Form No.

6A
(For Unexempted Establishments only)
The Employees' Provident Funds Scheme, 1952 (Para 35 & 42)
The Employees' Pension Scheme, 1995 (Para 19)
Annual Statement of Contribution for the Currency Period From 19.01.2011 to 02/2011
Name & Address of the Factory /Establishments: Executive Engineer, Phulbani (R&B) Division
Statutory rate of Contribution _______12%_____________________________________________
Voluntary Higher rate of employee's contribution if any___NA_____________________________
Code No. of the Establishment- OR/BAM/1849
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
1 1 SANTOSH KUMAR SAHU 9226 339 768
2 2 LAXMIDHAR BAGARTY 9226 339 768
3 3 RABINDRA KUMAR SATAPATHY 9226 339 768
4 4 AMULYA KUMAR RATH 9226 339 768
5 5 SANTOSH KUMAR MISHRA 9226 339 768
6 6 RAMAKANTA SAHU 9226 339 768
7 7 S K BOAKHARI 9226 339 768
8 8 UMASANKAR BISWAL 9226 339 768
9 9 CHANDRA KANTA NAIK 9226 339 768
10 10 MANARANJAN MAHAPATRA 9226 339 768
11 11 SRINIBAS BARIK 9226 339 768
12 12 SRIKANTA KUMAR SAHOO 9226 339 768
13 13 RANJAN KUMAR SASAMAL 9226 339 768
14 14 BHAGIRATHI SAHOO 9226 339 768
15 15 UMESH CHANDRA SATAPATHY 9226 339 768
16 16 JAYADEV ROWLO 9226 339 768
17 17 SAHADEB SENAPATI 9226 339 768
18 18 NAROTTAM KONHAR 9226 339 768
19 19 GADADHAR SETHI 9226 339 768
20 21 MD SAMIM AKHTAR 9226 339 768
21 22 NALINI KUMARI PATRA 9226 339 768
22 23 GHANASYAM MAHARANA 9226 339 768
23 24 PRASANNA KUMAR PATTNAYAK 9226 339 768
24 25 KAMAL KUMARI BEHERA 9226 339 768
25 26 ASHOK KUMAR TRIPATHY 9226 339 768
26 27 BHIKARI PRADHAN 9226 339 768
27 28 CHAMARU SAHU 9226 339 768
28 29 SURENDRA MUKHI 9226 339 768
29 30 JAMBESWAR DIGAL 9226 339 768
30 31 UPENDRA GURU 9226 339 768
31 32 SADASIV NAG 9226 339 768
32 33 SRIBATSA NAIK 9226 339 768
33 34 SANTOSH BEHERA 9226 339 768
34 35 CHAKRADHARA BEHERA 9226 339 768
35 36 AMIN DIGAL 9226 339 768
36 37 AKUR PRADHAN 9226 339 768
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
37 38 SUKAMUNI BEHERA 9226 339 768
38 39 TARINI CHARAN NAYAK 9226 339 768
39 40 UMACHARAN PRADHAN 9226 339 768
40 41 BISWAMBAR PRADHAN 9226 339 768
41 42 MADHUSUDAN CHAND 9226 339 768
42 43 BENUDHAR PRADHAN 9226 339 768
43 44 APARTI DEHURY 9226 339 768
44 45 RUSHI KANHAR 9226 339 768
45 46 SHANKARSHAN PRADHAN 9226 339 768
46 47 GOBARDHAN MALLICK 9226 339 768
47 48 DILLIP KUMAR RAJAHANSA 9226 339 768
48 49 PRAMOD KUMAR HOTA 9226 339 768
49 50 BANAMALI KANHAR 9226 339 768
50 51 SUDHANTA BURGI 9226 339 768
51 52 SAMBARU NAIK 9226 339 768
52 53 SARASWATA BEHERA 9226 339 768
53 54 HARIBANDHU BEHERA 9226 339 768
54 55 GOPAL KRISHNA PRADHAN 9226 339 768
55 56 BHASKAR SAHU 9226 339 768
56 57 BRAHMA NAIK 9226 339 768
57 58 BHAGABANA BAGHA 9226 339 768
58 59 BHAGABATI BISHOI 9226 339 768
59 60 SIBA BAGH 9226 339 768
60 61 RAIDHAR BEHERA 9226 339 768
61 62 BHABINDRA KANHAR 9226 339 768
62 63 SHYAM BAGARTI 9226 339 768
63 64 SANJAYA KUMAR NAYAK 9226 339 768
64 65 PURNACHANDRA PANIGRAHI 9226 339 768
65 66 RAMACHANDRA BEHERA 9226 339 768
66 67 ANGADA BEHERA 9226 339 768
