[Audit report under section 268(5)]

Row

No.

PART A: Particulars ofthe assessee

1.

Name

(refer Note 1)

2.

Address

(refer Note 2)

3.

Permanent Account Number

4.

Email id

5.

Contact number

Country Code

Number

6.

Tax Year

Row No.

PART B: Statement of particulars

1.

Whether books of account are maintained under section 62?

Yes/No

2.

If answer to 1 is yes, list of books of account maintained and the ad- dress at which the books of account are kept

S.No.

Ad-

dress

Books of ac-

count main-

(In case books of account are maintained in a computer system, men- tion the books of account generated by such computer system. If the books of account are not kept at one location, please furnish the ad- dresses of locations along with the details of books of account main- tained at each location.)

tained

(refer

Note 2)

(refer

Note 2)

3.

List of books of account and nature of relevant documents exam- ined.

4.

Method of accounting employed during the tax year

5.

Whether there has been any change in the method of accounting em-

ployed vis-a-vis the method employed in the immediately preceding tax year

Yes/No

6.

If answer to 5 is Yes, give details of such change, and the effect thereof on the profit or loss.

(refer Note 6)

7.

Method of valuation of opening and closing stock of

a.

Raw materials

b.

Stores

c.

Work-in-progress

d.

Stock-in-trade

8.

State whether there is any change in the method of valuation of any of the aforesaid items as compared to the method employed in the immediately preceding tax year

9.

If the answer to 8 above is in the affirmative, specify the amount by which the profit or loss for the year has been affected by such change

10.

In respect of items manufactured full quantitative details along with valuation of raw materials, finished products and by-products as indicated below

Raw materials

(a)

Opening Stock

(b)

Purchases during the year

(c)

Consumption during the year

(d)

Sales during the year

(e)

Closing stock

(f)

Yield of finished products

(g)

Percentage of yield

(h)

Shortage/Excess

Finished Products

(a)

Opening Stock

(b)

Purchases during the year

(c)

Quantity manufactured during the year

(d)

Sales during the year

(e)

Closing stock

(f)

Shortage/Excess and percentage thereof

By-Products

(a)

Opening Stock

(b)

Purchases during the year

(c)

Quantity manufactured during the year

(d)

Sales during the year

(e)

Closing stock

(f)

Shortage/Excess and percentage thereof

Work-in-progress

(a)

Opening Stock

(b)

Purchases during the year

(c)

Quantity manufactured during the year

(d)

Sales during the year

(e)

Closing stock

(f)

Shortage/Excess and percentage thereof

11.

In the case ofa trading concern, give quantitative details of principal items of goods traded

(a)

Opening Stock

(b)

Purchases during the year

(c)

Sales during the year

(d)

Closing stock

(e)

Shortage/Excess and percentage thereof

12.

Has the assessee conducted physical verification of raw materials, stores and finished products/by-products, or the goods dealt in?

Yes/No

13.

Details of discrepancies, if any

(refer Note 6) Particulars of an-

nexure with respect to Part B

(Row No. 13)

14.

Amount of expenditure incurred by the assessee in respect of

(a)

Advertisement

(b)

Maintenance of accommodation in the nature of gust house

(c)

Travelling

(d)

Entertainment (including the amount of entertainment allowance paid to any employee or other person)

15.

Whether the expenditure incurred by the assessee in respect of any of the items referred to in 14(a) above exceeds the amount admissible under the

Yes/No

Act/Rules?

16.

If answer to 15 is yes, give details

(refer Note 6)

17.

Where the assessee is a firm, give following details

Sl. No.

Name of

the Part-

ner

PAN of

the Part-

ner

Details of payments made by firm to the partner of the firm by way of

Percent-

age Share

in the

profit of

the firm

Amount of

share in the

profit

Capital

balance

on 31st

March in

the firm

Interest

Salary

Bo-

nus

Commis- sion

Remunera- tion

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

18.

Where the assessee is a company, give details of

Sl. No.

