Proforma INSTRUCTIONS Please read these instruction before by niusheng11

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									                                                 INSTRUCTIONS


Please read these instruction before filling the Proforma.

 1   Form-C and enclosures thereof must be properly indexed and numbered. Further said indexing and
     numbering must be mentioned in the index forming part of Form-C.

 2   Form-C and enclosures thereof must be submitted in two hard copies and one soft copy in excel-2003
     format.

 3   Do not change the format except where specified specifically.

 4   Both the set of Form-C and enclosures submitted with AFRC Office should be sealed and signed in original by
     the management.

 5   Only Statutory Auditor can sign the Auditor’s Certificate in Form-C.

 6   Statutory Auditor certificate in Fom-C must be in original in both the set of Form-C submitted with AFRC
     Office.

 7   Statuary Auditor must seal and sign all the pages of Form-C forming part of it in original including index.

 8   Do not leave any item of Form-C blank.

 9   Furnish relevant information against each item. Furnishing improper information will be treated as non-
     furnishing of information.

 10 Audit Report of Institutions must be in the format specified in the Form-C. If Audit Report is not furnished in
    the specified format then said accounts will be treated as un-audited.

 11 Submit separate audit report for each course and Institution instead of submitting consolidated audit report
    of all the courses or Institutions.

 12 In case proper detail is not furnished in Salary Annexures or any item/detail is left blank then it may treated
    non-furnishing of information

 13 Last date of furnishing Audit Report of F.Y. 2009-10 along with required documents is 30.04.2010.
                                                             INDEX
S. Relevant Item No. of           Documents/Information Required            Whether    Chapter     From     For AFRC Office
No.     Proforma                                                            enclosed    Name     Page No.    Use (Remarks)
                                                                            (Yes/No)              to Page
                                                                                                    No.
 1   Item No. 7 of Form-C Audited Final Accounts of Course for the
                          period 01.04.09 to 31.03.10
 2   Item No. 9 of Form-C Salary and Staff Details as per Annexure-IB

 3   Item No.12(i) of Form- Working and basis of apportionment of
     C                      common expenses
 4   Item No.12(ii) of Form- Interest detail as per Annexure-IIA and
     C                       Annexure-IIB
 5   Item No.12(ii) of Form- Working and basis of apportionment of loan
     C                       and interest amount amongst different
                             Institution/Courses under one
                             Society/Institution

 6   Item No.12(v)(b) of      Either Audited Income & Expenditure of
     Form-C                   Hostel Accounts or detail as per Annexure -
                              III

 7   Item No.12(vi)(b) of     Either Audited Income & Expenditure of
     Form-C                   Mess Accounts or detail as per Annexure -
                              III

 8   Item No.12(vii)(b) of    Either Audited Income & Expenditure of
     Form-C                   Transportation Accounts or detail as per
                              Annexure - III

 9   Item No.12(viii)(b) of   Either Audited Income & Expenditure of
     Form-C                   Training & Placement Accounts or detail as
                              per Annexure - III

10 Item No.12(ix) of          Either Audited Income & Expenditure of
   Form-C                     Hospital/OPD/Clinic etc. Accounts or detail
                              as per Annexure - III

11 Item No.12(x) of Form-Either Audited Income & Expenditure of
   C                     Uniform Accounts or detail as per Annexure
                         - III

12 Item No.12(xi) of          Audited Income & Expenditure of University
   Form-C                     accounts if maintained separately or detail
                              as per Annexure - III.

13 Item No.12(xiv) of         Either Audited Income & Expenditure of
   Form-C                     Growth & Development Fund if maintained
                              separately or reasons for not maintaining
                              separate accounts.

14 Item No.13 of Form-C Fixed Assets schedule prepared in
                        accordance with the Companies Act as per
                        Annexure - IV.

15 Item No.15 of Form-C Copy of Final Accounts and Auditors Report
                        of F.Y. 2009-10 of Trust/Society
                                                                                                       For AFRC Office use only

                                                                                               AFRC File No.


