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Form for filing financial statement and other documents with the Registrar

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....igures appearing in the e-Form should be entered in Absolute Rupees only. Figures should not be rounded off in any other unit like hundreds, thousands, lakhs, millions or crores SEGMENT- I: GENERAL INFORMATION OF THE COMPANY AND PARTICULARS IN RESPECT OF BALANCE SHEET Part A - General information of the Company 1 (a) *Corporate Identity Number (CIN) (b) Authorised capital of the company as on the date of filing (c) Number of members of the company as on the date of filing 2 (a) *Name of the company (b) *Address of the registered office of the company (c) *e-mail ID of the company 3 Financial year to which financial statements relates *From (DD/MM/YYYY) *To (DD/MM/YYYY) 4 (a) *Date of Board of directors' meeting in which financial statements are approved (DD/MM/YYYY) (b) (i) *Nature of financial statements (Provisional un-adopted Financial statements/Adopted Financial statements/Revised Financial statements u/s 130/Revised Financial statements u/s 131) (ii) Nature of revision (Financial statement/Directors' Report/Both) (iii) Whether provisional financial statements filed earlier C Not applicable No Yes (iv) Whether adopted in adjourned AGM No Not applicabl....

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....on number (d) *Name of the auditor or auditor's firm (e) Address of the auditor or auditor's firm * Address Line 1 Address Line 2 *Country *Pin Code/Zip Code * Area/Locality *City *District *State/UT (f) Details of the member signing for the above firm (i) Name of the member (ii) Membership number General Information and Other Applicant Details 10 (a) *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) (Commercial & Industrial/Banking Company/Insurance Company/Power Company/Non-banking Financial Company (NBFC) registered with RBI) (b) *Whether Schedule III of the Companies Act, 2013 is applicable Yes No 11 *Whether consolidated financial statements required or not Yes No 12 (a) *Whether company is maintaining books of account and other relevant books and papers in electronic form Yes No (b) Complete Postal Address of the Place of maintenance of computer servers (Storing Accounting Data) 134 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II-SEC. 3(i)] Address Line 1 Address Line 2 Country Pin Code/Zip Code Area/Locality City District State/ UT (c) Particulars o....

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....) 8 Out of above total, aggregate amount guaranteed by directors 136 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II-SEC. 3(i)] B Details of short-term borrowings (unsecured) ParticularsCurrent reporting periodPrevious reporting periodReason for change in pre-filled figures of previous reporting period 1 Loans repayable on demand a From banks b From other parties 2 Loans and advances from related parties 3 Deposits 4 Other loans and advances Total short-term borrowings (unsecured) 5 Out of above total, aggregate amount guaranteed by directors C Details of long-term loans and advances (unsecured, considered good) ParticularsCurrent reporting periodPrevious reporting periodReason for change in pre-filled figures of previous reporting period 1 Capital advances 2 Loans and advances to other related parties 3 Other loans and advances Total long term loan and advances 4 Less: Provision/ allowance for bad and doubtful loans and advances a From related parties b From others 5 Net long term loan and advances (unsecured, considered good) 6 Loans and advances due by directors/ other officers of the company D Details of long-term loans and advances (doubtful) ParticularsCurrent reportin....

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....RY [PART II-SEC. 3(i)] 27Forfeited shares reissued 28Borrowing from foreign institutional agencies 29Borrowing from foreign companies 30Inter-corporate borrowings -secured 31Inter-corporate borrowings -unsecured 32Commercial Paper 33Conversion of warrants into equity shares during the reporting period 34Conversion of warrants into preference shares during the reporting period 35Conversion of warrants into debentures during the reporting period 36Warrants issued during the reporting period (In foreign currency) 37Warrants issued during the reporting period (In Rupees) 38Default in payment of short-term borrowings and interest thereon 39Default in payment of long-term borrowings and interest thereon 40Whether any operating lease has been converted to financial lease or vice-versa Yes C No Provide details of such conversions 41Net Worth of the company 42Number of shareholders to whom shares allotted under private placement during the reporting period 43Secured Loan 44Gross Property Plant and Equipment and Intangible Assets 45Depreciation and amortization 46Miscellaneous expenditure to the extent not written off or adjusted 47Unhedged Foreign Exchange Exposure IV Share capital raise....

