Annual Return Under Factories Act

 I have Attached Annual Return Under Factories Act

FORM 27 (Annual Return) [see rule 119 (1)]

 

For the year ending________________________________________

 

General information

 

1

Name  and  address  of  factory  –                
  street, city, Taluka, district                  

2

Name and

designation

of

               
  occupier                        

3

Name and

designation

of

               
  manager                        

4

Contact details of occupier   Telephone           Fax  
              e-mail          

Mobile

5

Contact details of manager   Telephone           Fax  
              e-mail          

Mobile

6

Registration number of factory                

7

License under Factories Act   License Number        

Renewed

              upto              

8

Installed HP                      

9

Legal organization     (a)   sole   proprietor (b) partnership

(c)   private

              company (d) public company      
              (e)  cooperative  (f)  family  business  (g)  govt./semi
              government(h) other          

10

Ownership         (a)  national (b) foreign (c) joint national

and

              foreign              

11

Manufacturing process as

per

3   digit   code   as   per   attached   Classification

of

  NIC 2008         Manufacturing Processes        

12

Plan approval number and date  ( Number           Date  
  in chronological order)                    

13

Does the factory have

a

Yes/No     If  yes,  what  is  the  date  of  issue  of

the

  Certificate of Stability?     certificate?              

14

Permanent

serial No. of factory

               
Workforce                          

15

Mention  maximum  number  of  workers  employed  for  any          
  day of the year                 Male   Female
  Permanent employees                      
  i) Managers and supervisors                    
  ii) Workers                          
  a)   Workers over 18 years                    
  b)   Workers over 14 years but < 18 years                
  Total-                            

16

Contract workers                      

17

Daily wage workers                      
  i) Temporary workers                      
  ii) Casual workers                      

18

i) Apprentices                        
              – 3 –              

 

ii) Trainees

 

Total of Sr.No.15 to 18

 

19          Family members of the owner of the factory

 

a)     Paid

 

b)     Unpaid

 

20          a) Security/watchmen

 

b)Name of Security Agency/ Security Guard Board

 

c)  Mathadi workers

21

For   permanent   workers,   how   many   years   of service?
  Less than 1 year  
  1 year to <5years  
  5 years to <10 years  
  More than 10 years  

 

Yes

No

(If so,number)

 

 

22          Does the factory employ its own security guards as direct employees?

 

23          Does the factory employ its own Mathadi workers as direct employees?

 

24          Does the factory employ its own cleaning staff as direct employees?

 

25          Are any contract workers inter-State migrant workers?

 

Inspections

 

26

What  was  the  date  of  the  last Date
  inspection by   a

factory

 
  inspector?            

27

What  was  the  date  of  the  last Date
  spot  safety  audit  by  a  factory  
  inspector?            

28

What  was  the  date  of  the  last Date
  occupational, health and

safety

 
  audit  conducted  by  an  internal  
  auditor?            

29

What  was  the  date  of  the  last Date
  occupational, health and

safety

 
  audit  conducted  by  an  external  
  auditor?            

30

What  was  the  date  of  the  last Date
  examination by a

competent

 
  person?           Equipment/machinery examined ______________
  What   was   examined   on   that  
  date? (Indicate)          

31

Does    the    factory    hold    any Yes/No
  OSHA   18001,ISO 14001

or

If YES, which certification(s) and what was the last
  other similar certification?   date of certificate renewal?

32

Does the factory have a Code of Yes/No
  Conduct  as  required  by  buyers If  YES,  what  was  the  last  date  of  inspection  by  a
  of the factories’ products?   buyer or buyer’s representative?

 

 

– 4 –

 

Dangerous operations and hazardous processes

 

33

Which  of  the  operations  among Indicate all operations that are conducted
  Dangerous  Operations  Schedule  
  are conducted in the factory? If none of the operations listed in the schedule are
    conducted, write NIL.
     

34

Is   your   factory   in   the   list   of  
  Industries   involving   hazardous  
  processes     as     defined     under  
  section  2  (cb)  of  the  factories If none, write NIL.
  Act 1948?  
     