                                                   Form - C (In two copies)
                               Proforma for additional information on……………( Course ) Of………………..
                                                               (Institute )
 1   Acknowledgment No. of Original Fees Proposal
 2   Name of the Trust / Society
 3   Name of the College / Institute
 4   Name of the Course
 5   Whether Institution has applied to Regulatory Authority        Yes/No (If Yes, enclose copy of relevant letter to Regulatory
     for Double Shift of the course                                 Authority)

 6   If the Institution has applied for Double Shift, furnish the
                                                                     2010-11    2011-12     2012-13      2013-14
     Projected Double Shift Sanctioned Intake capacity for
     first year of the course for the years mentioned herein-
     against
 7   Audited Financial Statements of the course                     Attach Audit Report along with Audited Final Accounts and all
                                                                    necessary schedules for each course separately for the F.Y. 2009-
                                                                    10

 8   Furnish comparative data of Audited Financial                  Furnish comparative data of Audited Final Accounts in the below
     Statements of the course                                       mentioned chart for the last two years i.e. 2007-08 and 2008-09
                                                                    along with for the period 01.04.2009 to 31.12.2009 and F.Y. 2009-
                                                                    10


                                                        …………………... INSTITUTION

                                                    ………………………….. COURSE

                                                 INCOME & EXPENDITURE ACCOUNT


 EXPENDITURE       2007-08     2008-09    01.04.09 to    2009-10           INCOME            2007-08      2008-09   01.04.09 to   2009-10
 (Heads as per                             31.12.09                 (Heads as per Audited                            31.12.09
Audited Income                                                           Income and
and Expenditure                                                     Expenditure Account)
   Account)




Surplus                                                             Deficit



TOTAL                                                               TOTAL
                                                         …………………... INSTITUTION

                                                     ………………………….. COURSE

                                                             BALANCE SHEET


  LIABILITIES      2007-08       2008-09   01.04.09 to    2009-10         ASSETS            2007-08    2008-09   01.04.09 to   2009-10
 (Heads as per                              31.12.09                (Heads as per Audited                         31.12.09
Audited Balance                                                        Balance Sheet)
     Sheet)




      TOTAL                                                                TOTAL



 9    Salary and Staff Details                                      Enclose details as per Annexure-IB and furnish
                                                                    following details.
 i.   Whether VIth Pay Commission Recommendations have Yes/No
      been implemented                                 If Yes, Date of Implementation…………………….
                                                       If No, Intended Date of
                                                       Implementation…………………….
10 Whether employees details for academic year 2009-10              Yes/No
   submitted to Regulatory Authority in the format                  If Yes, Please mention date of submission
   prescribed by the concern Regulatory Authority.

11 Whether any capital expenditure has been made out of Yes/No(If Yes, furnish the following details)
   fresh interest free funds brought in by the
   Institution/Society during 2009-10
        Head of Capital Expenditure          Amount of Capital       Source of Interest Free Funds     Total Amount of
                                               Expenditure                                             Funds Brought In




12 Financial Information for the year 2009-10


 i.   Give details of common expenses apportioned between different
      courses in the following format
        S.No.           Head of expenditure                Total Expenditure            Amount Apportioned between
                                                                                       Course…………. ...…….
                                                                               Course………….      Course     Course ...…….
                                                                                                                      Course ..
          1
          2
          3
      Note: Also enclose working and basis of apportionment of
      common expenses
  ii.    Interest paid/ provided on loans                                        Give details as per enclosed Annexure-IIA and
                                                                                 Annexure-IIB along with working and basis of
                                                                                 apportionment of loan and interest amount amongst
                                                                                 different Institution/Courses under one
                                                                                 Society/Institution


  iii.   Advertisement Expenses                                                  Furnish details as per following table:
                   S.No.     Particulars                                                                                    Amount
                    1            Faculty Recruitment
                    2            Counseling/admission of students for regular students
                    3            Counseling/admission of students for lateral students
                    4            Conference/ Seminar
                    5            Training and Placement
                    6            Others (Please specify each head individually)
                                 TOTAL (must match with audited Income and Expenditure figure)


iv.      Rent                                                                    Furnish details as per following table:
                    S.No.                                          Particulars
                    1            Paid for Building Premises allowed by Regulatory Body                                      Amount
                    2            Paid for Building Premises not so allowed by Regulatory Body
                    3            Paid for staff residence and not debited in salary head
                    4            Office Rent
                    5            Paid for Vehicle
                    6            Paid for Equipment
                    7            Others (Please specify)
                                 TOTAL (must match with audited Income and Expenditure figure)