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....ORDINARY [PART II-SEC. 3(i)] (iii) Sale or supply of services Export turnover (i) Sale of goods manufactured (ii) Sale of goods traded (iii) Sale or supply of services (II)Other Income (i) Dividend income (ii) Interest income (iii) Net gain/loss on sale of investments (iv) Other non-operating income (net of expenses directly attributable to such income) (III)Total Income (I+II) (IV)Expenses (a) Cost of materials consumed (b) Purchases of stock in trade (c) Changes in inventories of -Finished goods -Work-in-progress -Stock in trade (d) Employee benefit expenses (e) Managerial remuneration (f) Payment to Auditors (g) Insurance expenses (h) Power and fuel (i) Finance costs (j) Depreciation and amortization expenses (k) Other expenses Total expenses (V)Profit before exceptional and extraordinary items and tax (III-IV) (VI)Exceptional items (VII)Profit before extraordinary items and tax (V-VI) (VIII)Extraordinary items (IX) Profit before tax (VII-VIII) (X) Tax Expense (i) Current tax (ii) Deferred tax (XI) Profit/(Loss) for the period from continuing operations (IX-X) (XII) Profit /(Loss) from discontinuing operations (XIII) Tax expense of discontinuing operations (XIV) Profit/ (Loss)....

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....ervice (in Rupees) Note - Please refer to 'Indian Trade Classification' based on harmonized commodity description and coding system issues by the ministry of Commerce & Industry for Product Codes and National Product Classification for Services (NPCS) for Services codes issued by Ministry of Statistics & Programme Implementation, Government of India. SEGMENT III: DISCLOSURE ABOUT RELATED PARTY TRANSACTIONS No Yes 1 *Whether any transactions entered with related party? SEGMENT IV: AUDITOR'S REPORT I (a) In case of a government company, whether Comptroller and Auditor-General of India (CAG of India) has commented upon or supplemented the audit report under section 143 of the Companies Act, 2013 Yes Not applicable C No (b) If yes, provide following details :- S. No.Provide details of comment(s) or supplement(s) received from CAG of IndiaBoard of Director's reply(ies) on comments received from CAG of India I II (c) Whether Comptroller and Auditor-General of India has conducted supplementary or test audit under section 143 Yes No II Whether the auditors have reported as to whether company had provided requisite disclosures in its financial statements as to holdings....

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....th. I further declare that: 1 Whatever is stated in this form and in the attachments thereto is true, correct and complete and no information material to the subject matter of this form has been suppressed or concealed and is as per the original records maintained by the company. 144 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II-SEC. 3(i)] 2 All the required attachments have been completely and legibly attached to this form. *To be digitally signed by DSC BOX *Designation (Director/Manager/Secretary/CEO/CFO/Interim Resolution Professional (IRP)/ Resolution Professional (RP)/Liquidator) *Director identification number of the director; or PAN of the manager or CEO or CFO or Interim Resolution Professional (IRP) or Resolution Professional (RP) or Liquidator; or Membership number of the secretary Certificate by Practicing Professional I declare that I have been duly engaged for the purpose of certification of this form. It is hereby certified that I have gone through the provisions of the Companies Act, 2013 and Rules thereunder for the subject matter of this form and matters incidental thereto and I have verified the above particulars (including attachment(s)) from the ori....

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....rt A - General information of the Company 1 (a) SRN of form AOC-4 filed by the company for its standalone financial statements (b) *Corporate Identity Number (CIN) 2 (a) *Name of the company (b) *Address of the registered office of the company (c) *e-mail ID of the company 3 (a) Financial year to which financial statements relates *From (DD/MM/YYYY) *To (DD/MM/YYYY) (b)(i) *Nature of consolidated financial statements (Provisional un-adopted consolidated Financial statements/Adopted consolidated Financial statements/Revised consolidated Financial statements u/s 130/Revised consolidated Financial statements u/s 131) (ii) Nature of revision Directors' Report Consolidated financial statement Both (iii) Whether provisional consolidated financial statements filed earlier No Yes Not applicable 146 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II-SEC. 3(i)] (iv) Whether adopted in adjourned AGM No Not applicable Yes (v) Date of adjourned AGM in which consolidated financial statements were adopted (DD/MM/YYYY) (vi) SRN of form INC-28 (vii) SRN of form AOC-4 CFS (viii) Date of order of competent authority (DD/MM/YYYY) AGM details 4 (a) * Whether annual gen....

