FORM NO. 10CCB
[See rule 18BBB]
Audit report under section 80-I(7)/80-IA(7)/80-IB/80-IC
1. Name of the assessee
2. PAN
3. Status
4. Ownership status of the undertaking/enterprise :
(a) Fully owned by assessee Yes No
(b) Partly owned by assessee Yes No
If yes, please specify the percentage of ownership
5. Address
6. Name of the enterprise or undertaking eligible for
deduction under section 80-IA, 80-IB or 80-IC
7. Section and sub-section of the Income-tax Act,
1961, under which deduction is being claimed
8. Date of commencement of operation/activity by the
undertaking or enterprise
9. Initial assessment year from when deduction is
being claimed
10. Address (with District and State) of the enterprise/
undertaking claiming deduction
11. Excise/service tax registration number and office
where registered
12. Sales-tax registration number and office where
registered
13. Local/State authorities from whom approval is
taken (attach copy of approval)
ELIGIBLE BUSINESS UNDER SECTION 80-IA
14. Development, operation, maintenance of an
infrastructure facility:
(a) With respect to the infrastructure facility, does
the enterprise (please tick):
Develop Operate and
maintain,
Develop, operate and maintain, the
infrastructure facility.
(b) Please specify the nature of the infrastructure
facility
[e.g., road, bridge, rail system, port, etc.
[Explanation to section 80-IA(4)(i)]]
(c) Has the operation and maintenance of the
infrastructure facility been received on transfer
from its developer in accordance with the
agreement with the Central/State Government/local
authority/any other statutory body
Yes No

(d) If yes, please specify the first year of claim of
deduction under section 80-IA by the developer
(Attach copy of Form 10CCB of developer)
15. Providing telecommunication services :
(a) Please specify the nature of telecom service
[e.g., basic telecom service, cellular service, etc.
[Section 80-IA(4)(ii)]]
16. Development, operation, maintenance of industrial
park/SEZ
(a) With respect to the industrial park/SEZ, does the
undertaking (please tick) :
Develop Develop and
operate
Maintain and operate an industrial
park/SEZ
(b) Name and address of the industrial park/SEZ£
(c) Has the operation and maintenance of the
industrial park/SEZ been received on transfer from
its developer
Yes No
(d) If yes, first year of claiming deduction under
section 80-IA by the developer (Attach copy of
Form 10CCB of developer)
17. Generation, transmission, distribution of power :
(a) Does the undertaking generate power or
generate and distribute power
Yes No
(i) If yes, indicate the year in which the undertaking
has started generating power
(b) Does the undertaking transmit or distribute
power
Yes No
(i) If yes, indicate the year in which the new
transmission and distribution lines were laid
(c) Has there been substantial renovation and
modernization of the existing network of
transmission or distribution lines
Yes No
If yes, please specify,-
(i) the year in which the substantial renovation and
modernisation of the existing network of
transmission or distribution lines took place
(ii) book value of plant and machinery as on 1-4-
2004
(iii) value of increase in the plant and machinery in
the year of substantial renovation and
modernisation
ELIGIBLE BUSINESS UNDER SECTION 80-IB
18. Industrial undertakings engaged in manufacture or
production of article or thing or operation of cold
storage plant
(a) Does the industrial undertaking manufacture or
produce any article or thing specified in the
Yes No
Eleventh Schedule
(Please specify the article or thing......)
(b) If yes, does the manufacturing process use
power
Yes No
(c) Number of workers employed in the
manufacturing process
(d) Does the industrial undertaking operate any cold
storage plant
Yes No
(e) Please specify if the company is a small scale
industrial undertaking
Yes No
(f) If the industry is located in the North Eastern
Region, is the industry a notified industry as per
second proviso to section 80-IB(4)?
Yes No
(g) If the industry is located in Jammu & Kashmir,
does it manufacture or produce any article or thing
specified in part ‘C’ of the Thirteenth Schedule?
Yes No
19. Business of ship
(a) Is the ship owned by an Indian company and
wholly used for the business carried on by it
Yes No
(b) If the ship was acquired on transfer, was the
ship owned or used in Indian territorial waters by a
person resident in India
Yes No
20. Business of hotel
(a) Is the hotel located in
(i) Hilly area
(ii) Rural area
(iii) Place of pilgrimage
(iv) Other notified area (Please specify____________)
(v) None of the above (Please specify____________)
(b) Is the hotel approved by the prescribed authority
under rule 18BBC of the Income-tax Rules, 1962?
