Form XXI

(see rule 53 and 56)

(FORM FOR ANNUAL RETURNS)

Annual returns prescribed under Section 26 of the Industrial Relations Code,2020 for

the year ending 31st December, 20………………….

Part - A

1. Name of the Trade Union:

2. Address of the Trade Union:

3. Number and date of certificate of registration:

4. Classification of industry (to be shown as per schedule of industries attached) :

5. Classification of Sector (please 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

d. Private Sector – State Sphere.

6. Name of the All India Body/Federation to which to which affiliated:

7. Affiliation number:

8. Affiliation fee paid during the year:

9. Number and date of receipt for payment of affiliation fee:

10. Membership fee per month:

11. Number of Members on books at the beginning of the year:

12. Number of members admitted during the year:

13. Number of members who left during the year:

14. Number of members on books at the end of the year:

(i.e. on 31st December, 20………….):

Male/Female Total

15. Number of members contributing to Political Fund:

16. Number of members who paid their subscription for the whole year:

17. A copy of the rules of the Trade Union corrected up to the date of dispatch of this return

is appended:

18. Part B of the return overleaf has been duly completed:

Dated the ……………………….

Secretary

Part – B

General Fund Account

Income Rs. P Expenditure Rs.P

Balance at the beginning of the year Salaries and allowances of office-bearers

Subscription from members Travelling allowance, salaries,

(Including unpaid subscription allowances and expenses of

due for the year establishment.

a. subscription received.

b. Subscription in arrears for Auditor’s

fees………………………………….

three months or less.

Legal

expenses………………………………..

c. Subscription in arrears for Expenses in conducting trade

More than three months. Disputes…………………………….

Donations………………. Compensation paid to members for loss

Arising out of trade disputes.

Sale of periodicals, books, rules etc. Funeral, old age, sickness,

Unemployment benefits, etc.

Educational, Social and religious benefits.

Cost of publishing periodicals rents, rates

Interest on Investment. And taxes.

Income from Miscellaneous

Source (to be specified). ………………………..

Expenses incurred under rules 63(j)

Of the Industrial Relations (Gujarat) rules ,2021

(to be specified).

Other expenses (to be specified)

Balance at end of the year.

Total Total.

Part – C

Political Fund Account

Rs. P Rs.P

Balance at the beginning of the year Payments made on objects specified

Under Section 15(2) of the

Industrial Relations Code,2020

(to be specified).

Contributions from ……………………….. Expenses of Management

(to be fully specified).

Members at …………………………………. Balance at the end of the year.

Per member

Total Total

Treasurer.

PART – D

Statement of Liabilities and Assets on the 31st day December,

20……………………………………

Liabilities Rs.P. Assets Rs. P.

Amount of general fund Cash-

Amount of political fund In hands of Treasurer

In hand of Secretary

Loan from In hands of-

In the ………………………. Bank

In the ………………………. Bank

Debts due to Securities as per list below

Unpaid subscription due for

*(a) the year

*(b) Previous year

Other Liabilities (to be specified) Loans to-

*(a) the year

*(b) Members

*(c)Others

Immovable property

Goods and furniture

Other assets (to be specified)

Total Liabilities Total Assets.

PART – E

List of Securities

Particulars Face Cost of Market price at the date on which accounts In hands

Value Price have been made up of

Treasurer.

Auditor’s Report

We have audited the forgoing ‘General Fund Account’ in Part B and the ‘Political Fund

Account’ Part G of the ……………………………… (Name of the Trade Union) for the period

ending …………………………. And also the Statement of Liabilities and Assets in Part ‘D’ and

the List of Securities in Part ‘E’ of the said Trade Union as on ……………………… and report

that-

i.We have obtained all the information and explanation and have had access to all the books and

accounts of the Trade Union which were necessary for the purposes of our audit;

ii.The Trade Union has properly maintained its Membership Register and its books of accounts as

required by law;

iii.(Subject to whatever remarks or qualifications the auditor wants to make). In our opinion and to

the best of our information and according to the explanations given to us, the foregoing accounts,

statement and list have been properly drawn up and they give a true and correct view of income,

expenditure, assets and liabilities of the Trade Union.