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....A : EXTRAORDINARY [PART II-SEC. 3(i)] Part B - Consolidated Balance Sheet PART I - CONSOLIDATED BALANCE SHEET ParticularsFigures as at the end of (Current reporting period)(in Rs.)Figures as at the end of (Previous reporting period) (in Rs.) (DD/MM/YYYY)Reason for change in pre-filled figures of previous reporting period (DD/MM/YYYY) IEQUITY AND LIABILITIES (1)Shareholders' Funds (a) Share capital (b) Reserves and surplus (c) Money received against share warrants (d) Minority Interest (2)Share application money pending allotment (3)Non - current liabilities (a) Long-term borrowings (b) Deferred tax liabilities (net) (c) Other long-term liabilities (d) Long-term provisions (4)Current liabilities (a) Short-term borrowings (b) Trade payables (i) Total outstanding dues of micro enterprises and small enterprises (ii) Total outstanding dues of creditors other than micro enterprises and small enterprises (c) Other current liabilities (d) Short-term provisions Total IIASSETS 1Non-current assets (a) Property, Plant and Equipment and Intangible assets (i) Property, Plant and Equipment (ii) Intangible assets (iii) Capital work - in- progress (iv) Intangible assets under development (b) No....

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.... : Provision/ allowance for bad and doubtful loans and advances -From related parties -From others Net long-term loans and advances (doubtful) Loans and advances due by directors/ other officers of the companies E Details of trade receivables ParticularsCurrent reporting periodPrevious reporting periodReason for change in pre-filled figures of previous reporting period Secured, considered good Unsecured, considered good Doubtful Total trade receivables Less: provision/ allowance for bad and doubtful debts 151 [भाग II-खण्ड 3(i)] भारत का राजपत्र : असाधारण Net trade receivables Debt due by (directors/ others officers of the companies) III Financial parameters - Balance sheet items (Amount in Rupees) as on financial year end date 1Amount of issue for contracts without payment received in cash during reporting period 2Share application money given 3Share application money given during the reporting period 4Share application money received during the reporting period 5Share application money received and due for refund 6Paid-up capital held by....

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....iod (Previous reporting period)Reason for change in pre- filled figures of previous reporting period FromFrom (DD/MM/YYYY)(DD/MM/YYYY) ToTo (DD/MM/YYYY)(DD/MM/YYYY) (I)Revenue from operations Domestic turnover (i) Sale of goods manufactured (ii) Sale of goods traded (iii) Sale or supply of services Export turnover (i) Sale of goods manufactured (ii) Sale of goods traded (iii) Sale or supply of services (II)Other Income (i) Dividend income (ii) Interest income (iii) Net gain/loss on sale of investments (iv) Other non-operating income (net of expenses directly attributable to such income) (III)Total Income (I+II) (IV)Expenses Cost of materials consumed Purchases of stock in trade Changes in inventories of - Finished goods - Work-in-progress - Stock in trade Employee benefit expenses Managerial remuneration Payment to Auditors Insurance expenses Power and fuel Finance costs Depreciation and Changes in inventories of - Finished goods - Work-in-progress - Stock in trade 153 [भाग II-खण्ड 3(i)] भारत का राजपत्र : असाधारण amortization expenses ....

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....tor-General of India (CAG of India) has commented upon or supplemented the audit report under section 143 of the Companies Act, 2013 No Not applicable Yes (b) If yes, provide following details :- S. No.Provide details of comment(s) or supplement(s) received from CAG of IndiaBoard of Director's reply(ies) on comments received from CAG of India I II 155 [भाग II-खण्ड 3(i)] भारत का राजपत्र : असाधारण (c) Whether Comptroller and Auditor-General of India has conducted supplementary or test audit under section 143 C )No SEGMENT IV: MISCELLANEOUS 1 *Whether the Secretarial Audit is applicable Yes C )No 2 Whether secretarial audit report has been qualified or has any observation or other remarks Yes No 3 Number of observations made 4 Provide details of secretarial qualifications or observations or other remarks in secretarial audit report 5 Details of signatories of secretarial audit report (a) Category of secretarial auditor (b) Name of secretarial audit firm (c) Firms registration number of secretarial audit firm (d) Membership number of s....

