chinthamani Co-operative Commercial Complex,

Anna Nagar East, Chennai – 600 102. Phone : 26631147
29
FORM – III
[See Clause 11 (1)]
1. Name and address of the Employer :
2. Name of the establishment :
REGISTER OF CONTRIBUTION
Name Registration Nature of Wages Total Employers’ Particulars of

of the No. employment earned Wages Contribution D.D. No. date and
worker during the made to the name of the Bank
month Board
(1) (2) (3) (4) (5) (6) (7)

30
1[“FORM – IV
[See Clause 11 (4)]
MEMBERSHIP REGISTER
Serial Name Sex Religion Caste Category Name and Date of Registration
Number of the address of the Registration Number
Manual establishment
worker (in case of self
employed
worker indicate
the same)
(1) (2) (3) (4) (5) (6) (7) (8) (9)
”.]

31
FORM – V
[See Clause 13 (3)]
1. Name and address :
2. Name of the establishment :
STATEMENT OF CONTRIBUTION
Particulars
Wages
Employees of DD
earned
Sl. Nature of Contribution (No.,
Name of Registration during Total
No. Employment made to the Date and
the worker No. the Wages
Board Name of
month
the Bank)
(1) (2) (3) (4) (5) (6) (7) (8)
32
FORM – VI
[See Clause 17 (3) (a) ]
ACCIDENT INTIMATION FORM
To

…………………………….District
…………………………….
To
The Inspector / Sub-Inspector of Police,

…………………………….
…………………………….
Sir,
Thiru / Thirumathi/Selvi/Selvan ……………………………… son of / wife of /
daughter of ……………………………………………………..employed in the work
place……………………………………………………………. has suffered loss of limbs
/ loss of eye-sight/total disablement/partial injury/ 1[“death due to accident occurred on
the ………….. (date) at ……………. (time)”.]
(Signature of the Employer)
Address:
Date:
Signature of the Worker/Nominee/

Representative of a Trade Union.
for Form VII, the following Form shall be substituted namely:-
FORM-VII
[see clause 17(3)(b)]
APPLICATION FOR PAYMENT OF COMPENSATION FOR ACCIDENTAL
DEATH/DISABILITY/ PROVISION OF ARTIFICIAL LIMBS OR WHEEL CHAIR
To
……………………………………district.
1.(a)Name of the registered manual

worker :
(b)Address(in full)
(on the date of death/disability) :
(c)Age :
(d)Registration number and date of
initial registration :
(e)Renewal date :
(f)Occupation
2.(a) Area :
(b)Place :
(c)District :
3.(a)Name of the nominee :
(b)Relationship with the deceased registered manual worker
(in the case of accidental death only) :
(c)Age of the nominee
(d) Address in full (with PIN) :
4.Whether the claimant is the registered worker?

himself(in the case of accidental
disability)or the nominee of the registered manual worker?
5.Date and time of accident
6.Place of accident :
(a)at the work place
(b)outside the work place
7.Whether intimation regarding accident has been given :
in Form VI as per clause 17(3)(a)?
8.Whether the accident resulted in death/

loss of limb/loss of eye sight/partial injury? :
9.In the case of accidental disability, a certificate :
from a Civil Surgeon of the Government
Hospital indicating the percentage of
disability due to accident with details should be
obtained and enclosed in original.
1[“9-A In the case of accidental disability, whether
the applicant requires wheel chair/artificial limbs :
(strike out whichever is not applicable).”;]
1 substituted by G.O.Ms.No.64, Labour and Employment (I1) Dept, Dt.01.03.2016

10.(i)Date and time of death(in case of accidental death) :
(ii)Attested copy of First Information Report from
the Police Station nearer to the place of accident
to be closed :
(iii)Post-Mortem Certificate and final
Investigation Report should be sent in original :
(iv)Death Certificate(attested copy)should be
enclosed :
Signature/Thumb impression of the
registered manual worker/
nominee in case of death.
DECLARATION BY THE CLAIMANT*
I hereby declare that the particulars furnished above are correct and true to the
best of my knowledge. In the event of any of the information given above is ultimately
found to be false, I hereby agree to refund in full the amount 1[of compensation and /
or value of artificial limbs or wheel chair] received as assistance for accidental
death/disability. I also hereby declare that I have not received similar benefit by claim in
any other Welfare Board or Boards constituted by the Government of
Tamil Nadu or under any other Government schemes.
Place:
Date :
Signature/Thumb impression of the registered manual worker/
nominee in case of death.
*Any false declaration/certification will entail legal action.
______________________________________________________________
SANCTION
I hereby sanction, after due verification, for payment of Rs………/-
(Rupees………………………. only) towards accidental death/disability/2[provision of
artificial limbs or wheel chair] to Selvi/Thiru/Tmt……….nominee of the deceased
manual worker/ egistered worker himself.
Office Seal: Labour Officer (Social Security Scheme)

