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A. FOR OFFICIAL USE ONLY
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B. TO BE FILLED BY OWNER
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1. Schedule Despatch No.
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1. Name & address of the industrial
undertaking
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Vill/Town:
District:
State:
PIN Code:
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2. PSL No.
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3. Scheme Code (Census-1, Sample-2)
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4.
Industry Code as per frame
(4-digit level of NIC-98)
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5.
Industry Code as per Return
(5-digit level of NIC-98)
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2. Name & designation of contact person
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Tele (with STD code):
Fax No.:
E-mail :
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6.
Description of Industry
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7. State Code
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8. District Code
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3. Type of organisation(code)
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9. Sector Code(Rural-1, Urban-2)
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4. Type of ownership(code)
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10. RO/SRO
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5. Year of initial production
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11. No. of Units
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6. Accounting year (---- to ----)
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12. Status of Unit(code)
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7. Number of months of operation
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8. Does your unit have any computers? (Yes-1, No-2)
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9.
Can you supply ASI data in computer floppy if
software provided? (Yes-1, No-2)
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Sl.
No.
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Category of staff
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Man-days worked
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Average
Number of Persons worked
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No. of Mandays paid for
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Wages/ salaries (in Rs.)
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Bonus (in Rs.)
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Contrib-ution to Provident & Other funds (in Rs.)
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Workman & staff welfare expenses (in Rs.)
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Manufac-turing
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Non
Manufac-turing
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Total
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1
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2
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3
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4
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5
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6
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7
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8
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9
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10
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11
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1
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Male Workers employed directly
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2
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Female Workers employed directly
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3
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Child Workers employed directly
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4
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Sub-total (1+2+3)
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5
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Workers employed through contractors
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6
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Total Workers (4+5)
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7
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Supervisory & managerial staff
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8
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Other employees
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9
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Unpaid family members/
proprietor/ Coop. members
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X
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X
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X
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X
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X
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X
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X
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X
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10
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Total employees
(6+7+8+9)
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11
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Number of working days
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(i) Manufacturing days
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(ii) Non-Manufacturing days
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(iii) Total
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12
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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
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Sl. No.
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Item description
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Item Code
(ASICC)
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Unit of quantity
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Quantity consumed
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Purchase Value(in Rs.)
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Rate per unit(in Rs.)
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1
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2
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3
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4
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5
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6
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7
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Major Five Basic Items(indigenous)
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X
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X
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X
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X
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X
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1
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2
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3
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4
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5
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6
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Other basic items(indigenous)
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99201
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X
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X
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X
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7
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Total Basic Items(1 to 6)
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99901
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X
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X
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X
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8
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Non-basic Chemicals-All kinds
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99203
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X
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X
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X
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9
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Packing items
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99908
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X
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X
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X
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10
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Electricity own generated
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99904
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KWH
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X
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X
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11
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Electricity purchased & consumed
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99905
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KWH
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12
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Petrol, Disel, Oil and Lubricants consumed
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99906
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X
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X
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X
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13
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Coal consumed
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99907
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Tonne
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14
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Other fuel consumed
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99204
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X
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X
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X
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15
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Consumable store
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99220
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X
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X
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X
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16
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Total Non-basic items (8 to 15)
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99920
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X
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X
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X
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17
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Total input(7+16)
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99930
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X
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X
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X
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18
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Any additional requirement of electricity (unmet demand)
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KWH
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X
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X
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