  If  yes,  which  are  the  hazardous  
  processes  that  are  carried  out  in  
  the factory  

 

Storages of Hazardous Substances

35. Do you store any

hazardous

   
(i) chemicals as listed in Schedule 1    
annexed to CIMAH Rules 2003,    
     
  in  your  factory?  If  so,  give  the If none write NIL  
  list.              
(ii) Do you store quantities

of

   
hazardous  chemicals  equal  to  or    
     
  above  threshold  limits  as  listed If none write NIL  
  in   column   3   of   Schedule   2    
  annexed to CIMAH Rules 2003,    
  in  your  factory?  If  so,  give  the    
  list along with inventory.      
  Does   your   factory   fall   under Yes/No  
  MAH category?          
(iii) If your factory falls under MAH    
category,            
             
  (a)   Have   you   submitted   site Give date of submission  
  notification report?        
  (b)    Have    you    prepared    and Give date of preparation  
  submitted ON site

emergency

   
  plan?            
  (c)Have   you   updated   ON   site Give Date when last updated and submitted.  
  emergency plan?          
  (d)Dates   of   Mock   drill   along Give   Dates  of  Mock  drill  along  with  scenario,  
  with  scenario,  carried  out  in  the carried out in the year.  
  year.              
(iv) Do you store quantities

of

   
hazardous  chemicals  equal  to  or    
     
  above  threshold  limits  as  listed    
  in   column   4   of   Schedule   2    
  annexed to CIMAH Rules 2003,    
  in  your  factory?  If  So,  give  the    
  list along with inventory.      
  (a)    Have    you    prepared    and Give date of submission  
  submitted Safety Report?      
  (b)Have  you  carried

out  safety

Give  date  and  date  of  submission  of  compliance  

 

 

– 5 –

 

audit internally in a year? If not report.
(c)Have  you  carried  out  safety  
audit externally? Give  date  and  date  of  submission  of  compliance
  report.

 

Safety and health

 

36             Does  the  factory  have  a  written    Yes/No

 

safety and health policy? If YES, how is this communicated to workers?

 

(a)    notice board

(b)     circular

(c)     other

If YES, what language is used?

(a)    Marathi

(b)   Hindi

(c)     English

 

37             Does   the   factory   have   written    Yes/No

safety guidelines for workers. If YES, how is this communicated to workers?

 

(a)    notice board

(b)     circular

(c)     other

    If YES, what language is used?  
    (a) Marathi  
    (b) Hindi  
    (c) English  

38

Does  the  factory  have  an  onsite Yes/No  
  emergency plan? If YES, evacuation plan is displayed throughout the
    factory for all workers to see?  
    If  YES,  is  there  regular  onsite  emergency  mock
    drills involving  evacuation drills?  
    If YES, what was the date of the last mock drill?

39

Does   the   factory   have   safety Yes/No  
  officers? If YES, how many as on reporting date? _______
    If  yes,  Whether  he  is  a  qualified  Safety  Officer  as
    per Rules?  

40

Does  the  factory  have  a  safety Yes/No  
  committee? If YES,  how  many  workers  are member  of  the
    safety committee? ______  
    how     many     management     representatives     are
    members?  
    If YES, how often does it meet?  

41             Does the factory have at least 2 Yes/No exits on each floor in each

building it occupies?

 

42             Are    fire    extinguishers    placed    Yes/No

throughout the factory?     If YES, how many extinguishers  
        Sr.No. Type capacity Quantity
       

1.

Foam type    
       

2.

Dry power    
       

3.

Co2    
       

4.

Any other    
        If YES, how many workers have been trained to use
        extinguishers?    

43

Does  the  factory  have first aid Yes/No      

 

 

 

– 6 –

 

boxes?     If YES, how many throughout the factory? _______
        If   YES,   how   often   are   they   checked   for   their
        contents?__________

44

Do  any  workers  have  a  first  aid If YES, how many?
  certificate?      

45

Does     the     factory     have     a Yes/No
  HIV/AIDS policy?      

46

Does the factory provide workers If YES, which items are provided?
  with personal protective   Head protection
  equipments (PPE’s) ?     Foot protection
          Eye protection
          Ear protection
          Hand protection
          Body protection
          Respiratory protection

Others

 

47             Are  workers  required  to  pay  for    Yes/No

any protective

clothing

or

If YES, which items?
  equipment?            

48

Has the  

factory

reported

any

Yes/No  
  accidents to the factory inspector If YES, how many non-fatal? __________
  during the reporting period?     how many fatal? __________

49

Has the  

factory

reported

any

Yes/No  
  occupational diseases

to

the

If YES, how many non-fatal? __________
  factory

inspector

during

the

  how many fatal? __________
  reporting period?          

50

Has the  

factory

reported

Yes/No  
  dangerous  

occurrence

to

the

If YES, how many __________
  factory

inspector

during

the

   
  reporting period?          

51

Are safety  posters

displayed  in

Yes/No  
  the factory?            

 

 

Welfare facilities

 

Yes No

52          Does the factory provide drinking water for workers?

 

53          Does the factory have a crèche?

 

54          (a)Does the factory have a canteen?

(b) Is the canteen managed by-

(i)  Departmentally  or

(ii)  Through a contractor or (iii)By co-operative society.

55          Is a lunch room provided?

 

56          Does the factory provide a locker for workers?

 

57          Is there a changing room for workers?

 

 

 

– 7 –

 

58          Is there a rest room or shelter  for workers?

 

59          Is there a Occupational Health Centre?

 

60          Is the occupational health centre open to members of the worker’s family?

 

61          Is there an ambulance room?

 

62          Is there a full-time doctor in attendance?

 

63          Is there a part- time doctor?

 

64          Is there a full-time nurse in attendance?

 

65          Is there a part-time nurse?

 

66          Does the factory have separate toilets for men and women?

 

67          How many latrines for men?

 

68          How many urinals for men?

 

69          How many latrines for women?

 

70          Are the above facilities available to contract workers?

 

71          Is there a welfare officer?

If yes, number of welfare officers? ________________________

 

 

Wages and benefits  
72 Are    workers    required    to    work Yes/ No
  overtime? If yes, what is the overtime rate of pay?______
    If   yes,   what   was   the   highest   number   of
    overtime hours worked by a worker last month?
    ________
73      a)How many hours per day (without  
  overtime) Number ____________________
  do workers work?  
  b)How  many  days  are  required  to ______________________
  work for the worker per week?  

 

Industrial Relations

74

Does  the  factory  have  a  written Yes/No  
  Policy   against

sexual

   
  harassment?            

75

Does the factory have

a

Yes/No  
  committee

for

redressal

of

   
  sexual harassment ?        

76

Have any sexual

harassment

Yes/No  
  complaints

been

lodged  within

   
  the  factory  during  the  reporting    
  period?              

77

Does the factory operate

a

Yes/No  
  suggestion box scheme?   If  YES,  how  many  useful  suggestions  received
              during the period? ______  
              how many suggestions were acted upon?  _______
              how many workers rewarded for suggestions?

___

              how much amount was distributed as rewards?—–

 

78 Employment information        
No. of days worked in a year:———        
Workers *Avg.No. Number **Avg. No. Number of Number of

 

 

 

– 8 –

 

of workers

of man-

of hours

man-hours

man hours

 
  employed

days

worked per

worked on

worked

 
  daily

during the

week

overtime in

including

 
   

year

 

a year

overtime in a

 
Adults M      

year

 
         
  F          
Adolescents M          
(15-<18 years) F          
Children M          
(14-15 years) F          
Total            
See the explanatory note given below        

 

79   Leave with wages

 

Workers Numb

Number

Number

Number

Number

Number

Number

No.of

Number

  er

entitled

who

of

of

of

of workers

workers

of

  emplo

to

were

discharg

dismiss

workers

superannu

who

workers to

  yed

annual

granted

ed

ed

who

ated

died

whom

   

leave

leave

workers

workers

quit the

 

while in

wages in

           

employ

 

service

lieu of

           

ment

   

leave were

                 

paid

Adults M                
  F                
Adolesc M                
ents F                
(15-<18                  
years)                  
Children M                
(14-15 F                
years)                  

 

80

Accident details

                       
(a)                                
              Workers employed directly         Total    
              Permanent Temporary     Contract      
                          worker          
No. Of Fatal accident                            
No. Of Non Fatal accidents                          
(b)                                
Dangerous occurrences   Fire Explosion Toxic gas Collapse of  building  /    
                  release   structure      
No.  Of  dangerous occurrences                      
in a year                              
(c)                                    
Number of