…………………..district.
Place: (Affix Rubber Stamp)
Date :
___________________________________________________________________
Received from Selvi / Thiru/ Tmt………………………………………………..
…………………………………………….application for sanction of assistance towards
accidental death / disability/3[provision of artificial limbs or wheel chair] in respect of
deceased registered manual worker Selvi/ Thiru/ Tmt,
……………………………………………..(Registration Number ) /
registered manual worker Selvi / Thiru /
Tmt………………………………………………………………………………………….
(Registration Number )
Labour Officer (Social Security Scheme)……… district
with date
Name :
Designation:
Office Seal:
1,2,3 substituted by G.O.Ms.No.64, Labour and Employment (I1) Dept, Dt.01.03.2016
FORM-VIII
[see clause 18(2))
APPLICATION FOR PENSION
To
The Labour Officer (Social Security Scheme), Passport
……………………district. size
photograph
1.Name of the Applicant : duly signed
2.Address in full(to which pension
is to be sent)(with PIN code) :
3.Registration number and date :
(original Identity Card should be enclosed)
4.Age and date of completion of
60 years of age :
5.Date of completion of continuous
period of five years as registered manual
worker of the Board :
6.Whether the registration has been
renewed regularly without any default?
If so, details may be furnished :
Date of initial registration/ Period of validity of registration/renewal

Sl. Subsequent renewal
No. From To
(1) (2) (3) (4)
7.Whether in receipt of any other pension?

If so, furnish complete details :
Signature/Thumb impression of the registered
manual worker.
DECLARATION**
I hereby certify that the facts mentioned above are true to the best of my knowledge and
information. I am not a registered manual worker of any other Board. If ultimately it is found that
any of the information given by me is false, I agree to refund the entire amount received by me as
pension besides any other action that may be deemed fit by the appropriate authorities.
I also hereby declare that I have not received similar benefits by claim in any other
Welfare Board or Boards constituted by the Government of Tamil Nadu or under any other
Government schemes.
Place:
Date : Signature/Thumb impression of the registered manual worker.
Name:
**Any false declaration/ Certification will entail legal action.
______________________________________________________________________
Note:1.Besides the photograph affixed above, another passport size
Photograph should be enclosed with the application.
2.Incomplete application will not be considered.
36
SANCTION
I hereby sanction, after due verification, a monthly pension of Rs………../-

(Rupees……………only) with effect from……………………………….The amount shall be
sent by money order.
Office Seal:
Place: Labour Officer (Social Security Scheme)
Date: ………..District .
________________________________________________________________
Received from Selvi/Thiru/Tmt………………………….(Address in

full)………………………………………........(Registration No………………………………)
application for sanction of pension.
Labour officer (Social Security Scheme) …………district with date

Name:
Designation:
Office Seal:
________________________________________________________________
37
for Form VIII-A the following Form shall be substituted namely:-
FORM VIII-A
[see clause 18(2)]
APPLICATION FOR DISABILITY PENSION
To Passport size
The Labour Officer (Social Security Scheme), Photograph
………………………..district. duly signed
1.Name of the Applicant :
2.Address in full(to which pension
3.Registration number and date
(Original identity card should be enclosed) :
4.Age and date of completion of
60 years of age :
5.Date of completion of continuous period of five
years as registered manual worker of the Board :
6.Whether the registration has been renewed
regularly without any default? If so,
Details may be furnished
:
Sl. Date of initial registration/ Period of validity of registration/renewal
No. subsequent renewal
From To
(1) (2) (3) (4)
7.Whether the applicant has become disabled

due to sickness and incapacitated from normal
work?(If so, a certificate by a Medical Officer
not below the rank of Civil Surgeon of the Government
Hospital under his name and seal should be enclosed in
Original) :
8.Whether in receipt of any other pension?
If so, furnish complete details :