v.(a) Whether Hostel Facility is available                                       Yes/No
         If yes, mention capacity                                                Boys
                                                                                 Girls
                                                                                 Total Capacity
 (b) Whether Hostel accounts maintained separately? (i.e. not clubbed
                                                                                 Yes/No/NA(If Yes,enclose Audited Income &
     with Audited Income & Expenditure furnished in response to item
                                                                                 Expenditure Account of the same and also furnish
     no. 45 above)
                                                                                 following details. If No, give details in annexure-III)
         No. of students using      Fees charged per student pa        Total Hostel Fees received           Total Expenses on Hostel
         Hostel facility




vi. (a) Whether Mess Facility is provided to Hostelers                           Yes/No

(b)      Whether Mess accounts maintained separately? (i.e not clubbed           Yes/No/NA (If yes, enclose audited Income and
         with Audited Income & Expenditure furnished in response to item         Expenditure Account of the same also furnish following
         no.45 above)                                                            details. If No, give details in Annexure-III)

         No.of students using       Fees charged per student pa        Total Mess Fees received              Total Expenses on Mess
         Mess facility


vii      Whether Transportation Facility is provided to students                 Yes/No
(a)
(b)    Whether Students Transportation accounts maintained separately? Yes/No/NA (If yes, enclose audited Income and
       (i.e not clubbed with Audited Income & Expenditure furnished in Expenditure Account of the same also furnish following
       response to item no.45 above)                                   details. If No, give details in Annexure-III)

       No. of students using     Fees charged per student pa         Total Transport Fees received     Total Expenses on Transport
       transport facility



       S.No.        Nature/Head of Transportation Expenses of Students                                                        Amount
       1            Diesel
       2            Bus hire charges
       3            Salary of Transport Staff
       4            Repairs & Maintenance
       5            Others (please specify)

viii        Whether Training & Placement Facility is provided to students                             Yes/No
(a)

(b)    Whether Training & Placement accounts maintained separately?            Yes/No/NA (If yes, enclose audited Income and
       (i.e not clubbed with Audited Income & Expenditure furnished in         Expenditure Account of the same also furnish following
       response to item no.45 above)                                           details. If No, give details in Annexure-III)

          Students using         Fees charged per student pa        Total Training & Placement Fees     Total Training & Placement
       Training & Placement                                                      received                        Expenses
               facility

       Studying       No. of
        in Year      students
           Ist
            IInd
            IIIrd
            Ivth

ix     Whether Hospital/OPD/Clinic etc. accounts maintained separately? Yes/No/NA (If yes, enclose audited Income and
       (i.e not clubbed with Audited Income & Expenditure furnished in  Expenditure Account of the same also furnish following
       response to item no.45 above)                                    details. If No, give details in Annexure-III)

           No. of years completed by the        Hospital/ OPD/ Clinic etc. Bed/ No. required as per   Hospital/ OPD/ Clinic etc. Bed/
                     Institution                            Regulatory Body Norms                        No. actually maintained


x      Whether Uniform accounts maintained separately? (i.e. not clubbed Yes/No/NA (If yes, enclose audited Income and
       with Audited Income & Expenditure furnished in response to item   Expenditure Account of the same also furnish following
       no. 45 above)                                                     details. If No, give details in Annexure-III)

       No. of students             Fees charged per student           Total Uniform Fees received        Total Uniform Expenses




xi     Whether University accounts maintained separately? (i.e. not            Yes/No/NA (If yes, enclose audited Income and
       clubbed with Audited Income & Expenditure furnished in response         Expenditure Account of the same also furnish following
       to item no. 45 above)                                                   details. If No, give details in Annexure-III)

       S.No.        Heads of University Fees                                               Total Fees Received    Total Fees Paid to
                                                                                                                      University

             1      Exam Fees
           2       Development Fees
           3       Student welfare Fees
           4       Others (please specify)
                   Total

xii    Whether any scholarship has been granted to students                  Yes/No
(a)
xii    If yes, the amount thereof and the head where it has been parked      Yes/No
(b)    in the Income and Expenditure Account.


xiii   Whether any amount has been spent on student welfare                  Yes/No (If Yes, furnish the following details)
       S.No.            Head where parked in Income and                      Nature of Expenditure                        Amount
                             Expenditure Account

