Copies of the documents relied upon by the complainant and referred to in the complaint
An index of documents
Other documents as annexed along with the complaint
Signature of the complainant(s)
Verification
I __________ (name in full block letters) [son/ daughter] of ______ the complainant do hereby verify that the contents of paragraphs [1 to 8] are true to my personal knowledge and belief and that I have not suppressed any material fact(s).
Place:
Date:
Signature of the complainant(s)
Instructions: (1) Every complaint shall be filed in English and in case it is in some other Indian language, it shall be accompanied by a copy translated in English and shall be fairly and legibly type-written, lithographed or printed in double spacing on one side of standard petition paper with an inner margin of about four centimetres width on top and with a right margin on 2.5 cm, and left margin of 5 cm, duly paginated, indexed and stitched together in paper book form.
(2)
Every complaint shall be presented along with an empty file size envelope bearing full address of the respondent and where the number of respondents are more than one, then sufficient number of extra empty file size envelopes bearing full address of each respondent shall be furnished by the party preferring the complaint.
Form 'O'
[See rule 35(1)]
Annual Statement of Accounts
Receipts and Payments Account
For the year ended _______________________
(In Rupees)
A/c Code
Receipts
Current year As on
Previous Year As on
A/c Code
Payments
Current year As on
Previous year As on
1.
To Balance Brought down:
13.
By Chairperson and Members:
1.1.
To Bank
13.1.
By Pay and Allowances
1.2.
To Cash in hand
13.2.
By Other benefits
2.
To Fee, Charges and Fine:
13.3.
By Traveling expenses:
2.1.
To Fees
13.3.1.
By Overseas
2.2.
To Charges
13.3.2.
By Domestic
2.3.
To Fines
14.
By Officers:
2.4.
To Others (specify)
14.1.
By Pay and Allowances
3.
To Grants:
14.2.
By Retirement benefits
3.1.
To Accounts with Government
14.3.
By Other benefits
3.2.
To Others (specify)
14.4.
By Traveling expenses:
4.
To Gifts
14.4.1.
By Overseas
5.
To Seminars and conferences
14.4.2.
By Domestic
6.
To Sale of Publications
15.
By Staff:
7.
To Income on investments and deposits:
15.1.
By Pay and Allowances
7.1.
To Income on investments
15.2.
By Retirement benefits
7.2.
To Income on Deposits
15.3.
By Other benefits
8.
To Loans:
15.4.
By Traveling expenses:
8.1.
To Government
15.4.1.
By Overseas
8.2.
To Others (specify)
15.4.2.
By Domestic
9.
To Sale of Assets
16.
By Hire of Conveyance
10.
To Sale of Investments
17.
By Wages
11.
To Recoveries from pay bills:
18.
By Overtime
11.1.
To Loans and Advances Principal Amount
19.
By Honorarium
11.2.
To Interest on Loans and Advances
20.
By Other office expenses
11.3.
To Miscellaneous
21.
By Expenditure on Research
51
To Others (specify)
22.
By Consultation expenses
23.
By Seminars and conferences
24.
By Publications of Authority
25.
By Rent and Taxes
26.
By Interest on Loans
27.
By Promotional Expenses
28.
By Membership fee
29.
By Subscription
30.
By Purchase of Fixed Assets (specify)
31.
By Investments and Deposits:
31.1.
By Investments
31.2.
By Deposits
32.
By Security Deposits
33.
By Loans and Advances to:
33.1
By Employees:
33.1.1.
By Bearing Interest
33.1.2.
By Not bearing Interest
33.2.
By Suppliers/contractors
33.3.
By others (specify)
34.
By Repayment of loan
35.
By Others
35.1.
By Leave Salary and Pension
35.2.
Contribution
35.3.
By Audit Fee
35.4.
By Misc:
36.
By Balance carried down:
36.1
By Bank
36.2
By Cash in hand
Total
Total
Chairperson (Signature)
Member(s) (Signature)
Secretary (Signature)
Officer In-charge (Finance and Accounts)
Income and Expenditure Account
For the period 1st _______________ to 31st ________________________
(In Rupees)
A/c Code
Expenditure
Schedule
Current Year As on
Previous Year As on
A/c Code
Income
Schedule
Current Year As on
Previous Year As on
13.
To Chairperson and Members
2.
By Fee, Charges and Fine
A
13.1.