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....orm and matters incidental thereto and I have verified the above particulars (including attachment(s)) from the original/certified records maintained by the Company/applicant which is subject matter of this form and found them to be true, correct and complete and no information material to this form has been suppressed. I further certify that: 1 The said records have been properly prepared, signed by the required officers of the Company and maintained as per the relevant provisions of the Companies Act, 2013 and were found to be in order. 2 All the required attachments have been completely and legibly attached to this form. 3 It is understood that I shall be liable for action under Section 448 of the Companies Act, 2013 for wrong certification, if any found at any stage. * To be digitally signed by DSC BOX Chartered accountant (in whole-time practice) or C )Cost accountant (in whole-time practice) or O Company secretary (in whole-time practice) *Whether associate or fellow: Fellow C Associate Membership number Certificate of practice number Submit Save 157 [भाग II-खण्ड 3(i)] भारत का रà¤....

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....f filing SEGMENT-I: INFORMATION AND PARTICULARS IN RESPECT OF BALANCE SHEET Part A I. General information of the company 1. (a) *Corporate identity number (CIN) of company (b) Global location number (GLN) of 2. (a) Name of the company (b) Address of the registered office of the company (c) *e-mail id of the company Pre-fill company 3. * Financial year to which financial statements relates From (DD/MM/YYYY) Taxmanagementindia.com (DD/MM/YYYY) 4. (a) *Date of Board of Directors' meeting in which financial statements are approved (b) (i) *Nature of financial statements (ii) Nature of revision o Financial statement o Directors' Report o Both (iii) Whether provisional financial statements filed earlier o Yes o No o Not applicable (iv) Whether adopted in adjourned AGM o Yes o No o Not applicable (v) Date of adjourned AGM in which financial statements were adopted (vi) SRN of form INC-28 (vii) SRN of form AOC-4 (viii) Date of order of competent authority (DD/MM/YYYY) (DD/MM/YYYY) (c) Details of director(s), manager, secretary, CEO, CFO of the company who have signed the financial statements Provide Director Identification number (DIN) in case of director and....

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....ete Postal Address of the Place of maintenance of computer servers (Storing Accounting Data) *Line I Line II *City *State/Union Territory *District *ISO Country code Country *Phone (with STD/ISD code) (c) Particulars of the service provider (if any) (i) Name of the service provider *Pin code Fax Taxmanagementindia.com (ii) Internet protocol address of service provider (iii) Location of the service provider (iv) Whether books of account and other books and papers are maintained on cloud o Yes o No Address as provided by the service provider I. Balance Sheet Particulars I. (1) (2) (3) (4) EQUITY AND LIABILITIES Shareholders' funds (a) Share capital (b) Reserves and surplus (c) Money received against share warrants Share application money allotment Non-current liabilities (a) Long-term borrowings (b) Deferred tax liabilities (net) (c) Other long term liabilities (d) Long term provisions Current liabilities (a) Short-term borrowings (b) Trade payables (c) Other current liabilities (d) Short-term provisions TOTAL pending Part-B Figures as at the end of (Current reporting period) (in Rs.) Figures as the end of (Previous reporting period) ....

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.... advances due by directors/ other officers of the company E. Details of trade receivables Particulars Taxmanagementindia.com Current reporting period Previous reporting period six Exceeding six months Within six months Secured, considered good Unsecured, considered good Exceeding six Within months months Doubtful Total trade receivables 0.00 0.00 0.00 0.00 Less: provision/ allowance for bad and doubtful debts Net trade receivables 0.00 0.00 0.00 0.00 Debt due by (directors/others officers of the company III. *Financial parameters - Balance sheet items (Amount in Rupees) as on financial year end date 1 Amount of issue for contracts without payment received in cash during reporting period 2 Share application money given 3 Share application money given during the reporting period 4 5 6 Share application money received during the reporting period Share application money received and due for refund Paid-up capital held by foreign company % 7 Paid-up capital held by foreign holding and/ or through its subsidiaries % 8 9 Number of shares bought back during the reporting period Deposits accepted or renewed during the reporting period 10....