           1       Insurance                                     Insurance of Students
           2                                                     Provision of medical facilities
           3                                                     Others (please specify)
                   Total

xiii   Whether any rebate on tution fees as fixed by the AFRC has been       Yes/No (If yes, furnish following details)
(a)    granted to students to promote admission in the Institution


   a   Give brief description of the said rebate as follows
  b      No.of students to      Discounted Fees        Fees fixed by AFRC Total Rebate in tuition     Head where parked in Income
        whom rebate given      charged per student                                fees                  and Expenditure Account



   c   Explain who is going to bear burden of said rebate on fees


xiii   Whether any promotional/gift scheme as mentioned hereunder has Yes/No (If yes, furnish following details)
(b)    been offered to students during any time of their study period by
       the Institution whether free of cost or at subsidized rates



                Nature of scheme             Head where parked in Income      Cost of said scheme      No. of Who is to bear cost of
                                              and Expenditure Account or                              students   said scheme
                                                    Balance Sheet                                     availing
                                                                                                        said
                                                                                                      scheme

  a    Laptop
  b    Abroad Tour
   c   Compute / Software Course
  d    SAP/ERP Course
  e    Others (please specify each item
       individually)


xiv    Whether Growth and Development Fund accounts maintained               Yes/No/NA (If yes, enclose audited Income and
       separately? (i.e. not clubbed with Audited Income & Expenditure       Expenditure Account of the same also furnish following
       furnished in response to item no.45 above)                            details. If No, give reasons for not maintaining
                                                                             separate accounts and also furnish following
                                                                             details.)


       Receipts: 2009-10 Batch
             Year                     No. of Students             Growth & Development fee per      Total Growth & Development
                                                                            Student                        Fees Received
            Ist Year
           IInd Year
           IIIrd Year
           Total (A)

     Expenditure on Growth and Development: F.Y.2009-10
     Head of Expenses                                                                                        Amount Expended
     Construction


     Total (B)

                    Give reasons for short expenditure [A - B]

Xv   Details of Income/Receipts                                  Furnish details of all Income (segregating the same nature wise in
                                                                    as much detail as possible) received in the following format

S.No Head of Income                             Amount           Whether credited in   Head of Income        Specify the nature
.                                                                    Income and      where reflected in the   and purpose for
                                                                 Expenditure Account     Income and         which the same has
                                                                    of Institution.  Expenditure Account       been received
                                                                       (Yes/No)

 A   Tuition Fees
 B   Development Fee
 C   Sports Fee
 D   Library/Book Bank Fee
 E   Internet & Email facility fee
 F   Cultural Activity fee
 G   Registration fee
 H   Fine & Penalty
 I   Prospectus Sale
 J   Books & Study Material Sale
 K   Alumni Fees
 L   Admission Fees
 M   University Fees
 N   Hostel Fees
 O   Mess Fees
 P   Transportation Fees
 Q   Training & Placement Fees
 R   Caution Money
 S   Hospital/Clinic /Day Care
 T   Rent Receipts
 U   Donation
 V   Interest
     - On FDRs with Regulatory Body
     - On Caution Money
     - Other Deposit
     - Saving Bank
     - Other (Please specify)
 W   Dividend
     Examination and Enrollment
 X   Fees
 Y   Any Other Fee(Please Specify)

 13 Fixed Assets and Depreciation                                Enclose a Fixed Assets schedule prepared in accordance with the
                                                                 provisions of Companies Act as per Annexure-IV as per Gross
                                                                 Block basis .
 14 Audited Financial Statements of the Society                   Attach Audit Report along with Audited Final Accounts and all
                                                                  necessary schedules of the Society for the F.Y. 2009-10

 15 Furnish comparative data of Audited Financial                 Furnish comparative data of Audited Final Accounts in the below
    Statements of the Society                                     mentioned chart for the last three years i.e. 2007-08, 2008-09 and
                                                                  2009-10




                                                   …………………... SOCIETY / TRUST


                                                  INCOME & EXPENDITURE ACCOUNT

      EXPENDITURE               2007-08     2008-09     2009-10               INCOME                  2007-08     2008-09     2009-10
   (Heads as per Audited                                          (Heads as per Audited Income and
  Income and Expenditure                                               Expenditure Account)
         Account)