67 68 CHITRASEN NAIK 9226 339 768
68 69 SURESH KUMAR PRADHAN 9226 339 768
69 70 AMAR KUMAR NAYAK 9226 339 768
70 71 DUTIA MAHAKUD 9226 339 768
71 72 BASYANANDA PRADHAN 9226 339 768
72 73 ASWASTHAMA DEHURI 9226 339 768
73 74 DHANESHWAR PRADHAN 9226 339 768
74 75 RABINDRA BEHERA 9226 339 768
75 76 DHARANIDHAR KANHAR 9226 339 768
76 77 JALANDHAR SANDA 9226 339 768
77 78 RAMESH KANHAR 9226 339 768
78 79 PRADESI BAGHA 9226 339 768
79 80 MADHUSUDAN BEHERA 9226 339 768
80 81 GOREKHA DEEPA 9226 339 768
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
81 82 JALANDHAR BEHERA 9226 339 768
82 83 PREMANANDA BHOI 9226 339 768
83 84 NOROTTAM BAGARTY 9226 339 768
84 85 SUKURIA PRADHAN 9226 339 768
85 86 BIJAY KUMAR GOUDA 9226 339 768
86 87 SABAJAN KANHAR 9226 339 768
87 88 LAMBODAR BAGH 9226 339 768
88 91 MRUTUNJAYA SATAPATHY 9226 339 768
89 92 NARENDRA BAGH 9226 339 768
90 93 KRUSHNA CHANDRA BEHERA 9226 339 768
91 94 PHADRI BEHERA 9226 339 768
92 95 HARESH SINGH 9226 339 768
93 96 MOHAN PRADHAN 9226 339 768
94 97 MANOJ KUMAR KANHAR 9226 339 768
95 98 UPENDRA BEHERA 9226 339 768
96 99 BIJAYA KUMAR NAIK 9226 339 768
97 100 CHITARAJAN PATTNAIK 9226 339 768
98 101 SUBASACHANDRA SAHU 9226 339 768
99 102 AGASTI KUMAR BEHERA 9226 339 768
TOTAL 913374 33561 76032

Signature of the Employer with Seal

 Form No. 6A
(For Unexempted Establishments only)
The Employees' Provident Funds Scheme, 1952 (Para 35 & 42)
The Employees' Pension Scheme, 1995 (Para 19)
Annual Statement of Contribution for the Currency Period From 03/2011 to 02/2012
Name & Address of the Factory /Establishments: Executive Engineer, Phulbani (R&B) Division
Statutory rate of Contribution _______12%_____________________________________________
Voluntary Higher rate of employee's contribution if any___NA_____________________________
Code No. of the Establishment- OR/BAM/1849
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
1 1 SANTOSH KUMAR SAHU 78000 2868 6492
2 2 LAXMIDHAR BAGARTY 78000 2868 6492
3 3 RABINDRA KUMAR SATAPATHY 78000 2868 6492
4 4 AMULYA KUMAR RATH 78000 2868 6492
5 5 SANTOSH KUMAR MISHRA 78000 2868 6492
6 6 RAMAKANTA SAHU 78000 2868 6492
7 7 S K BOAKHARI 78000 2868 6492
8 8 UMASANKAR BISWAL 78000 2868 6492
9 9 CHANDRA KANTA NAIK 78000 2868 6492
10 10 MANARANJAN MAHAPATRA 78000 2868 6492
11 11 SRINIBAS BARIK 78000 2868 6492
12 12 SRIKANTA KUMAR SAHOO 78000 2868 6492
13 13 RANJAN KUMAR SASAMAL 78000 2868 6492
14 14 BHAGIRATHI SAHOO 78000 2868 6492
15 15 UMESH CHANDRA SATAPATHY 78000 2868 6492
16 16 JAYADEV ROWLO 78000 2868 6492
17 17 SAHADEB SENAPATI 78000 2868 6492
18 18 NAROTTAM KONHAR 78000 2868 6492
19 19 GADADHAR SETHI 78000 2868 6492
20 20 SANTOSH KUMAR SAHU 14677 540 1222
21 21 MD SAMIM AKHTAR 78000 2868 6492
22 22 NALINI KUMARI PATRA 78000 2868 6492
23 23 GHANASYAM MAHARANA 78000 2868 6492
24 24 PRASANNA KUMAR PATTNAYAK 78000 2868 6492
25 25 KAMAL KUMARI BEHERA 78000 2868 6492
26 26 ASHOK KUMAR TRIPATHY 78000 2868 6492
27 27 BHIKARI PRADHAN 78000 2868 6492
28 28 CHAMARU SAHU 78000 2868 6492
29 29 SURENDRA MUKHI 19500 717 1623
