THE SECOND SCHEDULE FORMS FORM I (To be submitted in Duplicate) [ See Paragraphs 2, 3 and 4 ] Form of information/application for fixation or revision of prices of Scheduled bulk drugs. 1. Name of the Bulk Drug. 2. Name of the manufacturer. 3. Address of the Registered/Head Office of the Manufacturer. 4. Address of the Factory. 5. Capacity under Industrial Licence/Small Scale Industry Registration/Industrial Entrepreneure Memorandum acknowledgement:- No. and date of Industrial Licence/Small Scale Industry Registration/Industrial Entrepreneure Memorandum acknowledgement; Production Capacity (Tonnes/Kgs./Litres etc.).

• Definitions • Fixation of Sale Prices    of Bulk Drugs • Bulk Drug Manufacturers • Calculation of Retail Price • Power to fix Formulation Prices • Power to Fix Ceiling Price • Power to recover Dues • Power to recover Overcharged Amt. • Issue of Price List • Power to Review • List of Price Controlled Drugs • Application for Bulk    Drug prices : Form I • Information for non-Scheduled    Bulk Drugs : Form II • Application for Formulation    Prices : Form III • Form IV, V, VI • The Third Schedule

6. Installed Capacity:- Number of shifts per day; Number of operating days per year; Maximum production per shift (Tonnes/Kgs./Litres etc.); Date of commissioning; Annual installed capacity. 7. Date of Commencement of Commercial Production. 8. Actual production achieved during the last accounting year (preferably monthwise) and also monthly production during the current year (Tonnes/Kgs/Litres etc.). 9. Brief note on the manufacturing process adopted by you indicating all stages including recovery of by-products, if any, solvents etc. and sagewise overall yield for each bulk drug. 10. Average hourly rate of production for each of the bulk drug since the commencement of the commercial production. 11. Maximum hourly rate of production achievable. 12. Estimated production of the bulk drug during the next three years. 13. If the production is proposed to be captively consumed for manufacturer of the formulation, please furnish the quantity to be so consumed out of the production given against Serial No.8 and Serial No.12. 14. Capital employed for the manufacture of the bulk drug(s):- Net fixed assets; Working Capital; Total. 15. Please state how the above capital employed is financed by net worth and borrowings. (In the case of multi-purpose plant the capital employed/net worth as above and the share to be allocated to the bulk drug/intermediate under consideration to be given.) 16. Please state the average rate of interest paid by you on your borrowings, supported by figures of the amount of loans, average rate of interest etc. as per latest audited Balance Sheet. 17. Please furnish latest c.i.f price of the bulk drug if the same had been imported or is being imported by you or by any other agency known to you. 18. Please furnish the cost of production of the bulk drug as per Annexure to this Form duly certified by a Practicing Cost Accountant/Chartered Accountant. 19. Please furnish number of persons employed/to be employed, gradewise, and their average monthly emoluments including contribution on account of Provident Fund etc. 20. Please furnish the total amount of expenses under each of the element of other conversion costs viz. stores, factory and administration overheads and depreciation and the basis adopted for allocation to the product in question. 21. If this item is manufactured/to be manufactured in a multi-product plant, the method adopted for allocations to individual drugs for common expenses viz. process hours, equipment hours etc. may be furnished. 22. Please also furnish the following:- The types of packing materials used and their average rates; Basis and calculations of profit margin; Photocopies of invoices of raw materials having substantial consumption and also for power, fuel ofi etc.; Details of the fixed assets, method of depreciation, rate of depreciation alongwith, working capital required for the product; A copy each of Audit & Balance Sheet and Profit & Loss Account for the last three years and in the case of a company copies of the latest Cost Audit Report & Annual Report. Notes : Any hold up affecting production to be shown clearly against Serial No.8. In case the same plant facilities are used for production of more than one product, the information as per serial No.6 may be given product wise. Annexure (See Item No. 18 of the Form I of the First Schedule) I. Name of the Bulk Drug. II. (a) Production in Tonnes/Kgs. /litres etc.    (b) Sales In Tonnes/Kgs./litres etc.    (c) Despatches In Tonnes/Kgs. /litres etc. III. Details of Cost:-    (a) Period;    (b) Cost Data: Sl. No. Particulars Norms of Consumption guaranteed by the know how supplier or as per standards developed unit Actual Consumption (Per kg/Lit etc. of the product) Quantity Rate/Unit (Rs.) Amount (Rs.) (1) (2) (3) (4) (5) (6) (7) 1. Raw Materials :- (a) Imported 1. 2. 3. etc. (b) Indigenous 1. 2. 3. etc. Total raw materials cost : Less Recoveries of Solvents : Net Raw Materials Cost : 2. Utilities:- (a) Power (b) Water (c) Fuel (Oil/Coal) (d) Others (To be specified) Total Utilities Cost. 3. Conversion Cost:- (a) Salaries and wages (b) Operating supplies or consumable stores (c) Repairs and Maintenance (d) Quality Assurance (e) Effluent treatment Other factory overheads (f) Administration overheads (h) Research and Development expenses (i) Depreciation Total Conversion Cost. 4. Cost of production (1+2+3). 5. Interest on borrowings. 6. Minimum Bonus. 7. Total (4+5+6). 8. Packing:- (a) Materials (b) Other expenses Total Packing Cost. 9. Selling Expenses. 10. Transport Charges. 11. Transit Insurance Charges. 12. Non-Recoverable Taxes. (Please specify and submit details alongwith supporting documents.) 13. Total cost of sales. 14. Profit Margin. (Basis of calculations be submitted) 15. Selling Price (13+14) 16. Place notified by the Govenunent, if any. (Please give No. and date of Notification) 17. Actual sale price, or Notional price, if used captively. NOTES:- 1. Items of expenses to be excluded from costs Bonus in excess of statutory minimum, Bad debts and Provisions Donations and charities Loss/Gain on sale of assets Brokerage and commission Expenses not recognised by Income Tax authorities (Salary, perquisities, advertisements etc.) Adjustments relating to previous years. 2. In the case of imported raw materials, please furnish seperately the c. i. f. price, duty of customs and other charges totalling to the landed cost adopted against 8. No. 1 (a). 3. Cost of intermediates Manufactured for captive use should be on the basis of factory cost of production inclusive of administration overheads and shown separately against 8. No. 1(b). A separate cost-sheet in the same proforma may please be appended. 4. Cost of generated utilities like power, steam etc. should be separately given furnishing the details of purchased utilities consumed, rate and cost with other expenses incurred on generation with reference to S. No. 2 . 5. Details in respect of factory overheads, administration overheads and selling expenses should be furnished against S.No. 3(d), 3(e) and 8. 6. The basis of depreciation adopted in your financial accounts may please be given against S.No. 3(f). 7. Please indicate clearly whether the existing price is notified by the Government or notional price against S. No. 16 and 17. 8. The information furnished in this form is to be certified by the Authorised Signatory of the Company and by the cost accountant/chartered accountant. The information furnished above is correct and true to the best of my knowledge and belief. Authorised Signatory: Place : Name : Date : Designation :