ANNUAL SURVEY OF INDUSTRIES 2004

ANNUAL SURVEY OF INDUSTRIES 2004-05 VOL.I

CONFIDENTIAL

Government of India

Ministry of Statistics & Programme Implementation

Return under rule 3 and 4 of the Collection of Statistics(Central) Rules, 1959

Annual Survey of Industries 2004-05 (Part-I)

(Please read the instructions before filling the return)

A. FOR OFFICIAL USE ONLY	B. TO BE FILLED BY OWNER

1. Schedule Despatch No.	1. Name & address of the industrial undertaking	Vill/Town: District: State: PIN Code:
2. PSL No.
3. Scheme Code (Census-1, Sample-2)
4. Industry Code as per frame (4-digit level of NIC-2004)
5. Industry Code as per Return(5-digit level of NIC-2004)
	2. Name & designation of contact person	Tele (with STD code): Fax No.: E-mail :
6. Description of Industry
7. State Code
8. District Code	3. Type of organisation(code)
9. Sector Code(Rural-1, Urban-2)	4. Type of ownership(code)
10. RO/SRO	5. Year of initial production
11. No. of Units	6. Accounting year (---- to ----)
12. Status of Unit(code)	7. Number of months of operation
	8. Does your unit have any computers? (Yes-1, No-2)
	9. Can you supply ASI data in computer floppy if software provided? (Yes-1, No-2)

DECLARATION

I hereby declare that information furnished in this return is correct and complete to the best of my knowledge and belief.

Date:

Place: (Name and Signature of owner with stamp)

BLOCK E: EMPLOYMENT AND LABOUR COST DSL No./PSL No._________

Sl. No.	Category of staff	Man-days worked			Average Number of Persons worked	No. of Mandays paid for	Wages/ salaries (in Rs.)	Bonus (in Rs.)	Contrib-ution to Provident & Other funds (in Rs.)	Workman & staff welfare expenses (in Rs.)
Sl. No.	Category of staff	Manufac-turing	Non Manufac-turing	Total	Average Number of Persons worked	No. of Mandays paid for	Wages/ salaries (in Rs.)	Bonus (in Rs.)	Contrib-ution to Provident & Other funds (in Rs.)	Workman & staff welfare expenses (in Rs.)
1	2	3	4	5	6	7	8	9	10	11
1	Male Workers employed directly
2	Female Workers employed directly
3	Child Workers employed directly
4	Sub-total (1+2+3)
5	Workers employed through contractors
6	Total Workers (4+5)
7	Supervisory & managerial staff
8	Other employees
9	Unpaid family members/ proprietor/ Coop. members	X	X	X		X	X	X	X	X
10	Total employees (6+7+8+9)
11	Number of working days			(i) Manufacturing days
				(ii) Non-Manufacturing days
				(iii) Total
12	Total Cost of Production (in Rs.) Item 10. Col.8,9,10 & 11 of Bl. E (+) item 7.8.9 & 10 Col 3 of Bl. F (+) item 17 of Col 6 of Bl. H (+) item 7, Col 6 Bl.I

F. OTHER EXPENSES DSL NO./PSL NO.

Sl. No.	Items	Expenditure(in Rs.)
1	2	3
1	Work done by others on material supplied by the industrial undertaking
2	Repair & Maintenance of (i) Building (ii) Plant & Machinery (iii) Pollution Control Equipment (iv) Other Fixed Assets
3	Operating Expenses
4	Non-operating Expenses (excluding insurance charges)
5	Insurance Charges
6	Rent paid for P & M and other Fixed Assets
7	Total Expenses (1 to 6)
8	Rent Paid for Buildings
9	Rent Paid for Land on Lease or Royalties on Mines, Quarries and similar Assets
10	Interest Paid
11	Purchase Value of goods sold in the same condition as purchased

H. INPUT ITEMS: Indigenous items consumed DSL NO./PSL NO.

Sl. No.	Item description	Item Code (ASICC)	Unit of quantity	Quantity consumed	Purchase Value(in Rs.)	Rate per unit(in Rs.)
1	2	3	4	5	6	7
	Major Five Basic Items(indigenous)	X	X	X	X	X
1
2
3
4
5
6	Other basic items(indigenous)	99201	X	X		X
7	Total Basic Items(1 to 6)	99901	X	X		X
8	Non-basic Chemicals-All kinds	99203	X	X		X
9	Packing items	99908	X	X		X
10	Electricity own generated	99904	KWH		X	X
11	Electricity purchased & consumed	99905	KWH
12	Petrol, Disel, Oil and Lubricants consumed	99906	X	X		X
13	Coal consumed	99907	Tonne
14	Other fuel consumed	99204	X	X		X
15	Consumable store	99220	X	X		X
16	Total Non-basic items (8 to 15)	99920	X	X		X
17	Total input(7+16)	99930	X	X		X
18	Any additional requirement of electricity (unmet demand)		KWH		X	X

I. INPUT ITEMS: directly imported items only (consumed)