registered manual worker.
38
DECLARATION**
I hereby declare that the facts mentioned above are true to the best of my knowledge and
information. I am not a registered worker of any other Board. If ultimately it is found that any of
the information given by me is false, I agree to refund the entire amount received by me as
disability pension besides any other action that may be deemed fit by the appropriate authorities.
I also hereby declare that I have not received similar benefits by claim in any other
Government Schemes.
Place: Signature/Thumb impression of the
Date: registered manual worker.
Name:
**Any false declaration/certification will entail legal action.
______________________________________________________________________
Note:1.Besides the photograph affixed above another passport size
2.Incomplete applications will not be considered.
SANCTION
I hereby sanction after due verification a monthly pension of Rs……………./-(Rupees

…………………………only) with effect from………………..The amount shall be sent by
money order.
Office Seal:
Place:
Date: Labour Officer (Social Security Scheme)
…………..District
______________________________________________________________________
Received from Selvi/Thiru/Tmt…………………… (Address in

full)…………………………………………………..(Registration No. ……………………..)
application for sanction of disability pension.
Labour Officer (Social Security Scheme)………………district with date

Name:
Office Seal: Designation:
39
[After Form VIII-A the following Form - VIII-B shall be inserted namely:-]
FORM VIII-B
[see clause 17(3)]
APPLICATION FOR ARTIFICIAL AIDS.
To Passport size
The Labour Officer (Social Security Scheme), Photograph
………………………..district. duly signed
Sir,
Sub: Application for sanction of payment for purchase of/reimbursement
of /issue of Artificial Aids.
1.Name of the Applicant :

2.Address in full(to which payment
3.Registration number and date
(Original identity card should be enclosed) :
4.Age and Date of Birth :
5.Whether the registration has been renewed
regularly without any default? If so,
Details may be furnished :
Sl. Date of initial registration/ Period of validity of registration/renewal

No. subsequent renewal
From To
(1) (2) (3) (4)
(Original receipt for registration and last renewal to be enclosed)
6.Whether the applicant has become disabled

due to sickness and incapacitated from normal
work? Nature of disablement(If so, a certificate by a Medical Officer
not below the rank of Civil Surgeon of the Government
Hospital under his name and seal should be enclosed in
Original along with recommendation of the Medical Officer for
the use of artificial aids) :

40
DECLARATION**
I hereby declare that the facts mentioned above are true to the best of my
knowledge and information. I am not a registered worker of any other Board. If ultimately
it is found that any of the information given by me is false, I agree to refund the entire
amount received by me for artificial aids besides any other action that may be deemed
fit by the appropriate authorities.
I also hereby declare that I have not received similar benefits by claim in any
other Welfare Board or Boards constituted by the Government of Tamil Nadu or under
any other Government Schemes.
Place: Signature/Thumb impression of the
Date: registered manual worker.
Name:
**Any false declaration/certification will entail legal action.
______________________________________________________________________
Note:1.Besides the photograph affixed above another passport size
2.Incomplete applications will not be considered.
SANCTION
I hereby sanction after due verification for Rs……………./-(Rupees

…………………………only) ………………..The amount shall be sent by money
order/Cheque/through Bank
Office Seal:
Place:
Date: Labour Officer (Social Security Scheme)
…………..District
______________________________________________________________________
Received from Selvi/Thiru/Tmt…………………… (Address in

full)…………………………………………………..(Registration No. ……………………..)
application for sanction of artificial aids.
Labour Officer (Social Security Scheme)………………district with date

Name:
41
for Form IX the following Form shall be substituted namely:-
FORM-IX
[See clause 19(2) and 20(2)]
APPLICATION FOR PAYMENT OF FUNERAL EXPENSES/
NATURAL DEATH ASSISTANCE
To
The Labour Officer (Social Security Scheme)
……………………district.
1.Name of the deceased registered manual worker :

