Employer Registration Number (ERN)
Business Registration Number (BRN)
CONTACT PERSON DETAILS
National Identity Card Number
Mobile Phone No.
Total Wage Bill for all Employees for March 2020
Wage assistance Amount (Rs) applied for
Number of Employees under the scheme
The Eligible Employers will benefit assistance from the Government as per the table below
For every employee with basic salary in March 2020
Assistance per employee(Rs)
From 9,700 to Rs 25,000
From Rs 4,850 to Rs 12,500
From Rs 25,000 to Rs 50,000
Above Rs 50,000
Capacity in which acting
I declare that:
(i) financial support is required for payment of March 2020 wages to employees.
(ii) all the information submitted is true and complete.
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