Items to be entered into a roster of workers (Form No. 19) under paragraph (1) of Article 107 of the Act shall be those listed as follows in addition to those provided by the same paragraph of the same Article:
Sex
性別
Address
住所
Type of work in which the worker is engaged
従事する業務の種類
Date of hiring
雇入の年月日
Date and cause of retirement (including its reason in the case where the cause of the retirement is dismissal)
退職の年月日及びその事由（退職の事由が解雇の場合にあつては、その理由を含む。）
Date and cause of death
死亡の年月日及びその原因