2.Address in full(at the time of death) :
3.Age(on the date of death) :
4.Nature of work :
5.(a)Registration Number and date of initial registration
(original Identity card should be enclosed). :
(b)Date of last renewal, indicating the
period upto which renewed
6.(a)Place of death :
(b)Date of death :
(c)Cause of death(to be indicated clearly)
(Avoid indicating as ‖Natural Death‖)
(Death Certificate in original shall be enclosed) :
7.(a)Name of the nominee :
(b)Age on the nominee(in completed years) :
(c)Address of the nominee in full indicating PIN Code :
(d)Relationship of the nominee with the deceased
registered manual worker :

nominee of the registered manual worker
DECLARATION OF THE NOMINEE**
I hereby declare that the particulars furnished above are correct and true to the best of my
knowledge. In the event of any of the information given above is ultimately found to be false, I
hereby agree to refund in full the amount received as assistance for death/funeral expenses of the
deceased manual worker.
I also hereby declare that I have not received similar benefit by claim in any other
Government schemes.
Place: Signature/Thumb impression

Date : of the nominee of the registered manual worker
**Any false declaration/Certification will entail legal action.

42
CERTIFICATE**
I hereby certify that the particulars furnished in the application are correct.
Place:
Date: Members,………….TamilNadu………………………………
Welfare Board/President/Secretary of the Registered Trade
Union of the Employment concerned/Assistant Inspector
of Labour concerned/Any other officer permitted to give
employment certificate.
**Any false declaration/certification will entail legal action
SANCTION
1.I hereby sanction, after due verification, a sum of Rs…………./-

(Rupees………………………….only) as assistance to Thiru/tm,t/Selvi…………………..,
nominee/ nominees, for the funeral of Thiru/Thirumathi/Selvi……………………………….
a registered manual worker.
2.I hereby sanction, after due verification, a sum of Rs………………/-

(Rupees………………………….only) as assistance to
Thiru/Tmt/Selvi………………………,nominee/nominees, on the natural death of
Thiru/Thirumathi/Selvi……………………………a registered manual worker.
Office Seal:
Place: Labour Officer (Social Security Scheme)
Date : ……………………………district.
Received from Selvi/Thiru/Tmt……………………………………………………….

.……………………………………………………………………………….claim application for
sanction of Funeral/Natural death assistance in respect of deceased registered manual worker
Selvi/Thiru/Tmt…………………………………(Registration No………………..)

…………district with date
Name:
43
for Form- X, the following Form shall be substituted namely:-

FORM-X
[See Clause 21(3)]
APPLICATION FOR EDUCATION ASSISTANCE FOR PASS IN
10TH STANDARD AND 12TH STANDARD EXAMINATION
To
………………………district.
1.Name of the registered manual worker :

(Original Identity card should be enclosed) :
period upto which renewed :
3.Address(in full) with PIN Code :
4.Details of family members of the registered
manual worker:-
Name Relationship with the registered Age
Sl. manual worker
No
(1) (2) (3) (4)
5.Details of the son or daughter for whom educational assistance is sought for:-
Sl. Name Date of Examination Month and year Name of the

No (Son/Daughter) Birth passed of pass School studied
(1) (2) (3) (4) (5) (6)
Note:-Xerox copy of the Mark Sheet in support of having passed the Examination, duly
attested by a Group A or Group B Officer should be enclosed.
6.Number of children for whom the educational assistance has already been availed from
the Board:-
Sl. Name Son/Daughter Course for which Year of availing Amount of
No assistance availed Assistance assistance
(Rs)
(1) (2) (3) (4) (5) (6)
Signature/Thumb impression of the registered manual worker

DECLARATION BY THE APPLICANT*
hereby agree to refund in full the amount received as assistance. I further declare that I have not
availed similar assistance from any other Welfare Board or Boards constituted by the
Government of Tamil Nadu or under any other Government
Schemes.
Place:
Date: Signature/Thumb impression of
the registered manual worker
*Any false declaration /certification will entail legal action.
44
CERTIFICATE*
Place:
Date: Members,………….Tamil Nadu………….
Welfare Board/
President/Secretary of the Registered Trade Union
of the Employment concerned/Assistant Inspector
of Labour concerned/Any other Officer permitted
to give employment certificate.
*Any false declaration/Certification will entail legal action.
SANCTION
I hereby sanction, after due verification a sum of Rs………../-

(Rupees………………………..only) as educational assistance, in respect of
*Selvan/*Selvi………………….*Son/*daughter of *Thiru/Tmt………………………….
registered manual worker (Registration No……………………….).
Office Seal:
Place: Labour Officer(Social Security Scheme)…………..district.
Date:
*Strikeout whichever is not applicable.
Received from Thiru/Tmt/Selvi/………………….(Registration No…………)claim

application for sanction of educational assistance.

