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ent of India
Programme Implementation
tere under in 20!! Annual Survey of Industries 20!"#20!$ %Part &I'
ons (efore filling te return )
CONFIDENTIAL
Block A: Identification particulars (for official use)
!) Scedule *espatc %*S+' o)
2) PS+ o)
-) Sceme code %Census-1, Sample-2'
") Industry code as per frame %4-digit level of NIC-2008'
$) Industry code as per return %5-digit level of NIC-2008'
.) *escription of Industry/
) State Code
8) *istrict Code
1) Sector % Rural-1, r!an-2'
!0) R 3SR code
!!) o) of 4nits
!2) Status of 4nit %Code'
Block B: Particulars of te factor! (to "e filled "! o#ner of te factor!)
!) ame and address of te Industrial underta5ing/ !)! 6ill)37on/
!)2 *istrict name/
!)- State name/
!)" PI Code
2) 7ype of organisation %"ode'
-) 7ype of onersip %"ode'") 9eter te unit as IS Certification, !"000 Series
% es-1, no-2)
$) :ear of initial production
.) Accounting year %))))))))))) to $$$$$$$$$$$$' to
) um(er of monts of operation
8) *oes your unit ave computerised accounting system; % #es-1, no-2'
1) Can your unit supply ASI data in computer media; % #es-1, no-2'
!0) *etails of contact person i' ame < designation/
ii' 7ele %it S7* code'
iii' =A> no)
iv' ?#mailDECLA$ATION
I ere(y declare tat information furnised in tis return is correct and complete to te (est of my 5noledge
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%!' %2' %-' %"' %$' %.' %'
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Place /
D%L No P%L No
Block C: FI&ED A%%ET%
Sl) o)
7ype of Assets Gross value %Rs)'
penin gas on# # # #
Addition during te year *eduction< ad@ustment
during teyear
Closing ason
# # # #%cols) -"$#
.'
(*ue to revaluation Actual additions
+and
Building
Plant <Maciner
7ransport
euipmentComputereuipmentincluding softare
Pollution controleuipment3?nvironmentimprovementeuipment
ters
%u"'total (ites to *)
Capital or5 in progress
Total(ites +,-,.)
D%L No P%L No
Block D: /O$0IN1 CAPITAL AND LOAN%Sl) o) Items pening %Rs)'
Ra Materials < Components and Pac5ing materials
=uels < +u(ricants
Spares, Stores < oters
%u"'total (ites + to 2)
Semi#finised goods3or5 in progress
=inised goods
Total in3entor! ( ites 4 to 5)
Cas in Dand < at Ban5
Sundry *e(torster current assets
Total current assets (ites * to +6)
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!2)
!-)
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!$)
!.)!)
! 2 - " $
!)
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.)
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+47
%!' %2' %-'
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2)
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Sundry Creditors
ver draft, cas credit, oter sort term loan from (an5s < oter financialinstitutions
ter current lia(ilities
Total current lia"ilities (ites + to +4)
/orkin8 Capital (ite ++'ite +9)utstanding loans %eEcluding interest (ut including deposits'FF
Note%& 'ive reasons in t(e footnote for negative values and a!normal verifi"ation in opening and "losing values$&& If outstanding loans in"lude interest, a footnote ma# !e given
D%L No P%L No
Block E: E;PLO
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$)
.)
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!2)
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!0)
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%!' %2' %-' %"'
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.)
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1)
!0)!!) 1120!00
et (alance of goods sold in te same condition as purcased)%item !! of (loc5 G minus item !! of (loc5 ='
Rent received for plant < macinery and oter fiEedassets
Total receipts (+ to 5)
Rent received for (uildings
Rent received for land on lease or royalties on mines,uarries and similar assets
Interest received
Sale value of goods sold in te same condition asurcased
ter Production su(sidies
Block F : OTE$ E&PEN%E%
Sl) o)
Items ?Ependiture %inRs)'
9or5 done (y oters on materials supplied (y te industrial
underta5ingRepair < maintenance of
%i' Buildings and oter construction
%ii' ter fiEed assets
perating eEpenses
?Epenses on ra materials and oter components for on construction
Insurance carges
Rent paid for plant < macinery and oter fiEed assets
Total epenses (+ to 5)
Rent paid for (uildings
Rent paid for land on lease or royalties on mines, uarries and similarassets
Interest paid
Purcase value of goods sold in te same condition as purcased
D%L No P%L No
Block : Indi8enous input ites consued (if needed? additional seets a! "e used for recordin8 inpu
Sl) o)
Item description Item code %PC#MS' 4nit of uantity uantity co
Ma@or ten (asic items %indigenous'
ter (asic items %indigenous'F
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!2) ...6+66
!-) 1120-00
!") 1110800
!$) 1110"00
!.) 1110$00
!) 1110.00
!8) 111000
!1 1110100
20) 1120"00
2!) 1122000
22) 1112000
2-) ...2666
2")
%!' %2' %-' %"' %$'
!)