30 30 JAMBESWAR DIGAL 78000 2868 6492
31 31 UPENDRA GURU 78000 2868 6492
32 32 SADASIV NAG 78000 2868 6492
33 33 SRIBATSA NAIK 78000 2868 6492
34 34 SANTOSH BEHERA 78000 2868 6492
35 35 CHAKRADHARA BEHERA 78000 2868 6492
36 36 AMIN DIGAL 78000 2868 6492
37 37 AKUR PRADHAN 78000 2868 6492
38 38 SUKAMUNI BEHERA 78000 2868 6492
39 39 TARINI CHARAN NAYAK 78000 2868 6492
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
40 40 UMACHARAN PRADHAN 78000 2868 6492
41 41 BISWAMBAR PRADHAN 78000 2868 6492
42 42 MADHUSUDAN CHAND 19500 717 1623
43 43 BENUDHAR PRADHAN 78000 2868 6492
44 44 APARTI DEHURY 78000 2868 6492
45 45 RUSHI KANHAR 78000 2868 6492
46 46 SHANKARSHAN PRADHAN 78000 2868 6492
47 47 GOBARDHAN MALLICK 78000 2868 6492
48 48 DILLIP KUMAR RAJAHANSA 78000 2868 6492
49 49 PRAMOD KUMAR HOTA 78000 2868 6492
50 50 BANAMALI KANHAR 78000 2868 6492
51 51 SUDHANTA BURGI 78000 2868 6492
52 52 SAMBARU NAIK 78000 2868 6492
53 53 SARASWATA BEHERA 78000 2868 6492
54 54 HARIBANDHU BEHERA 78000 2868 6492
55 55 GOPAL KRISHNA PRADHAN 78000 2868 6492
56 56 BHASKAR SAHU 78000 2868 6492
57 57 BRAHMA NAIK 78000 2868 6492
58 58 BHAGABANA BAGHA 78000 2868 6492
59 59 BHAGABATI BISHOI 78000 2868 6492
60 60 SIBA BAGH 78000 2868 6492
61 61 RAIDHAR BEHERA 78000 2868 6492
62 62 BHABINDRA KANHAR 78000 2868 6492
63 63 SHYAM BAGARTI 78000 2868 6492
64 64 SANJAYA KUMAR NAYAK 78000 2868 6492
65 65 PURNACHANDRA PANIGRAHI 78000 2868 6492
66 66 RAMACHANDRA BEHERA 78000 2868 6492
67 67 ANGADA BEHERA 78000 2868 6492
68 68 CHITRASEN NAIK 78000 2868 6492
69 69 SURESH KUMAR PRADHAN 78000 2868 6492
70 70 AMAR KUMAR NAYAK 78000 2868 6492
71 71 DUTIA MAHAKUD 78000 2868 6492
72 72 BASYANANDA PRADHAN 78000 2868 6492
73 73 ASWASTHAMA DEHURI 78000 2868 6492
74 74 DHANESHWAR PRADHAN 78000 2868 6492
75 75 RABINDRA BEHERA 78000 2868 6492
76 76 DHARANIDHAR KANHAR 78000 2868 6492
77 77 JALANDHAR SANDA 78000 2868 6492
78 78 RAMESH KANHAR 78000 2868 6492
79 79 PRADESI BAGHA 78000 2868 6492
80 80 MADHUSUDAN BEHERA 78000 2868 6492
81 81 GOREKHA DEEPA 78000 2868 6492
82 82 JALANDHAR BEHERA 78000 2868 6492
83 83 PREMANANDA BHOI 78000 2868 6492
84 84 NOROTTAM BAGARTY 78000 2868 6492
85 85 SUKURIA PRADHAN 78000 2868 6492
86 86 BIJAY KUMAR GOUDA 78000 2868 6492
SL NO PF NO NAME WAGES EE (12%) ER (3.67%) EPS (8.33%)
87 87 SABAJAN KANHAR 78000 2868 6492
88 88 LAMBODAR BAGH 78000 2868 6492
89 89 MANOHAR MALLICK 46129 1696 3839
90 90 GANESWAR NAIK 46129 1696 3839
91 91 MRUTUNJAYA SATAPATHY 78000 2868 6492
92 92 NARENDRA BAGH 78000 2868 6492
93 93 KRUSHNA CHANDRA BEHERA 78000 2868 6492
94 94 PHADRI BEHERA 78000 2868 6492
95 95 HARESH SINGH 78000 2868 6492
96 96 MOHAN PRADHAN 78000 2868 6492
97 97 MANOJ KUMAR KANHAR 78000 2868 6492
98 98 UPENDRA BEHERA 78000 2868 6492
99 99 BIJAYA KUMAR NAIK 78000 2868 6492
100 100 CHITARAJAN PATTNAIK 78000 2868 6492
101 101 SUBASACHANDRA SAHU 78000 2868 6492
102 102 AGASTI KUMAR BEHERA 78000 2868 6492
103 103 CHANDRABATI MOHANTY 46129 1696 3839
TOTAL 7758064 285258 645709

Signature of the Employer with Seal