Surplus                                                           Deficit


            TOTAL                                                              TOTAL




                                                   …………………... SOCIETY / TRUST


                                                           BALANCE SHEET

       LIABILITIES              2007-08     2008-09     2009-10                ASSETS                 2007-08     2008-09     2009-10
   (Heads as per Audited                                            (Heads as per Audited Balance
      Balance Sheet)                                                            Sheet)




            TOTAL                                                              TOTAL



                                                             Verification
          (The person signing the Verification clause must satisfy himself/herself about correctness of the information before affixing
                                                          his/ her signature)
I, .................................................. (full name in block letters), son/daughter ................................................ solemnly declare that
to the best of my knowledge, the information given in this additional information and statements accompanying is correct and
complete. I further declare that I am submitting this additional information in my capacity ......................................... and I am
competent to submit and verify the same.


                                                                                                                                             (Sign with stamp)
Date :                                                                                                                                     Chairman/Secretary
Place :

                                                                      Auditors Certificate

We have audited the above said additional information and Annexures thereof. In our opinion and to the best of our information
and according to explanations given to us the particulars given in the said additional information and Annexures thereof are true
and correct.
                                                                                                                  For XYZ & Co.
                                                                                                         Chartered Accountants


Date :                                                                                                                                                      (ABC)
Place :                                                                                                                                              Partner/Prop.
                                                                                                                                                           M. No.

Note: Above certification should be given by the statutory auditor of Trust/Institution.
                                                               ANNEXURE - II

                                                        INTEREST STATEMEMT
                                                                PART - A
                                       Total Interest as per Audited Final Account of F.Y. 2009-10


S.      Particulars (Submit      Rate of     Date of        Where        Loan    Interest   Descriptio     Whether     If No, name of the
No.     detail of each loan      Interest   Sanction      Reflected     Amount   Amount        n and         said    owner of the security,
            seperately)                                  [i.e. in the                       address (if   security is relationship of the
                                                        accounts of
                                                                                              any) of     owned by owner with society
                                                         Institution/
                                                                                                the         Society       and nature of
                                                          Society+
                                                        Institution)]                         security     (Yes/No) agreement between
                                                                                              against                 the said owner and
                                                                                               which                       the Society
                                                                                             loan has
                                                                                               been
                                                                                             obtained
  1   Interest on Term
      Loan No.1
  2   Interest on Term
      Loan No.2
  3   Interest on Term
      Loan No.3
  4   Interest on
      Unsecured Loan No.1


  5   Interest on
      Unsecured Loan No.2


  6   Interest on Loan for
      Working Capital No.1
  7   Interest on Loan for
      Working Capital No.2
  8   Other Interest
      (Specify)
Total (Must match with the figure in Income and Expenditure
Account. If not matching explain reasons) (A)
                                                      INTEREST STATEMEMT
                                                              PART - B

                                     Total Interest as per Audited Final Account of F.Y. 2009-10


S.                     Particulars                     Purpose of Loan          Loan Amount           Interest & Bank Charges etc.
No.                                                                                                  Financial    Others      Total
                                                                                                    Institution
                                                                                                         (i)        (ii)       (iii)
                                                                                                                           [(i) + (ii)]
  1   Interest attributable to amount borrowed for
      initial infrastructure development. (Give
      name of lender(s) along with interest paid to
      each one)

  2   Interest attributable to amount borrowed for
      Modernization /Expansion forced due to
      change in norms of Regulatory Body. (Give
      name of lender(s) along with interest paid to
      each one)

  3   Interest attributable to amount borrowed for
      Modernization /Expansion by the Institute
      voluntarily. (Give name of lender(s) along
      with interest paid to each one)

  4   Interest attributable to amount borrowed for
      Working Capital. (Give name of lender(s)
      along with interest paid to each one)

  5   Others (Please specify the nature) (Give
      name of lender(s) along with interest paid to
      each one)

                                 (B) Total
Note:-Total(A) should match with Total (B). If not give reasons.


Notes-
 1 Interest and charges on amount borrowed for subsequent development/ setting up of infra-structure necessitated due to
    change in curriculum / course requirement / modernization / quality upgradation. This does not include interest and charges
    on capital expenditure related to establishment required as per Regulatory Body Norms in years subsequent to
    establishment which will be includible in item. I i.e. Interest and charges attributable to establishment of institution as per
    regulatory body norms.