2)
-)
")
$).) 1122!00
) ...4666
%!' %2' %-' %"' %$' %.' %' %8'
!)
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.)
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1)
!0)
!!) 112!!00
!2) ...9666
!-)
Total "asic ites (ites + to ++)
on#(asic cemicals & all 5inds
Pac5ing items
?lectricity on generated H9D
?lectricity purcased < consumed H9D
Petrol, diesel, oil, lu(ricants consumed
Coal consumed 7onne
Gas consumed HG
ter fuel consumed
Consuma(le store
7otal non#(asic items %items !- to 2!'
Total inputs (ites +, )
Any additional reuirement of electricity%unmet demand'
H9D
F =ull description of items not in PC#MS 20!!/
D%L No P%L No
Block I: Iported input ites consued ' directl! onl! (if needed? additional seets a! "e used for recordi
Sl) o)
Item description %Ma@or fiveimported items'
Item code %PC#MS' 4nit of uantity uantity consumed
ter imported items
Total iports (consued)(ites + to 5)
Block : Products and "!'products anufactured "! te unit (if needed? additional seets a! "e used for r
Sl) o)
Products3By# productsdescription %=irst tenma@or items as per value #no (rand name'
Item code%PC# MS'
4nit ofuantity
uantitymanu#
factured
uantitysold
Gross salevalue %Rs'%including
su(sidyreceived'
*istri(ut
?Eciseduty
ter products3 (y#roductsF
Total ( ites + to ++)
Sare %' of products3(y#products directly eEported
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!)
2)
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$)
.)
)
!)
2)
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!) $)
2) .)
-) )
") 8)
F =ull descri tion of items not in PC#MS 20!!/
D%L No
D%L No P%L No
Block 0: Inforation and Counication tecnolo8! (ICT) usa8e
%l7 No7 ICT indicator yes-1, no-2
*id te factory use computer3s during =: 20!"# !$;
*id te factory use te Internet during =: 20!"# !$;
*oes te factory ave a e( site as on te date of survey;
*id te factory receive orders via te Internet during =:20!"#!$;
*id te factory place orders for (usiness purpose via teInternet during =: 20!"#!$;
*id te factory connect to te Internet eiter (ya) arro(and or () =iEed (road(and or (y c) Mo(ile
(road(and during =: 20!"#!$ ;
*oes te factory ave a local area netor5 %+A' ason te date of survey;
Block L: Ener8! Conser3ation (EC) easures
%l7 No7 EC indicator yes-1, no-2
a3e an! easures "een taken durin8 lastfinancial !ear #it re8ard to:
?lectrical saving;
Coal saving;
il saving;
Gas saving;
FO$ OFFICIAL =%E ONL<
Block ;: Particulars of field operations ame of Superintending fficer *ate of receipt fro
Signature of Superintending fficer *ate of verificatio
ame < *esignation of Scrutinising fficer *ate%s' of scrutiny
Signature of Scrutinising fficer *ate of despatc
Block N: Coents of %uperintendin8 Officer%crutinisin8 Officer
Note% Reasons for negative or*ing "apital and for an# a!normal values or entries +(ig( or lo) in respe"t toor*ing "apital, age rate, num!er of or*ers, distri!utive e.penses, depre"iation et"$) s(ould !e given invar"ould !e in"reased demandprodu"tion, profit, govt$ su!sid# or for lo ', t(e reasons "ould !e de"reased(ig( input "ost et"$ similarl# reasons for an# a!normal values of "ertain important ratios eg$ Ratio of output te.penses to output et" s(ould !e given$
Please refer to detailed instructions also for further guidance.
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!