To Pay and Allowances
2.1.
By Fee
13.2.
To Other benefits
C
2.2.
By Charges
13.3.
To Traveling Expenses
2.3.
By Fines
13.3.1.
To Overseas
2.4.
By Others (specify)
13.3.2.
To Domestic
3.
By Grants
B
14.
To Officers
3.1.
By Account with Government
14.1.
To Pay and Allowances
3.2.
By Others (Specify)
14.2.
To retirement Benefits
D
4.
By Gifts
14.3.
To Other Benefits
C
5.
By Seminars and Conferences
14.4.
To Traveling Expenses
6.
By Sale of Publications
14.4.1.
To Overseas
7.
By Income on investments and Deposits
14.4.2.
To Domestic
7.1.
By Income on investments
15.
To Staff
7.2.
By Income on Deposits
15.1.
To Pay and Allowances
11.2.
By Interest on Loan and Advances
15.2.
To Retirement Benefits
D
12.
By Miscellaneous Income
15.3.
To Other Benefits
C
12.1.
By Gain on Sales of Assets
15.4.
To Traveling expenses
By Excess of expenditure over income
15.4.1.
To Overseas
(Transferred to Capital Fund Account)
15.4.2.
To Domestic
16.
To hire of Conveyance
17.
To Wages
18.
To Overtime
19.
To Honorarium
20.
To Other office expenses
E
21.
To expenditure on Research
22.
To Consultation expenses
23.
To Seminars and conferences
24.
To Publications of Authority
25.
To Rent and Taxes
26.
To Interest on loans
27.
To Promotional Expenses
28.
To membership fee
F
29.
To Subscription
G
35.
To Others
35.1.
To Leave Salary and Pension
35.2.
Contribution
35.3.
To Audit Fee
35.4.
To Misc.
37.
To Depreciation
H
48.
To Loss on sale of assets
49.
To Bad Debts written off
50.
To Provision for bad and doubtful debts
To Excess of income over expenditure
(Transferred to Capital Fund Account)
Total:
Total:
Chairperson (Signature)
Member(s) (Signature)
Secretary (Signature)
Officer In-charge (Finance and Accounts)
Balance Sheet as on 31st (Month) (Year) __________
(In Rupees)
A/c Code
Liabilities
Schedule
Current Year As on
Previous Year As on
A/c Code
Assets
Schedule
Current Year As on
Previous Year As on
40.
Funds
I
43.
Fixed Assets
H
40.1.
Capital Fund
43.1.
Gross Block at Cost
Add Excess of Income over Expenditure/ less excess of
Expenditure over Income
Less Cumulative depreciation
40.2.
Other Funds (Specify)
42.2.
Net Block
41.
Reserves
J
44.
Capital Work-in-progress
M
8.
Loans
K
31.
Investments & Deposits
N
8.1.
Government
31.1.
Investment
8.2.
Others
31.2.
Deposits
42.
Current Liabilities and provisions
L
33.
Loans and Advances
O
3.1.
Account with Government
S
45.
Sundry Debtors
P
36.
Cash and Bank Balances
Q
46.
Other Current Assets
R
Total
Total
Accounting Policies and Notes to
T
Instructions. - (1) The Schedules referred/ referenced above shall be prepared by the Authority based on accounting principles followed by the appropriate Government or by other regulatory authorities or as suggested by the Comptroller and Auditor General of India from time to time.
(2)
The Schedules referred to above shall form an integral part of the Income and Expenditure Account or the Balance Sheet, as the case may be.
Chairperson (Signature)
Member(s) (Signature)
Secretary (Signature)
Officer In-charge (Finance and Accounts)
Form 'P'
[See rule 36(1)]
Annual Report to be Prepared by Authority
A. Introduction:
(i) Chairman's statement:
(ii) Objectives:
(iii) Important achievements:
(iv) The year in review:
(v) Capacity building:
(vi) International engagements:
(vii) Impact on:
(i) Number of appeals filed against the orders of the Authority or the adjudicating officer in the year:
(ii) Number of appeals pending at the beginning of the year:
(iii) Appeals filed during the year:
(iv) Number of appeals allowed by the Appellate Tribunal during the year:
(v) Number of appeals disallowed by the Appellate Tribunal during the year:
(vi) Brief write up on the appeals allowed by the Appellate Tribunal: