Forms XIII-A explained: this guide covers what it means, who it applies to, the step-by-step process, documents required, fees, due dates and penalties in India — so you can stay compliant with confidence and avoid costly mistakes.
Three forms in the Schedule to the Central Rules deal with enforcement of maternity benefit. Form-XIII-A is the complaint to the Inspector-cum-Facilitator; Form-XIII-B is the appeal against the Inspector's decision; and Form-XIV is the abstract of Chapter VI and the Rules that the employer must exhibit.
A woman, or a person claiming that a payment was improperly withheld, complains in writing in Form-XIII-A to the Inspector-cum-Facilitator, who must pass an order immediately but not exceeding forty-five days (rule 39(1)). An aggrieved person appeals in Form-XIII-B; the Form-XIV abstract gives thirty days from communication of the decision. The employer must exhibit Form-XIV (rule 40(4)) and supply Forms X, XI, XII, XIII-A and XIII-B without charge on request (rule 40(2)).
Where the forms come from
Rule 39 is headed "Complaint before Inspector-cum-Facilitator and appeal"; rule 40 sets out the Inspector-cum-Facilitator's duties. See rules 39 and 40 and, on the Code side, sections 71 and 72. The Central Rules apply where the Central Government is the appropriate Government; State-sphere employers follow State rules. If you want to build a complaint-handling and notice-board routine, our employment and labour law advisory team can help.
| Form | Rule | Who | Purpose |
|---|---|---|---|
| XIII-A | 39(1)(a) | Woman employee, nominee or legal representative | Complaint to the Inspector-cum-Facilitator |
| XIII-B | 39(2)(b) | Aggrieved person (woman, her heir or representative, or employer) | Appeal |
| XIV | 40(4) | Employer | Abstract of Chapter VI and the Central Rules, to be exhibited |
Form-XIII-A: the complaint
What it says as printed. It is addressed to the Inspector-cum-Facilitator under the Code. The woman employee (or a person nominated under section 62, or her legal representative) states that, having fulfilled the conditions of the Code and the rules, she is entitled to stated amounts of maternity benefit, medical bonus and/or wages for leave under section 65, but that the amount has been improperly withheld by the employer, or that she has been discharged or dismissed during or on account of absence from work. She asks the Inspector to direct the employer to pay and/or to set aside the discharge or dismissal. It carries place, date, signature or thumb impression, an attester's signature if she cannot sign, and full address.
Handling under rule 39(1). On receipt, the Inspector-cum-Facilitator examines the employer's records, examines any person employed in the establishment and takes down statements. If satisfied that maternity benefit or any amount has been improperly withheld or that the woman has been discharged or dismissed, he directs the employer to pay the complainant or the person claiming under section 63 and passes such order as he deems fit, immediately but not exceeding forty-five days. The Form-XIV abstract adds that the Inspector may act on his own motion too.
Form-XIII-B: the appeal
What it says as printed. It is addressed to the Appellate Authority appointed under the Code and is an appeal under section 72(3) by the woman employee, her legal heir or representative, or the employer or his representative, aggrieved by an order of the Inspector-cum-Facilitator. It has two alternative limbs: (1) the order under section 72(2) denied the maternity benefit or other amount or refused to set aside a discharge or dismissal; or (2) the woman is not entitled to the benefit or was rightly discharged or dismissed, so the Inspector's order should be set aside. It is signed by the woman or aggrieved person or employer with an attester's signature if needed.
Rule 39(2). An appeal against the Inspector-cum-Facilitator's decision lies to the competent authority, in writing in Form-XIII-B with supporting documents. The authority calls for the record, may record statements of the aggrieved person and of the Inspector, and decides within three months of receipt, extendable for reasons recorded in writing by up to three more months.
Time to appeal. The Form-XIV abstract (para 9(3)) says an aggrieved person may appeal within thirty days from the date the decision is communicated, in Form-XIII-B, to the Authority prescribed by the appropriate Government, and that the decision of the Authority, or of the Inspector if no appeal is made, is final. Rule 39 itself does not repeat the thirty days, so cite the abstract for the period and check your appropriate Government's notification for the appellate authority.