Expenditure resulted directly or indirectly in the pro- vision of remuneration, benefit or amenity to

Expenditure or allowance in

respect of assets of the com- pany used wholly or partly for the purposes or benefit of any of the persons referred to in

Cl. (2), (3) and (4)

Whether such person referred to in Cl. (3) is an employee of the

Company? (Yes/No)

Director of the com- pany

Person who has a substantial

interest in the company

Relative of

Director or of such person

referred to in Cl. (3)

(1)

(2)

(3)

(4)

(5)

(6)

19.

Details of amounts not deductible under section 29 or 36

Sl. No.

Payments which

appear excessive or unreasonable in

terms of section 36(2)

Payments in excess of ₹ 10,000 or (₹ 35,000 in case the payment is for plying, hiring or

leasing of goods carriages) and is not made through specified banking or online mode – section 36(4) or 36(6)

Provisions for payment of gratuity not allowable – section 29(2)

Particu- lars

Amount

Particulars

Amount

Particulars

Amount

(1)

(2)

(3)

(4)

(5)

(6)

(7)

20.

Whether any amount is borrowed on a hundi from, or any

amount due thereon (including interest on the amount borrowed) is repaid to, any person otherwise than through an account payee cheque, or through any mode as specified by the Board in this

behalf?

Yes/No

21.

If answer to 20 is Yes, give details in following format

S. No.

Name of the per- son to whom re- payment is made

PAN of the

person to

whom repay-

ment is made

Amount bor-

rowed on a

hundi

Amount repaid

Interest on the amount borrowed

Total amount

repaid (3) + (4)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

22.

Particulars of proforma credits/drawback/refund of duties of customs or excise or both/refund of sales tax/ Input Tax Credit under GST.

Sl. No.

Proforma credits/drawback/refund of duties of customs or excise or both/refund of sales tax/Input Tax Credit under GST

Whether they have been credited to the profit and loss account? (Yes/No)

Particulars

Amount

(1)

(2)

(3)

(4)

23.

Particulars of expenditure/income of any earlier year debited/credited to the profit and loss account of the relevant tax year

Expenditure/income of any earlier year debited/credited to the profit and loss account of the relevant tax year

Particulars

Amount Debited

Amount Credited

(1)

(2)

(3)

(4)

24.

Particulars ofany liability of a contingent nature debited to the profit and loss account

Sl. No.

Any liability of a contingent nature debited to the profit and loss account

Particulars

Amount Debited in (₹)

(1)

(2)

(3)

25.

Whether any loan or deposit or specified sum in an amount exceeding the limit specified in section 185(1) taken or accepted during the tax year otherwise than through the modes specified in that section?

Yes/No

26.

If answer to 25 is yes, please furnish:

Sl. No.

Nature of

transaction

[Loan

/Deposit/

Specified

sum]

Name of pay-

er

Perma-

nent Ac-

count

Number

of payer

Amount

taken or

accepted

Whether

squared up dur-

ing the year

[Yes/No]

Maximum amount

outstanding at any

time during the tax

year

Code of the nature of

transaction, as given in

Note 7

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

27.

Whether there was any receipt of an amount exceeding the limit specified in section 186(1), in aggregate from a person in a day or in respect of a single transaction or in respect of transactions relating to one event or occasion, during the tax year, other-

Yes/No

wise than through modes referred to in that section?

28.

If answer to 27 is yes, please furnish:

Sl. No.

Nature of

transaction

Name of pay-

er

Perma-

nent Ac-

count

Number

of payer

Amount

of receipt

Date of receipt

Code of the nature of such transaction, as

given in Note 7

(1)

(2)

(3)

(4)

(5)

(6)

(7)

29.

Whether there was any payment of an amount exceeding the limit specified in sec- tion 186(1), in aggregate from a person in a day or in respect of a single transaction or in respect of transactions relating to one event or occasion, during the tax year, otherwise than through modes referred to in that section?

Yes/No

30.

If answer to 29 is yes, please furnish:

Sl. No.

Nature of

transac-

tion

Name of payee

Permanent

Account

Number of

payee

Amount of

payment

Date of payment

Code of the nature of such transaction, as given in Note 7

(1)

(2)

(3)

(4)

(5)

(6)

(7)

31.

Whether there was any repayment of loan or deposit or specified advance in an

amount exceeding the limit specified in section 188(1) during the tax year otherwise than through modes referred to in that section?

