THE FACTORIES ACT,1948 
FORM 34 
(Prescribed under Rule 125) 
 
ANNUAL RETURN 
 
For the year ending 31st December: _________________________________________________________ 
 
1. Registration Number of Factory: _________________________________________________________ 
2. Name of Factory:   _________________________________________________________ 
3. Name of Occupier:  _________________________________________________________ 
4. Name of the Manager:  _________________________________________________________ 
5. District:    _________________________________________________________ 
6. Full postal address of Factory: _________________________________________________________ 
7. Name of Industry:  _________________________________________________________ 
Number of workers and particulars of employment 
8. Number of days worked in the year:  ___________________________________________ 
9. Number of  Mandays worked during the year: ___________________________________________ 
(a) Men  ___________________________ 
(b) Women  ___________________________ 
(c) Children  ___________________________ 
10. Average number of workers employed daily (see explanatory note) 
 
(a) Adults (i) Men:  ______________________ 
  (ii) Women:  ______________________ 
(b) Adolescents (i) Male:  ______________________ 
  (ii) Female  ______________________ 
(c) Children (i) Boys:  ______________________ 
  (ii) Girls:   ______________________ 

11. Total number of man-hours worked including over-time 
(a) Men  ___________________________ 
(b) Women  ___________________________ 
(c) Children  ___________________________ 
12. Average number of hours worked per week (See explanatory note) 
(a) Men  ___________________________ 
(b) Women  ___________________________ 
(c) Children  ___________________________ 
13. (a) Does the factory carry out any process or operation declared as dangerous under Section 87? (See 
Rule 120) 
1. If so, give the following information:- 
 
Name of the dangerous processes or operation  Average number of persons employed daily in each of 
carried on  the processes or operation given in column 1 
1.   2.  
(i) 
(ii)   
(iii) etc. 

Leave with Wages 
 
14. Total number of workers employed during the year. 
(a) Men  ___________________________ 
(b) Women  ___________________________ 
(c) Children  ___________________________ 
15. Number of workers who were entitled to annual leave with wages during the year 
(a) Men  ___________________________ 
(b) Women  ___________________________ 
(c) Children  ___________________________ 
16. Number of workers who were granted leave during the year. 
(d) Men  ___________________________ 
(e) Women  ___________________________ 
(f) Children  ___________________________ 
17. (a) Number of workers who were discharged, or dismissed from the service or quit employment, or 
were superannuated, or who died while in service during the year: _____________________ 
(b) Number of such workers in respect of whom wages in lieu of leave were paid: ______________ 
 
Safety Officers 
18. (a) Number of Safety Officers required to be appointed as per Notification under Section 40-B______ 
(b) Number of Safety Officer appointed: ___________________________________________ 
 
Ambulance Room 

19. Is there an Ambulance Room provided in the factory as required in Section45? _____________________ 
20. (a) Is there a Canteen provided in the factory as required under Section 46? _____________________ 
(b) Is the Canteen provided managed/run 
(i) Departmentally, or _________________ 
(ii) Through a contractor? _________________ 
 
Shelters or Rest Rooms and Lunch Rooms 
21. (a) Are there adequate and suitable Shelters or Rest Rooms provided in the factory as required under 
Section 47? _____________________ 
(b) Are there adequate and suitable Lunch Rooms provided in the factory as required under Section 
47? _____________________ 
Crèches 

22. Is there a Crèche provided in the factory as required under Section 48*  _____________________ 
 
Welfare Officers 
23. (a) Number of Welfare Officers to be appointed as required under Section-49 ______________ 
(b) Number of Welfare Officers to be appointed as required under Section 49 ______________ 
Accidents 
 
24. (a) total number of accidents (See explanatory note) 
(i) Fatal     _____________________ 
(ii) Non-Fatal    _____________________ 
(b) Accidents in which workers returned to work during the year to which this return relates: 
(i) Accidents (workers injured) occurring during the year in which injured workers returned 
to work during the same year; 
(aa) Number of accidents  _____________________ 
(bb) Mandays lost due to accidents _____________________ 
(ii) Accidents (workers injured) occurring in the previous year in which injured workers 
returned to work during the year to which this return relates. 
aa) Number of accidents  _____________________ 
(bb) Mandays lost due to accidents _____________________ 
 
(c) Accidents (workers injured) occurring during the year in which injured workers did not  return to 
work during the year to which this returns relates: 
 
(i) Number of accidents   _____________________ 
(ii) Mandays lost due to accidents  _____________________ 
 
Suggestion Scheme 
 
25. (a) Is a Suggestion Scheme in operation in the factory _____________________ 
(b) If so, the number of suggestion   _____________________ 
(i) Received during the year   _____________________ 
(ii) Accepted during the year   _____________________ 
(c) Amount awarded in cash prizes during the year 
(i) Total amount awarded   _____________________ 
(ii) Value of the maximum cash prize awarded _____________________ 
(iii) Value of the minimum cash prize awarded _____________________ 
 
Certified that the information furnished above is, to the best of my knowledge and belief, correct. 
 
Signature of the Manager 
 
Date: 
 
*The term “ordinarily employed” as used in Section 48 of the Factories Act,1948 would mean “Total number of 
persons employed in all shifts. This should be over 50% of the number of Working days in the. establishment” 

 
THIS RETURNS SHOULD BE SENT TO THE PRESCRIBED STATE AUTHORITY BY 31ST JANUARY 
OF THE SUCCEEDING YEAR 
 
Explanatory Notes: 
1. The average number of workers employed daily should be calculated by dividing the aggregate number of 
attendances, attendance by temporary as well as permanent employed should be counted, and all employees 
(including apprentices) should be included, whether they are employed directly or under contractors. 
Attendance on separate shifts (e.g. night and day shifts) should be counted separately. Days on which the 
factory was closed for whatever cause, and day on which the manufacturing processes were not carried on 
should not be treated as working days. However if more than 40% of workers employed (on previous day) 
attend to repair maintenance or other such work on closed days, such days should be treated as working 
days, Partial attendance for less than half a shift on a working day should be ignored, while attendance for 
half a shift or more on such day should be treated as full attendance. 

2. For seasonal factories, the average number of workers employed during the working season and the off 
season should be given separately. Similarly the number of days worked and average number of man hours 
worked per week during the working and off season  should be given separately. 
3. The average number of hours worked per week means the total actual hours worked by all workers during 
the year excluding the rest intervals what including overtime work divided by the product of average 
number of workers employed daily in the factory during the year and . In case the factory has not worked 
for the whole year, the number of weeks during which the factory worked should be used in place of the 
figure 52. 
4. Every person killed or injured should be treated as one separate accident. If in one occurrence 6 persons 
were injured or killed it should be counted as six accidents. 
5. In item 24 (a), the number of accident s which took place during the year should be given. In case of non 
fatal accident only those accidents which prevented workers from working from 48 hours or more , 
immediately following the accidents should be indicated. 
6. In item.8, the information may be furnished as the number of days the factory worked during the year. 
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