…………….district with date
Office Seal: Name:

Designation:
______________________________________________________________________
45
for Form- XI, the following Form shall be substituted namely:-

FORM-XI
[See Clause 21(3)]
APPLICATION FOR EDUCATIONAL ASSISTANCE FOR GIRL CHILDREN
STUDYING IN 10TH STANDARD/11TH STANDARD /12TH STANDARD
To
manual worker:-
Sl. manual worker
No
(1) (2) (3) (4)
5.Details of the daughter for whom Educational Assistance is sought for:-

Sl. Name Date of Standard in which Year of Name of the
No Birth studying study(indicate School with full
(Std.10th /11th the academic address
/12tth ) year)
(1) (2) (3) (4) (5) (6)
Note:- Certificate from the Head Master/Principal of the School to the effect that the daughter of
the registered manual worker is studying the course, should be enclosed. 6.Number of children
for whom the assistance has already been availed from the Board:-
Sl. Name Son/Daughter Course for which Year of availing Amount of
(1) (2) (3) (4) (5) (6)

hereby agree to refund in full, the amount received as assistance.
I also hereby declare that I have not received similar benefits by claim from any other
Government Schemes.
Place:
46
CERTIFICATE*
Place:
Welfare Board/
President/Secretary of the Registered Trade
Union of the Employment concerned/Assistant
Inspector of
Labour concerned/Any other Officer permitted
SANCTION
I hereby sanction, after due verification, a sum of Rs………../-

(Rupees………………………..only) claimant as educational assistance, in respect of
Selvi………………….daughter of Thiru/Tmt………………………….
Registered manual worker (Registration No……………………….).
Office Seal:
Date:
Received from Thiru/Tmt………………….registered manual worker (Registration

No…………)claim application for sanction of educational assistance.

Office Seal: Name:

Designation:
______________________________________________________________________
47
for Form- XII, the following Form shall be substituted namely:-

FORM-XII
[See Clause 21(3)]
APPLICATION FOR EDUCATIONAL ASSISTANCE FOR HIGHER
EDUCATION
To
manual worker:-
Sl. manual worker
No
(1) (2) (3) (4)
5.Details of the son or daughter for whom educational assistance is sought for:-
Sl. Name Date of Name of the Duration of the Name of the
No Birth course studying course College/Institution
with address in full
(1) (2) (3) (4) (5) (6)
Note:- Certificate from the principal of the College/Educational institution to the effect that the
son or daughter of the registered manual worker is studying the course indicating whether a day
scholar or hosteller should be enclosed in original.
6.Number of children for whom the educational assistance has already been availed from
the Board:-
Sl. Name Son/Daughter Course for which Years of availing Amount of
(Rs.)
(1) (2) (3) (4) (5) (6)

Government Schemes.
Place:
48
CERTIFICATE*
I hereby certify that the above particulars are correct.
Place:
Welfare Board/
Inspector of
SANCTION
I hereby sanction, after due verification a sum of Rs………../-

(Rupees………………………..only) towards educational assistance, in respect of
*Selvan/*Selvi………………….(*Son/*daughter )of *Thiru/*Tmt………………………….
Registered manual worker (Registration No……………………….).

Date:
*Strikeout whichever is not applicable.

application for sanction of educational assistance.

Office Seal: Name:

Designation:
______________________________________________________________________
49
for Form- XIII, the following Form shall be substituted namely:-
FORM-XIII
[See clause 22(4)]
APPLICATION FOR PAYMENT OF MARRIAGE ASSISTANCE
To

2.Registration Number and Date of initial registration
(Original Identity Card should be enclosed) :
3.Address in full with PIN Code :
4.(a)Particulars of the members of the family of the registered
manual worker:
Sl.No Name Relationship Age Marital Status
(1) (2) (3) (4) (5)
( b).(i)Name of the person for whose marriage the :

assistance is sought for
(ii)Relationship to the registered manual worker :
(iii)age in completed years on the date of marriage :
(c).Names of the couple(i)Bride :
(ii)Groom :
(d).Date and venue of the marriage
(Marriage invitation to be enclosed in original) :
(e).Has the marriage assistance been availed earlier from the
Board? If so, furnish details :

hereby agree to refund in full, the amount received as assistance for the marriage of
self/daughter/son.
Government Schemes.
Place:

______________________________________________________________________
50
CERTIFICATE*
I hereby certify that the particulars furnished in the application form are correct.
Place:
Welfare Board/
Inspector of
SANCTION
I hereby sanction, after due verification, a sum of Rs………../-

(Rupees………………………..only) towards marriage assistance of the son/daughter/self of
Thiru/Tmt………………………….registered manual worker of the Board (Registration
No……………………….).
Labour Officer(Social Security Scheme)…………..district.

application for sanction of marriage assistance.

