1 条
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:
性別
Sex
住所
Address
従事する業務の種類
Type of work in which the worker is engaged
雇入の年月日
Date of hiring
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 retirement (including its reason in the case where the cause of the retirement is dismissal)
死亡の年月日及びその原因
Date and cause of death
常時三十人未満の労働者を使用する事業においては、前項第三号に掲げる事項を記入することを要しない。
A workplace which regularly employs less than 30 workers shall not be required to enter items listed in item (iii) of the preceding paragraph into the roster.