  2   Provide above referred details separately in respect of Loan and Interest accounted for in the books of Institution and in
      respect of Loan and Interest accounted for in the books of Society/Trust.

  3   Further if Society/Trust has taken a consolidated loan and used it for different Institution/ Courses then provide the basis and
      working of apportionment of said loan among different Institution/Courses
                                                         ANNEXURE- III

Please submit the details of receipts and expenditure related to mess, transportation, hostel, training & placement, Hospital and
 such other heads if credited / debited to the Income & Expenditure Account for the financial year 2009-10 and the accounting
           heads where these receipts / expenses have been parked / debited in the final accounts for FY 2009-10.


                                          As per Audited Final Accounts of F. Y. 2009-10
S.               Particulars                        Expenditure                                   Income
No.
                                           Amount    Head Where Parked     No. of     Fees per    Amount     Head Where Parked
                                                                          Students    Student
                                                                          availing
                                                                           facility
 1    Mess
                                              -                                                       -
 2    Hostel
                                              -                                                       -
 3    Transportation
                                              -                                                       -
 4    Training & Placement
                                              -                                                       -
 5    Hospital/OPD/Clinic etc. receipts
                                              -                                                       -
 6    Uniform
                                              -                                                       -
 7    University Fees

 a    Exam Fees

 b    Development Fees

 c    Student welfare Fees

 d    Others (please specify)

 8    Any other head of similar nature



                                              -                                                       -
      Total                                   -                                                       -
                                                                      ANNEXURE – IB

                     A. SALARY STATEMENT OF ………. (Course) of ………….COLLEGE / INSTITUTION


       I Primary Sheet (As per audited final accounts of ………..(Course) for the period 01.04.2009 to 31.03.2010

S. No. Heading (as per Audited Final Accounts of F.Y. 2009-10 of College / Institution)                             Amount

  1    Salary and Wages                                                                                                    0.00
  2    Other Heads                                                                                                         0.00
       (if amount of salary covered in any other head)                                                                     0.00
       a) Consultancy                                                                                                      0.00
       b) EPF                                                                                                              0.00
       c) Security Expenses                                                                                                0.00
       d) Wages and Labour Expenses                                                                                        0.00
       e) Rent or other perquisite/facilities provided/paid or reimbursed to Employees                                     0.00
       f) Others                                                                                                           0.00

       Total (A)                                                                                                           0.00




       II Secondary Sheet

 S.    Particulars                                                                                                Total Salary
 No.                                                                                                             during 2009-10



 B1    For Teaching Staff (Required as per Regulatory Body norms)                                                          0.00

 B2    For Additional Teaching Staff (In excess of Regulatory Body norms)                                                  0.00

 B3    For Administrative Staff (Required as per Regulatory Body norms)                                                    0.00

 B4    For Additional administrative Staff (In excess of Regulatory Body norms)                                            0.00

 B5    Hospital Staff                                                                                                      0.00

 B6    Others, if any                                                                                                      0.00

       Total (B)                                                                                                           0.00


Note: Total (B) must match with Total(A).
      Annexure to Item No. B1 of Secondary Sheet
      (For Teaching Staff)
S.    Names                   Designation        PAN      Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                      included in  appointment if left during                Salary for   for the period
                                                       employees list                the year                  March 2010     01.04.09 to
                                                        submitted to                                                            31.03.10
                                                         Regulatory
                                                          Authority
                                                          (Yes/No)

 1                                                                                                                                      0.00
 2                                                                                                                                      0.00
                                                                                                     Total                              0.00
                                                                                 Note: Must match with Item No. B1 of Secondry Sheet
      Annexure to Item No. B2 of Secondary Sheet
      (For Additional Teaching Staff)
S.    Names                     Designation      PAN      Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                      included in  appointment if left during                Salary for   for the period
                                                       employees list                the year                  March 2010     01.04.09 to
                                                        submitted to                                                            31.03.10
                                                         Regulatory
                                                          Authority
                                                          (Yes/No)
 1                                                                                                                                      0.00
 2                                                                                                                                      0.00
                                                                                                     Total                              0.00
                                                                                 Note: Must match with Item No. B2 of Secondary Sheet
      Annexure to Item No. B3 of Secondary Sheet
      (For Administrative Staff)
S.    Names                      Designation     PAN      Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                      included in  appointment if left during                Salary for   for the period
                                                       employees list                the year                  March 2010     01.04.09 to
                                                        submitted to                                                            31.03.10
                                                         Regulatory
                                                          Authority
                                                          (Yes/No)

