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Form for filing Profit and Loss account and other documents with the Registrar

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....d not be rounded off in any other unit like hundreds, thousands, lakhs, millions or crores. Authorised capital of the company as on the date of filing (in) Number of members of the company as on the date of filing Part A I. General information of the company Pre-Fill 1(a) *Corporate identity number (CIN) of company (b) Global location number (GLN) of company 2(a) Name of the company (b) Address of the registered office of the company (DD/MM/YYYY) 3(a) *Period of profit and loss account From (DD/MM/YYYY) To (b) *Date of signing of report on the annual accounts by the auditors (DD/MM/YYYY) No 4. (a) *Whether schedule VI of the Companies Act, 1956 is applicable Yes (b) *Type of Industry Note: In case the type of industry is other than Banking or Power or Insurance or NBFC, then select Commercial and Industrial (C&I). Page 13 of 54 Part - B I. STATEMENT OF PROFIT AND LOSS (As per Schedule VI to the Companies Act, 1956 applicable for the financial year commencing on or after 1.4.2011) Particulars Figures for the period (Current reporting period) (in ') Figures for the period (Previous reporting period) (in ') ....

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.... fuel Depreciation and amortization Other expenditure Total expenditure Net Profit or Net Loss (before tax and appropiation) Income tax including deferred tax Note 1: Raw material consumed is to be given as per following calculation - Opening stock of raw materials + purchases of raw materials - closing stock of raw materials Note 2: Purchases made for re-sale is to be given as per following calculation - Opening stock of goods traded + purchases of goods traded - closing stock of goods traded Note 3: Consumption of stores and spare parts to be given as per following calculation- Opening stock of stores and spares + purchases of stores and spares - closing stock of store and spares Page 16 of 54 n. Il. Detailed Profit and Loss items (Amount in ') (Applicable in case of Revised Schedule VI- that is for . . financial year commencing on or after 01.04.2011) A. Details of earning in foreign exchange 1 Particulars Current reporting period Previous reporting period Export of goods calculated on FOB basis Interest and dividend Royalty Know-how Professional & consultation fees Other income Total Earning in Foreign Exchange B. D....

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....aries as per section 212 Attach 3. Optional attachment(s) - if any Attach Remove attachment Verification I confirm that all the particulars mentioned above are as per the attached profit and loss account and other documents, all of which are duly signed and authenticated as required under the provisions of the Companies Act, 1956. To the best of my knowledge and belief, the information given in the form and its attachments is correct and complete. I have been authorised by the Board of directors' resolution number * dated* (DD/MM/YYYY) to sign and submit this form. To be digitally signed by Managing Director or director or manager or secretary of the company *Designation *Director identification number of the director or Managing Director; or Income-tax permanent account number (income-tax PAN) of the manager; or Membership number, if applicable or income-tax PAN of the secretary (secretary of a company who is not a member of ICSI, may quote his/ her income-tax PAN) Certificate It is hereby certified that I have verified the above particulars (including attachment(s)) from the records of and found them to be true and correct. I further cert....

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....ered tax Note 1: Raw material consumed is to be given as per following calculation - Opening stock of raw materials + purchases of raw materials - closing stock of raw materials Note 2: Purchases made for re-sale is to be given as per following calculation - Opening stock of goods traded + purchases of goods traded - closing stock of goods traded Note 3: Consumption of stores and spare parts to be given as per following calculation- Opening stock of stores and spares + purchases of stores and spares - closing stock of store and spares Page 2 of 4 II. Financial parameters - Profit and loss account items (Amount in Rs. thousands) per cent 1. Proposed Dividend 2. Earning per share (in Rs) Basic Diluted 3. Income in foreign currency 4. Expenditure in foreign currency 5. Revenue subsidies or grants recieved from government authority(s) 6. Rent 7. Gross value of the transaction with the related parties as per AS-18 (if applicable) 8. Bad debts of related parties as per AS-18 (if applicable) III. Turnover details of three principal products or services of the company (as per monetary terms) (i) Indian trade classification (ITC) code ....