FORM 'D' Form for Trade Union ANNUAL RETURNS PRESCRIBED UNDER SECTION 28 OF THE TRADE UNION ACT, 1936 FOR THE YEAR ENDING 31ST DECEMBER, 20________. (Part A) 1. Name of the Union _________________________________________________ 2. Address of the Union _______________________________________________ 3. Registered Head Office _____________________________________________ 4. Number and date of certificate of registration___________________________ 5. Classification (Nature) of Industry____________________________________ 6. Classification of Sector Place State to which of the following four categories the Union Belongs : (a) Public Sector-Central Sphere __________________________________ (b) Public Sector-State Sphere ____________________________________ (c) Private Sector-Central Sphere and _____________________________ (b) Private Sector-State Sphere____________________________________ 7. Name of the All India Body/Federation to which________________________ Affiliated_________________________________________________________ 8. Affiliation number _________________________________________________ 9. Affiliation fee paid during the year____________________________________ 10. Number and date of receipt for payment of affiliated fee _________________ 11. Member fee per month______________________________________________ 12. No. of members on books at the beginning of the year ____________________ 13. No. of members admitted during the year______________________________ 14. No. of members who left during the year_______________________________ 15. No. of the members on books at the end of the Male Female Total Year (i.e. on 31st December, 200______________________________________ 16. No. of members contributing to political fund __________________________ 17. No. of members who paid their subscription for the whole year ____________ 18. A copy of the Rules of the trade union corrected up to the date of dispatch of this return is appended ________________________________________________ 19. Part B of the return over-leaf has been duly completed Dated the General Secretary (PART B) STATEMENT OF LIABILITIES AND ASSETS ON THE 31st DAY OF DECEMBER, 20 Liabilities Rs. P. Assets Rs. P. Cash- Amount of general fund (i) In hands of Treasurer (ii) In hands of Secretary (iii) In the Bank Amount of Political fund Securities as per list below:- Loans from Unpaid subscription due for *(a) the year *(b) previous year Debts due to- Loans to- (a) Officers (b) Members (c) Others Other liabilities (to be specified) (i) Immovable properly (ii) Goods and Furniture (iii) Other assests (to be specified) Total Liabilities Total Assets LIST OF SECURITES Particulars Face Value Cost Price Market price at date In hands of on which accounts have been made up Treasurer GENERAL FUND ACCOUNT Income Expenditure Rs. P. Rs. P. Balance at the beginning of the year Salaries, allowances and expenses of office bearers Subscription from members (including Expenses of establishment :-Unpaid subscriptions due for the year): (i) Subscription received (i) Travelling allowance, salaries, allowances (ii) Subscription in arrears (ii) Rents rates and taxes For 3 months or less (iii) Subscription in arrears (iii) Stationery, printing and for more than 3 months postage DonationsSale of periodicals, books, Rules etc. ... . Auditors' fee Legal expenses Expenses in conducting trade disputes Interest on Investment . Income from miscellaneous sources Compensation paid to members (to be specified) :-for loss arising out of trade disputes (i) . Funeral, old age, sickness, unemployment, benefits, etc. (ii) . (iii) . Educational, social and religious benefits (iv) . Expenses incurred under Section 15 (j) of the Trade Union Act, 1926 (to be specified): (i) .. (ii) .. (iii) .. Other expenses ( to be specified): (i) .. (ii) .. (iii) .. Balance at the end of the year .. __________ ___________ Total Total .. Treasurer POLITICAL FUND ACCOUNT Income Expenditure Rs.P. Rs. P. Balance at the ... Payment made on objects beginning of year specifed in Section 16 (2) of the Trade Union Act, 1926 (to be specified). Contribution from members . At____________Per Member . Expenses of management (to be fully specified) balance at end of the year AUDITORS DECLARATION The undersigned, having had access to all the books and accounts of the Trade Union and having examined the foregoing statement and verified the same with the account vouchers relating there to, now sign the same as found to be correct, duly vouched and in accordance with the law, subject to the remarks, if any, appended here to and also certify that the trade union and properly maintained in its membership register and its accounts and the members had paid their membership subscription to the Trade Union as shown in the foregoing statement of the general fund account of the Union subject to the remarks, if any, appended hereto. Auditor The following changes of office bearers have been made during the year. OFFICE-BEARERS RELINQUISHING OFFICE Name of Office Bearers Date of Relinquishing Office OFFICE-BEARERS APPOINTED Name Date of Private Personal Title of Date on Other Birth address Occupation position which appoi offices Held in ntment in held in The column 5 additi- Trade Union was taken on to up memb ership of exe cutive with date 1 2 3 4 5 6 7 ELECTIONS Date of last election of Date of next election of Office-bearers__________ Office-bearers___________ General Secretary