Number of injured

Number of workers

   

Number of

   

Number of workers

 
workers  

workers who

injured in previous

   

man-days lost

 

injured this year but

 
injured  

returned to work in

year who joined the

           

have not joined during

 
     

this year

 

work this year

             

this year

 
                             
81 Occupational Disease  details                      
List of

occupational

Occupational diseases reported in

No. of Workers

Mandays lost due

 
diseases which

are

 

the reporting period

   

died due to

 

to occupational

 

 

 

 

– 9 –

 

relevant to your Type No.

occupational

diseases
factory        

diseases

 

 

 

 

82

Medical Checks by Certifying Surgeons

     

Frequency of

Dates of medical

Name of the

Number of

Occupational
 

health

examination of the

certifying surgeon

workers

diseases detected.

checkups in

workers

who carried out the

examined

Type No.

your factory

 

medical

     
     

examination

     

 

 

 

 

 

83       Compensation/Ex-gratia details

 

Name of

Age

Monthly

%

Compensatio

Ex-

Whether

Whether

 

worker

 

wages

Disability

n paid

gratia

legal heirs

covered under

 
         

amoun

of

ESIC or

 
         

t

deceased

insured under

 
         

Paid

employed

WC policy? If

 
             

so give

 
Injured            

details.

 
               
Died                

 

 

84       Closure information of factory as per rule 125(2) of M.F.R., 1963

 

Name of factory and full address  
Date of closure  
Reasons for closure  
Nature of  closure,  whether  entire

Entire/partial

or partial.  
If   partial   the   shift,   section   or  
department closed  
Number of workers  on the muster  
roll at the time of closure  
Number of workers affected by the  
closure    
85

Re-opening information of factory as per rule 125(3) of M.F.R., 1963

Name of factory and full address  
Date of closure  
Number of workers affected at the  
time of closure  
Factory  or  any  shift,  section   or  
department thereof reopened  
Number of workers  on the muster  
roll at the time of reopening  
     

 

 

 

– 10 –

 

Number  of  workers  re-employed Re-employed
and newly employed Newly employed

 

Other

 

86          Is the factory a member of Yes/No the Mutual Aid and Response Group (MARG)

 

87          Has  the  company  engaged    Yes/No

in any other

corporate

If YES,
  social

responsibility

what activities?  ___________________________
  activities during the period? who benefited?_____________________________

88

Does   the

factory   employ

Yes/No
  any disabled workers? If  YES,  what  types  of  disability?  (e.g.  physical,  sight,
          hearing, intellectual? _________
          how many men? ____________
          how many women ___________
          If YES,what special assistance and support, if any, has been
          provided for them? __________

 

I verify and state that the above information is true and correct to the best of my knowledge and belief.

 

 

Signature of owner/manager-

 

 

Name-

 

 

Designation-                                          Date:

 

Explanatory Notes :

*1 The average number of workers employed daily should be calculated by dividing the aggregate number of attendances on working days (that is, man-days worked) by the number of working days in year. In reckoning attendance, attendance by temporary as well as permanent employees should be counted, and all employees should be included, whether they are employed directly or by or through any agency including contractors. Attendance on separate shifts (e.g. night and day shifts) should be counted separately. Days on which the factory was closed for whatever cause, and days on which manufacturing process were not carried on should not be treated as working days. Partial attendance for less than half a shift on working days should be ignored, while attendance for half a shift or more on such day should be treated as full attendance.

 

 

– 11 –

 

2 For seasonal factories, the average number of workers employed during the working season and the off-season should be given separately. Similarly the number of days worked and average number of manhours worked per week during the working and off-season should be given separately.

 

**3 The average number of hours worked per week mean the total actual hours worked by all workers during the year excluding the rest intervals but including over-time work divided by the product of total number of workers employed in the factory during the year and 52. In case the factory has not worked for the whole year, the number of weeks during which the factory worked should be used in place of the figure 52.

 

4    Every person killed or injured should be treated as one separate accident. If in one occurrence, six persons were injured or killed, it should be counted as six accidents.

 

5          In items 24(a), the number of accidents which took place during the year should given. In case of non-fatal accidents only those accidents which prevented workers form working for 48 hours or more, should be indicated. 

 

 Click Here To Download Annual Return Under Factories Act