Office Seal: Name:

Designation:
______________________________________________________________________
51
for Form- XIV, the following Form shall be substituted namely:-
FORM-XIV
[See Clause 23(3)]
APPLICATION FOR PAYMENT OF MATERNITY ASSISTANCE
FOR PREGNANCY OR MISCARRIAGE OR TERMINATION OF PREGNANCY
BY A REGISTERED FEMALE MANUAL WORKER
To
…………………….district
1.Name of the registered female manual worker :

(b)Date of last renewal indicating the
3.Address(in full)with PIN Code :
4.Particulars of surviving son/daughter of the registered
female manual worker :
Sl. Name Sex Date of Birth Age
No.
(1) (2) (3) (4) (5)
5.Month of Pregnancy*on the date of claim application :

*(Certificate from the civil assistant Surgeon of the Government Hospital in
support of this should be enclosed in original)
6.Whether the claim is for pregnancy or miscarriage of
pregnancy or termination of pregnancy?
If so details may be furnished.(Certificate from the
Civil Assistant surgeon of the government Hospital
To this effect should be obtained and sent in original) :
7.Whether the assistance has already been availed by
the registered female manual worker?
If so, details may be furnished :


I also hereby declare that I have not received similar benefits by claim in any other Welfare
Board or Boards constituted by the Government of Tamil Nadu or under any other Government
schemes.
Place:
Date :
Signature/thumb impression of the
registered female manual worker.
52
______________________________________________________________________
Note:- (i) The Birth Certificate from the Register of Births of the area concerned should be
obtained and sent in original for release of the assistance after the date of delivery.
(ii) In the event of untoward demise of the registered female worker after the 7 th month of
pregnancy either before delivery or three months after delivery, the fact should be reported to the
Medical Officer of Primary Health Centre concerned and for Chennai district to the Health officer
concerned, immediately along with the Death Certificate in original, for sanction of Funeral
Expenses(or)Natural death assistance as admissible under the scheme.
______________________________________________________________________
CERTIFICATE*
I hereby certify that the particulars furnished in the application from are correct.
Place:
Date : Members, ……………………Tamil Nadu
………………………………..Welfare Board/
President/Secretary of the Registered Trade Union of the
Employment concerned/Assistant Inspector
of Labour concerned/Any other officer permitted
______________________________________________________________________
SANCTION
I hereby sanction, after due verification, for the payment of assistance of Rs………………./-
(Rupees ……….......................……………………………..only) to
Tmt………………………registered female manual worker(Registration No…………)
*at the time of seventh month of pregnancy/*on delivery of child/*for miscarriage of
pregnancy/*termination of pregnancy
(*Strike out whichever is not applicable).
Office Seal:
Labour officer (Social Security Scheme)
…………….district.
Received from Tmt……………………………………….registered female manual worker

(Registration Number…………………..) claim application for sanction of maternity assistance
for*pregnancy/*miscarriage of pregnancy/*termination of pregnancy in respect of the registered
female manual worker.
Labour Officer(Social Security Scheme)

………………………..district
Name:
53
for Form- XV, the following Form shall be substituted namely:-
FORM-XV
[See Clause 24(1)]
APPLICATION FOR REIMBURSEMENT OF COST ON PURCHASE OF
SPECTACLES BY THE REGISTERED MANUAL WORKER
To
…………………….district

(b)Date of last renewal indicating the
3.Address(in full)with PIN Code :
4.Date of purchase of spectacles and its actual cost :
5.Whether certificate issued by a registered
Opthalmist is enclosed in original? :
6.Whether cash bill is enclosed in original? :


hereby agree to refund in full, the amount reimbursement towards purchase of spectacles for
myself.
I also hereby declare that I have not received similar benefits by claim in any other Welfare
Board or Boards constituted by the Government of Tamil Nadu or under any other Government
schemes.
Place:
Date :
Signature/thumb impression of the
registered female manual worker.
CERTIFICATE*
I hereby certify that the particulars furnished in the application from are correct.
Place:
Date : Members, ……………………Tamil Nadu
………………………………..Welfare Board/
President/Secretary of the Registered Trade Union of the
Employment concerned/Assistant Inspector
of Labour concerned/Any other officer permitted
*Any false declaration/Certification will entail legal action.
54
______________________________________________________________________
SANCTION
I hereby sanction, after due verification, the reimbursement of a sum of Rs………………./-

(Rupees ……………………………………..only) to Selvi/Thiru/Tmt……………………… ,
towards the actual cost on purchase of spectacles for himself/herself.
Office Seal:
Labour officer (Social Security Scheme)
…………….district.
Received from Thiru/Tmt/Selvi……………………………………….registered manual

worker(Registration Number…………………..) application for reimbursement of cost on
purchase of spectacles for himself/herself.
Labour Officer(Social Security Scheme)

………………………..district with date
Name:

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TAMIL NADU COOKING FOOD WORKERS SOCIAL SECURITY

AND WELFARE SCHEME 2015

2. Definitions.- In this Scheme, unless the context otherwise requires:-

(a) ―Act‖ means the Tamil Nadu Manual Workers (Regulation of

6. Chief Executive Officer of the Board, etc., to be public servants.—The Chief

(a) Employer of any manual worker

** G.O.(Ms) No.78,Labour and Employment (I1) Dept, Dt.15th May 2015.

10. Suspension and cancellation of membership.— (1) The Labour Officer(Social

11. Maintenance of registers.—(1) Every employer shall maintain a Register of

(e) Permanent partial disablement as At the rate the specified in the

1. Loss of toes All 20

1[“(2-A) In case of disablement due to accident, the registered manual

1 Inserted by G.O.Ms.No.64,Labour and Employment (I1) Dept, Dt.01.03.2016

23. Assistance for delivery or miscarriage of pregnancy or the termination of pregnancy

1 substituted by G.O.Ms.No.230, Labour and Employment Department, dated 01.12.2016

2.Name of the Father/Husband :

Name and address ** Nominee’s Relationship Age of the

**Nominees shall be Dependant Family Members.

Signature/Thumb impression of the manual worker

1 Substituted by G.O.Ms.No.151,Labour and Employment (I1) Dept, Dt.12.07.2016

Signature or left hand thumb impression of the manual worker.

***Any false declaration/certification will entail legal action

Certified that the particulars furnished by Thiru/Thirumathi/Selvi……………………………

Signature and name of the person/

***Any false declaration/certification will entail legal action

Labour Officer (Social Security Scheme)

SCHEME ASSISTANCES OF THE BOARD

1 vide G.O.(D) No.230, Labour and Employment Department dt.01.12.2016

Registration should be renewed before ...................................................

1 Substituted by G.O.Ms.No.151,Labour and Employment (I1) Dept, Dt.12.07.2016

Signature of the Worker Signature of the Officer

Details of Scheme Assistance provided to the worker

Sl. No. Name of the 1 [Name of File No. Amount Signature of

1 substituted by G.O.Ms.No.122, Labour and Employment (I1), 24 th October 2008.

Date of Renewal Receipt No. and Next Renewal Signature of the

 The Registering individual should have completed 18 years of age and

G. 133, Chinthamani Co-operative Commercial Complex,

[See Clause 11 (1)]

1. Name and address of the Employer :

2. Name of the establishment :

Name Registration Nature of Wages Total Employers’ Particulars of

(1) (2) (3) (4) (5) (6) (7)

[See Clause 11 (4)]

1 Substituted by G.O.Ms.No.151,Labour and Employment (I1) Dept, Dt.12.07.2016

[See Clause 13 (3)]

1. Name and address :

2. Name of the establishment :

[See Clause 17 (3) (a) ]

ACCIDENT INTIMATION FORM

The Labour Officer (Social Security Scheme),

The Inspector / Sub-Inspector of Police,

Thiru / Thirumathi/Selvi/Selvan ……………………………… son of / wife of /

daughter of ……………………………………………………..employed in the work

place……………………………………………………………. has suffered loss of limbs

/ loss of eye-sight/total disablement/partial injury/ 1[“death due to accident occurred on

the ………….. (date) at ……………. (time)”.]

(Signature of the Employer)

Signature of the Worker/Nominee/