2
"
Annual %ur3e! of Industries 6+4'6+9Part A
Report of scrutiny on Part#I of te returnState %code' *istt) %code' *S+ o)3PS+ o) Ind) code %$#digitreturn Sceme Code
Sl) o) Bl) no) Item 4nit Average rate per unitF If i8 or lo#, reaso (y
D Input items %Indigenous' Ma@or 7en (asic items consumed
& & Superintendingfficer
!2'-'"'$'.8'
1'!0'!!' ?lectricity purcased!2' Coal
I *irectly imported items consumed%ma@or five items'
!2'-'"'$'
FAverage value per unit in nearest ole rupee is to (e reported)
-) Percentage yield of product from te (asic materials consumed %in case te uantity are common or directly converti(le
Ite Current !ear (6+4'+9) Pre3ious !ear (6+2'+4)
si
!' Average salaries3ages per manday or5ed %Rs)'%Bl ?/ item $, col) 8 3 item $, col) $'
2' 7otal or5er %num(er' %Bl) ?/ item $, col) .'
-' 7otal employees %num(er' %Bl)?/ item 1, col) .'
"' 7otal emoluments%Bl) ?/ item 1, col) 8 Bl) ?/ item !0, col) 8Bl) ?/ item !!, col) 8, Bl) ?/ item !2, col) 8 '
$' 6ariation in finised goods %Bl) */ item ., %col) " & col)-'
.' 9or5ing Capital%Bl) */ item !., col) "'
' Total input%Bl) =/ item , col)-'%'%Bl) D/ item 2-, col) .'%' %Bl) I/item , col) .'8' Total output%Bl) J/ item !2, col)'%#' %Bl) J/ item !2,col)!!'%Bl) */ item .'%col) "#col)-'%Bl) G/ item , col) -'
1' Gross value added %G6A' %Item 8#Item as a(ove'
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!)2)-)
")$)
.))
8)
1)
!0)
!!)
!2)
!-)
!)
Ite Current !ear (6+4'+9) Pre3ious !ear (6+2'+4)
si
!0' et value added%Item 1 as a(ove'#%*epreciation %Bl) C, item !0, col) 1'
!!' et Income%Item !0 as a(ove'%#' Bl) =/ items %81!0' under col)- %'Bl) G/ item %81!0' under col)-
!2' Profit%Item !! as a(ove'%#' %Bl) ?/ item 1, col) 8 Bl) ?/ item !0,col) 8 Bl) ?/ item !!, col) 8, Bl)?/ item !2, col) 8 '
!-' Actual addition to fiEed assets %Bl) C/ item !0, col)$'
!"' 1A (trou8 E'factor! alue)(Bl7 : ite +?col7+2)(,)(Bl7 1: ite - col7 2)(')(ite * as a"o3e)
97 Ipose ceck on te follo#in8 and 8i3e o"ser3ations a8ainst eac ite
%l7No7 Ceck points O"ser3at
9eter codes and identification particulars ave (een correctly furnised in Bloc5 A;9eter information for all te items in Bloc5 B ave (een correctly furnised;If te or5ing capital in item !. of Bloc5 * is negative eter reasons furnised in e footnote ofBloc5 * of te Return and also in Bloc5 along it code)
9eter te return as (een dul si ned ( oner it stam ;If ide variation is noticed (eteen pening < Closing value of 9or5ing Capital, eter reasonsfurnised in te footnote of Bloc5 * and also in Bloc5 along it code
9eter s ecial cec5 as (een made in case of ne ative G6A;9eter (asic entries ave (een torougly recec5ed ere output3input ratio Is less tan 0)$
9eter ratio of *istri(utive eEpenses to gross sales is reasona(le; If no, eter te relevantentries ave (een recec5ed particularly ere tis ratio eEceeds 20)
If te total Bonus is more tan 20 of total ages3salaries eter suita(le remar5s given in teReturn;
If sale value of goods sold in same condition as purcased %Item#!! of Bloc5 G' is less tan te purcase value of te same %Item#!! of Bloc5 =', eter reasons furnised in te return ;
9eter Balance Seet, Profit < +oss Account and 9or5ing Seet are attaced it te 3C of teReturn ;
9eter, te eE#factory value of output in column#!- of Bloc5 J ave (eencalculated correctly for eac of te !0 ma@or items of product and (y#product and also for item !! ;
9eter te entries in Bloc5s D < I are reported independently ;
Signature of te Superintending fficer % '
ame of te Superintending fficer
PA$T'B
(To "e filled in "! %crutiniGin8 officer)Impose cec5 on te folloing and give o(servations against eac item
%l7
No7
Ceck points O"ser3ations (
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2)
-)
")
$)
.)
)
8)
1)
!0)
!!)
9eter valid ne State Code as (een entered against item of Bloc5 KAL;
9eter Scedule *espatc no) as (een correctly filled in against item ! of Bloc5 A ;
State eter proper remar5s in Bloc5 for all important parameters suc as G6A,or5ing capital, age rate, num(er of or5ers, distri(utive eEpenses, depreciation etc)are given)
9eter average salaries3ages per manday or5ed %or5er' as (een cec5edcalculated correctly and are itin te reasona(le limits;
9eter special cec5 as (een made in case of negative G6A;
9eter (asic entries ave (een recec5ed ere output3Input ratio is less tan 0)$
9eter ratio of distri(utive eEpenses to gross sales is reasona(le; If no, eter te
relevant entries ave (een recec5ed particularly ere tis ratio eEceeds 20)
If total (onus eEceeds 20 of total salaries < ages, eter suita(le remar5s furnised;
9eter yield ratio of products from (asic materials consumed %in case te units ofuantity are common or directly converti(le' are correctly calculated and are itin prescri(ed limits ;
9eter data reported in te return ave (een cec5ed it Balance Seet and Profit <+oss Account ;
Signature of Scrutiniing officer % '
ame of Scrutiniing officer
IND=%T$IE% 6+4'6+9
%ENTEEI%; @ LABO=$ T=$NOE$
CONFIDENTIAL
Block +7 Identification and oter Particulars
!) Scedule *espatc o) !0) 7ype of rganisation %code'
2) PS+ o)
-. Sceme Code %census # !, sample # 2' !!) 7ype of onersip % code'
") Industry code as per frame (4-digit level of IC - !"# !2. Accounting :ear
$. Industry code as per return %$# digit level of IC # 08'
.) *escription of Industry !-) ame of Superintending fficer
. State code !") Personnel code
8) *istrict code !$. Deaduarter
1) R3SR code
ame and address of te Industrial 4nderta5ing
City3 7on3 6illage 7esil3 7alu5 *istrict S
Block ' Mandays or5ed, a(senteeism, la(our turnover for regular or5ers directly employed for eac mont of te year)
8/18/2019 ASIschedule_for_2014-15 (1).xlsx
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0 ! 2 - " $ . !)
2)
-
"
$
.
8
1
!0
!!
!2
Sl no) Mont Sceduled9or5ing daysfor 9or5ers
o of Mandays9or5ed
o ofMandays lost
due toa(sence
o of 9or5ers in employment on Accessionsduring te
Mont
=irst day ofmont
+ast day ofmont
Apr, 20!"
May, 20!"
June, 20!"
July, 20!"
Aug, 20!"
Sep, 20!"
ct, 20!"
ov, 20!"
*ec, 20!"
Jan, 20!$
=e(, 20!$
Mar, 20!$
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nd (elief) *ate /
8/18/2019 ASIschedule_for_2014-15 (1).xlsx
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%8' %1' %!0' %!!' %!2' %!-'
%"'
%ame and Signature of oner it stamp'
epreciation %Rs)' et value %Rs)'
p to yeareginning
Provi#ded
duringte year
Ad@ustment forsold3 discardedduring te year
4p to yearend
%cols) 81#!0'
pening ason
# # # # #%cols) -#
8'
Closing ason
# # # # # #%cols) #
!!'
Closing %Rs)'
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. 8
Average num(er of persons or5ed
o) of mandays paid for
9ages3 salaries%in Rs)'
entr! in col7 5 of ite 2 of "lock
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%$' %.' %'
ites #it serial nos7 startin8 fro 9)
nsumed Purcase value % in Rs)' Rate per unit %in Rs)'
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%.' %'
%1' %!0' %!!' %!2' %!-'
8 input ites #it serial nos7 startin8 fro -)
Purcase value %in Rs)' Rate per unit %in Rs)'
P%L No
cordin8 output ites #it serial nos7 startin8 fro +4)
ive eEpenses %Rs)' Per unit netsale value %Rs)
0)00'%col) # col)!!'
N col) .
?E#factory value ofuantity manufactured
including su(sidyreceived
%Rs)' %col)!2O col)$'
SalestaE36A7
ters 7otal
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factory
3compilation
important "(ara"teristi"s +Su"( as ',ia!l#$ /or instan"e t(e reasons for (ig( 'emandprodu"tion, "apa"it# under-utiliation,input, ratio of depre"iationdistri!utive
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IC 2008' as per
ns to (e furnised
Scrutinisingfficer
in ole num(er'
$easons for
nificant 3ariation?
if an!7
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$easons for
nificant 3ariation?
if an!7
ions (
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!.. Signature
!) ame of Scrutiniingfficer
!8) Personnel code
!17 Deaduarter
20. $ignature)
tate
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8 1
Separations during te mont dueto
*eat orretirement
ter causes