 1                                                                                                                                      0.00
 2                                                                                                                                      0.00
                                                                                                                                        0.00


      Annexure to Item No. B4 of Secondary Sheet
      (For Additional administrative Staff)
S.    Names                  Designation           PAN      Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                        included in  appointment if left during                Salary for   for the period
                                                         employees list                the year                  March 2010     01.04.09 to
                                                          submitted to                                                            31.03.10
                                                           Regulatory
                                                            Authority
                                                            (Yes/No)

 1                                                                                                                                        0.00
 2                                                                                                                                        0.00
 3                                                                                                                                        0.00

                                                                                                                                          0.00

      Annexure to Item No. B5 of Secondary Sheet
      (For Hospital Staff)
S.    Names                   Designation        PAN        Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                        included in  appointment if left during                Salary for   for the period
                                                         employees list                the year                  March 2010     01.04.09 to
                                                          submitted to                                                            31.03.10
                                                           Regulatory
                                                            Authority
                                                            (Yes/No)


 1                                                                                                                                        0.00
 2                                                                                                                                        0.00
 3                                                                                                                                        0.00

                                                                                                       Total                              0.00
                                                                                   Note: Must match with Item No. B5 of Secondary Sheet




      Annexure to Item No. B6 of Secondary Sheet
      (For others)

S.    Names                  Designation           PAN      Whether       Date of  Date of leaving   Pay scale      Gross       Gross Salary
No.                                                        included in  appointment if left during                Salary for   for the period
                                                         employees list                the year                  March 2010     01.04.09 to
                                                          submitted to                                                            31.03.10
                                                           Regulatory
                                                            Authority
                                                            (Yes/No)


 1                                                                                                                                        0.00
 2                                                                                                                                        0.00
 3                                                                                                                                        0.00

                                                                                                       Total                              0.00
                                                                                   Note: Must match with Item No. B6 of Secondary Sheet
REPORT:
We have audited the above statement for the period 01.04.09 to 31.03.10 and we certify the correctness of the above statement. Further, we also certify that
salary of an employee is considered only in one college/instituion or hospital or any other concern run by the Trust/Society out of X no. of institutions etc. run by
Trust/Society and not in more then one college/institution or Hospital or any other concern run by the Trust/Society except the list enclosed.
                                                                                                                                                     For X Y Z & Co.
                                                                                                                                              Chartered Accountants


                                                                                                                                                                ABC
PLACE:                                                                                                                                                 Partner/Prop.
DATE:                                                                                                                                                 M. No. 123456

Notes:
  1   Give the name of employees in the sequence of Regular employees first then adhoc employees and lastly employees on contract.
  2   Above certification should be given by the statutory auditor of trust/institution.
  3   Further if an employee's salary is included in more then one college/hospital etc. then give the name of each college/hospital, amount of salary debited in
      each respective college during the period 01.04.2008 to 31.12.2008 and basis of apportionment of such salary
                                                        ANNEXURE - IV: FIXED ASSETS
                                                              For the year 2009-2010

Name of Assets              Rate of             GROSS BLOCK                                    DEPRICIATION                             NET BLOCK
                          Depreciation AS AT    ADDITION      SALE      AS AT      UPTO       ADJUST-   FOR THE       UPTO        AS AT      AS AT
                          as per SLM 31.03.08                          31.03.09   31.03.08     MENT      YEAR        31.03.09    31.03.08   31.03.09
Land & Site Development     0.00%
Building                    1.63%
Lab / workshop /
Laboratory Equipment       7.07%
Other Equipment            7.07%
DG Set                     7.07%
Plant & Machinery          4.75%
Computers & Peripherals    16.21%
Vehicles
 - Motor Car               9.50%
 - Buses                   11.31%
Furniture & Fittings       9.50%
Library Books *            10.00%
Others                     4.75%

Total :Rs.                                  0        0.00       0.00          0        0.00         0         0.00        0.00       0.00           0.00
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