Yes/No

32.

If answer to 31 is yes, please furnish:

Sl. No.

Nature of

repayment

[Loan

/Deposit/

Specified

advance]

Name of payee

Permanent

Account

Number of

payee

Amount of

repayment

Maximum amount

outstanding at any

time during the tax

year

Code of the nature of such transaction, as given in Note 7

(1)

(2)

(3)

(4)

(5)

(6)

(7)

33.

Whether the assessee is required to deduct or collect tax as per the provisions of Chapter XIX-B of the Act?

Yes/No

34.

If answer to 33 is yes, please furnish:

Tax de-

duction

and col-

lection

account

number

(TAN)

Section

Nature of pay-

ment/receipt

Total

amount

of pay-

ment or

receipt

of the

nature

specified

in col-

umn (3)

Total

amount

on

which

tax was

required

to be

deducted

or col-

lected

out of

column

(4)

Total

amount

on which

tax was

deducted

or collect-

ed at

specified

rate out of

column

(5)

Amount of

tax deducted

or collected

out of col-

umn (6)

Total amount on which tax was deducted or col- lected at less than specified rate out of col- umn

(7)

Amount

of tax

deducted

or col-

lected on

column

(8)

Amount of

tax deduct-

ed or col-

lected but

not deposit-

ed to the

credit of the

Central

Govern-

ment out of

columns (7)

and (9)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

35.

Whether assessee is required to furnish the statement of tax deducted or tax collect- ed?

Yes/No

36.

If answer to 35 is yes, please furnish:

Sl. No.

Tax deduction

and collection

account number

(TAN)

Type of Form

Due date

for furnish-

ing state-

ment

Date on which statement was furnished

Furnish list of de-

tails/transactions

which are not reported

in the said statement

(1)

(2)

(3)

(4)

(5)

(6)

37.

Whether the assessee is liable to pay interest under section 398(3)(a)

Yes/No

38.

If answer to 37 is yes, please furnish:

Sl. No.

Tax deduction and

collection account

number (TAN)

Amount of in-

terest payable

under section

398(3)(a)

Amount paid out of column (3)

Date of payment

(1)

(2)

(3)

(4)

(5)

39.

Whether any loan/overdraft taken from a bank or financial institution?

Yes/No

40.

If answer to 35 is yes, please furnish:

S. No.

Particulars

Maximum amount

(in (₹)) outstanding

at any time during

the year

Details of security

including collat-

eral security of-

fered, if any

Name and PAN of the guarantor, if any

PAN of the guaran- tor, if any

(1)

(2)

(3)

(4)

(5)

(6)

41.

Details of taxes (Direct/Indirect), duties, etc., paid by the assessee during the tax year

Sl. No.

Details of taxes (Direct/Indirect), duties, etc, paid by the assessee during the tax year

Whether any discrepancy has been noticed in the respective dates of payments and the entries in the books of account? (Yes/No)

If answer to Cl. (4) is Yes, give partic- ulars thereof

Particulars

Amount paid (in (₹))

(1)

(2)

(3)

(4)

(5)

Annexure

With re-

spect to

Particulars

A-1

Part B of

Annexure

(Row No. 6)

Details of change in the method of accounting employed vis-a-vis the method em- ployed in the immediately preceding tax year

A-2

Part B of

Annexure

(Row No. 16)

A note on the expenditure incurred by the assessee in respect of any of the items re- ferred to in 14(a) of Part B of the Annexure which exceeds the amount admissible under the Income-tax Act/Rules

S. No

Nature of amount or receipt or repayment

Code

(A)

(B)

(C)

(i)

Cash payment

A

(ii)

Cash receipt

B

(iii)

Payment through non account payee cheque

C

(iv)

Receipt through non account payee cheque

D

(v)

Transfer of asset

E

(vi)

Transfer of liability

F

(vii)

Conversion of assets

G

(viii)

Conversion of liabilities

H

(ix)

Journal entry [Debit]

I

(x)

Journal entry [Credit]

J

(xi)

Any other mode [Debit]

K

(xii)

Any other mode [Credit]

L