Form-XIV: the abstract
Form-XIV is titled "Abstract for the Maternity Benefit, and the rules made under the Code on Social Security, 2020". Under rule 40(4), the abstract required to be exhibited under section 71 is in Form-XIV and is exhibited in the manner the competent authority requires. The abstract's eleven paragraphs cover:
| Para | Subject |
|---|---|
| 1 | No knowing employment during the six weeks after delivery, miscarriage or MTP; no work by the woman in that period |
| 2 | On her request, no arduous work, long standing or work likely to interfere with pregnancy in the month before the six weeks and any period of those six weeks not taken as leave |
| 3 | Eligibility after not less than eighty days of actual work in the establishment (including lay-off days); benefit at average daily wages, the minimum wage under the Code on Wages, 2019, or two hundred rupees a day, whichever is higher; pre-delivery amount paid in advance on Form-X; balance within forty-eight hours of Form-X or a birth register extract |
| 4 | Notice in Form-XI; date of absence not earlier than six weeks before expected delivery; late notice allowed after delivery |
| 5 | Medical bonus of rupees three thousand and five hundred if no pre-natal, confinement and post-natal care is provided by the employer at no charge; leave with wages for six weeks after miscarriage or MTP; up to one month for illness, with wages paid within 48 hours |
| 6 | Two nursing breaks of fifteen minutes until the child is fifteen months; extra travel time up to fifteen minutes |
| 7 | No discharge or dismissal during or on account of absence; deprivation only for listed acts; appeal in Form-XII within sixty days |
| 8 | Forfeiture if she works elsewhere after being permitted leave |
| 9 | Complaint in Form-XIII-A; Inspector's inquiry and direction; appeal within thirty days in Form-XIII-B; decision final |
| 10 | Copies, without charge, of Forms X, XI, XII, XIII-A and XIII-B; a wrong form does not defeat the right, and the authority may within fifteen days ask for the correct form |
| 11 | Register of women employees in Form-XXII; annual return in Form-XXIII by 28th or 29th February |
The money figures above are quoted as printed in the abstract. Do not apply them to a State-sphere establishment without checking the State's rules.
Practical notes. Display the abstract at a place where women employees can read it; the rule leaves the manner to the competent authority. Keep spare copies of the forms at HR to hand out on request. A complaint filed on the wrong form is not lost: the authority has fifteen days to ask for the right form.
Example. A woman is told her medical bonus will not be paid. She gives a complaint in Form-XIII-A to the Inspector-cum-Facilitator stating the bonus amount. The Inspector examines the records, hears employees and orders payment within the forty-five-day ceiling. The employer may appeal in Form-XIII-B within thirty days of communication of the decision.
Need help with complaints or the abstract?
A complaint is easiest to close when registers, payments and the notice board are in order. Our employment and labour law advisory team can help you prepare a forms pack and a response protocol.
Key takeaways
- Form-XIII-A is the complaint; the Inspector-cum-Facilitator orders payment immediately but within forty-five days.
- Form-XIII-B is the appeal; the abstract gives thirty days from communication; the competent authority decides within three months (extendable by three).
- Form-XIV is the abstract the employer must exhibit.
- Forms X, XI, XII, XIII-A and XIII-B are supplied without charge on request.
- State-sphere employers follow State rules.
Read next
- Rules 39 and 40: complaint before the Inspector-cum-Facilitator
- Forms X, XI and XII: certificate, receipt and appeal
- Employer obligations under maternity benefit
- Maternity benefit under the new labour codes
Disclaimer: Based on the Code on Social Security, 2020 (as enacted) and, where noted, the Code on Social Security (Central) Rules, 2026 (G.S.R. 344(E), 8 May 2026), as on 30 September 2026. The Code is in force from 21 November 2025; some provisions may be notified later, and State Governments make their own rules for establishments where the State is the appropriate Government. Verify the current position before acting.