Printed from www.taxmann.com FORM NO. 10CCB [See rule 18BBB] Audit report under section 80-I(7)/80-IA(7)/80-IB/80-IC 1. Name of the assessee 2. PAN 3. Status 4. Ownership status of the undertaking/enterprise : (a) Fully owned by assessee Yes No (b) Partly owned by assessee Yes No If yes, please specify the percentage of ownership 5. Address 6. Name of the enterprise or undertaking eligible for deduction under section 80-IA, 80-IB or 80-IC 7. Section and sub-section of the Income-tax Act, 1961, under which deduction is being claimed 8. Date of commencement of operation/activity by the undertaking or enterprise 9. Initial assessment year from when deduction is being claimed 10. Address (with District and State) of the enterprise/ undertaking claiming deduction 11. Excise/service tax registration number and office where registered 12. Sales-tax registration number and office where registered 13. Local/State authorities from whom approval is taken (attach copy of approval) ELIGIBLE BUSINESS UNDER SECTION 80-IA 14. Development, operation, maintenance of an infrastructure facility: (a) With respect to the infrastructure facility, does the enterprise (please tick): Develop Operate and maintain, Develop, operate and maintain, the infrastructure facility. (b) Please specify the nature of the infrastructure facility*** [e.g., road, bridge, rail system, port, etc. [Explanation to section 80-IA(4)(i)]] (c) Has the operation and maintenance of the infrastructure facility been received on transfer from its developer in accordance with the agreement with the Central/State Government/local authority/any other statutory body Yes No Printed from www.taxmann.com (d) If yes, please specify the first year of claim of deduction under section 80-IA by the developer (Attach copy of Form 10CCB of developer) 15. Providing telecommunication services : (a) Please specify the nature of telecom service [e.g., basic telecom service, cellular service, etc. [Section 80-IA(4)(ii)]] 16. Development, operation, maintenance of industrial park/SEZ (a) With respect to the industrial park/SEZ, does the undertaking (please tick) : Develop Develop and operate Maintain and operate an industrial park/SEZ (b) Name and address of the industrial park/SEZ£ (c) Has the operation and maintenance of the industrial park/SEZ been received on transfer from its developer Yes No (d) If yes, first year of claiming deduction under section 80-IA by the developer (Attach copy of Form 10CCB of developer) 17. Generation, transmission, distribution of power : (a) Does the undertaking generate power or generate and distribute power Yes No (i) If yes, indicate the year in which the undertaking has started generating power (b) Does the undertaking transmit or distribute power Yes No (i) If yes, indicate the year in which the new transmission and distribution lines were laid (c) Has there been substantial renovation and modernization of the existing network of transmission or distribution lines Yes No If yes, please specify,- (i) the year in which the substantial renovation and modernisation of the existing network of transmission or distribution lines took place (ii) book value of plant and machinery as on 1-4- 2004 (iii) value of increase in the plant and machinery in the year of substantial renovation and modernisation ELIGIBLE BUSINESS UNDER SECTION 80-IB 18. Industrial undertakings engaged in manufacture or production of article or thing or operation of cold storage plant (a) Does the industrial undertaking manufacture or produce any article or thing specified in the Yes No Printed from www.taxmann.com Eleventh Schedule (Please specify the article or thing......) (b) If yes, does the manufacturing process use power Yes No (c) Number of workers employed in the manufacturing process (d) Does the industrial undertaking operate any cold storage plant Yes No (e) Please specify if the company is a small scale industrial undertaking Yes No (f) If the industry is located in the North Eastern Region, is the industry a notified industry as per second proviso to section 80-IB(4)? Yes No (g) If the industry is located in Jammu & Kashmir, does it manufacture or produce any article or thing specified in part 'C' of the Thirteenth Schedule? Yes No 19. Business of ship (a) Is the ship owned by an Indian company and wholly used for the business carried on by it Yes No (b) If the ship was acquired on transfer, was the ship owned or used in Indian territorial waters by a person resident in India Yes No