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....apital raised during the reporting period Equity shares 0.00 Preference shares Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 V. *Details of Specified Bank Notes (SBN) held and transacted during the period from 8th November, 2016 to 30th December, 2016 as provided in the Table below :- Particulars Closing cash in hand as on 08.11.2016 (+) Permitted receipts (-) Permitted payments (-) Amount deposited in Banks SBNs Other denomination notes Total Closing cash in hand as on 30.12.2016 VI. Details related to cost records and cost audit 1. *Whether maintenance of cost records by the company has been mandated under Companies (Cost Records and Audit) Rules, 2014 o Yes o No If yes, Central Excise Tariff Act Heading in which the product/ service is covered 2. If yes, Central Excise Tariff Act Heading in which the product/ service is covered Taxmanagementindia.com SEGMENT II: INFORMATION AND PARTICULARS IN RESPECT OF PROFIT AND LOSS ACCOUNT I. Statement of Profit and Loss Particulars (I) Revenue from operations Domestic turnover (i) Sale of goods manufactured (ii) Sale of goods traded (iii) Sale or supply of services Export turnove....

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....2 Earnings per share (in Rupees) Basic % 3 Income in foreign currency 4 Expenditure in foreign currency Diluted 56 7 8 9 Revenue subsidies or grants received from government authority(ies) Rent paid Consumption of stores and spare parts Gross value of the transaction with the related parties as per AS-18 (if applicable) Bad debts of related parties as per AS-18 (if applicable) IV. Details related to principal products or services of the company Total number of product/ services category(ies) 1 Product or service category code (ITC/NPCS 4 digit code) Taxmanagementindia.com Description of the product or service category Turnover of the product or service category (in Rupees) Highest turnover contributing product or service code (ITC/NPCS 8 digit code) Description of the product or service Turnover of highest contributing product or service (in Rupees) Note - Please refer to 'Indian Trade Classification' based on harmonized commodity description and coding system issues by the ministry of Commerce & Industry for Product Codes and National Product Classification for Services (NPCS) for Services codes issued by Ministry of Statistics & Programme Implement....

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....te of approval Amount paid by the Board advances, if any Nature transactions of contracts/ arrangements/ as Date on which the resolution was passed in general meeting as required under first proviso to section 188 2. Number of material contracts or arrangement or transactions at arm's length basis Name(s) of the related party Nature of relationship Taxmanagementindia.com Nature transactions of contracts/ arrangements/ Duration of the contracts / arrangements/ Date of approval by Amount paid as advances, if any transactions the Board Segment V: Auditor's Report I. (a) In case of a government company, whether Comptroller and Auditor-General of India (CAG of India) has commented S. No. upon or supplemented the audit report under section 143 of the Companies Act, 2013 (b) If yes, provide following details:- o Yes o No Provide details of comment(s) or supplement(s) Board of Director's reply(ies) on comments received from CAG of India received from CAG of India I II (c) Whether Comptroller and Auditor-General of India has conducted supplementary or test audit under section 143 o Yes o No II. *Whether the auditors have reported as to whether company ha....

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....section 134 Attach 13. Details of remaining CSR activities Attach 14. Optional attachment(s), if any Attach Remove Attachment Declaration *dated to sign this I am authorized by the Board of Directors of the Company vide *resolution number form and declare that all the requirements of Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters incidental thereto have been complied with. I further declare that: 1. Whatever is stated in this form and in the attachments thereto is true, correct and complete and no information material to the subject matter of this form has been suppressed or concealed and is as per the original records maintained by the company. 2. All the required attachments have been completely and legibly attached to this form. *To be digitally signed by DSC *Designation *Director identification number of the director; or PAN of the manager or CEO or CFO; or Membership number of the secretary Taxmanagementindia.com Certificate by Practicing professional I declare that I have been duly engaged for the purpose of certification of this form. It is hereby certified that I have gone through the pr....