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Annual Return Under Factories Act

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I have Attached Annual Return Under Factories Act

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

For the year ending________________________________________

General information

Name and address of factory –

street, city, Taluka, district

Name

and

designation

occupier

Name

and

designation

manager

Contact details of occupier

Telephone

Fax

e-mail

Mobile

Contact details of manager

Telephone

Fax

e-mail

Mobile

Registration number of factory

License under Factories Act

License Number

Renewed

upto

Installed HP

Legal organization

(a) sole proprietor

(b)

partnership

(c) private

company (d) public company

(e) cooperative (f) family business (g) govt./semi

government(h) other

Ownership

(a) national

(b)

foreign

(c)

joint

national

and

foreign

Manufacturing

process

per

3 digit code as per attached Classification

NIC 2008

Manufacturing Processes

Plan approval number and date (

Number

Date

in chronological order)

Does

the

factory

have

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

the

Certificate of Stability?

certificate?

Permanent

serial No. of factory

Workforce

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-

Contract workers

Daily wage workers

i) Temporary workers

ii) Casual workers

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
(i)	annexed to CIMAH Rules 2003,
	annexed to CIMAH Rules 2003,
	in your factory? If so, give the						If none write NIL
	list.
(ii)	Do	you	store	quantities		of
(ii)	hazardous chemicals equal to or
	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
(iii)	category,
	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
(iv)	hazardous chemicals equal to or
	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

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?—–

– 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
Adults	M
	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)

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

Occupational Disease details

List

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.
Injured
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

Employment information

No. of days worked in a year:———

Workers

Number

**Avg. No.

Number of

Number of