Yes No
21. Business of scientific research and development
(a) Is the business approved by the prescribed
authority under rule 18D?
Yes No
(Please attach copy of approval)
(b) Does it fulfil the conditions prescribed in rule
18DA of the Income-tax Rules?
Yes No
22. Commercial production or refining of mineral oil
(a) Is the undertaking engaged in the commercial
production or refining of mineral oil?
Yes No
(b) If yes, please specify:
Commercial production of mineral
oil
Refining of mineral oil
23. Developing and building housing projects
(a) Date of approval by local authority
(Please attach copy of approval/if approval is
obtained more than once, attach copy of first
approval of the building plan)
(b) Date of completion of the housing project
(Please attach copy of the completion certificate
issued by the local authority)
(c) Size of plot of land of the project
(d) Is the project situated in Delhi or Mumbai or
within 25 kilometres from their municipal limits
Yes No
(e) Built-up area of the residential unit of the
project
(f) Built-up area of the shops and other commercial
establishments situated in the project
(g) Whether the project is carried out in accordance
with a scheme framed by Central/State Government
for re-construction/re-development of existing
buildings in areas declared to be slum areas under
any law in force and notified by the Board.
Yes No
(Please attach a copy of CBDT’s notification)
(h) Please specify the method of accounting
adopted
24. Other business activities
(a) Is the undertaking in the business of setting up
and operating a cold chain facility for agricultural
produce
Yes No
(b) Is the undertaking in the integrated business of
handling, storage and transportation of foodgrains
Yes No
(c) Is the undertaking in the business of processing,
preservation and packaging of fruits or vegetables
Yes No
Eligible business under section 80-IC
25. (i) Whether the undertaking or enterprise is located
in an area notified by the Board for the purposes of
section 80-IC
Yes No
(ii) If yes, please indicate,—
(a) Name of the Export Processing Zone/Integrated
Infrastructure Development Centre/Industrial
Growth Centre/Industrial Park/Estate/Software
Technology Park/Industrial Area/Theme Park and
the District/State in which located
(b) Khasra No. of the undertaking or enterprise
(Also indicate the Board’s Notification No.)
(c) If the eligible business is new, please give the
date of commencement of production or
manufacture of article or thing
(d) If the existing business has undertaken
substantial expansion, please specify,-
(i) The date of substantial expansion
(ii) The total book value of plant and machinery
(before taking depreciation in any year) as on first
day of the previous year in which substantial
expansion took place.
(iii) Value of increase in the plant and machinery
in the year of substantial expansion.
(e) Does the undertaking or enterprise manufacture
or produce any article or thing specified in the
Thirteenth Schedule
Yes No
(If yes, please specify the article or thing)
(f) Does the undertaking or enterprise manufacture
or produce any article or thing specified in the
Fourteenth Schedule
Yes No
(If yes, please specify the article or thing or operation)
26. For claim of deduction under section 80-IA(4)(ii)
and (iv)/ 80-IB(3), (4), (5), (7) and (11)/80-IC,
please indicate :
(a) Whether the undertaking or enterprise has been
formed by the splitting up or the reconstruction of a
business already in existence
Yes No
(b) If yes, whether the circumstances and the period
specified in section 33B is applicable
(Please give details)
(c) Has the undertaking or enterprise received any
machinery or plant on transfer which was
previously used for any purpose
Yes No
(d) If yes, please specify value of machinery or
plant received on transfer
(e) Total value of machinery or plant used in
business
27. Total sales of the undertaking
28. Transactions by the undertaking to a related
concern of the assessee, or another undertaking of
the assessee, or the co-owner of the undertaking, or
another undertaking of the co-owner :
[Related concern is a person within the meaning of
section 40A(2)(b)]
Name of the Related Concern Transaction
(Please specify nature and amount)
(a) Rs.
(b) Rs.
(c) Rs.
(d) Rs.
29. Profits and gains derived by the
Undertaking/enterprise from the Eligible business#
30. Deduction under section 80-I/80-IA/80-IB/80-IC
(Strike out whichever is not applicable).

Declaration
I/We have examined the balance sheet of the above industrial undertaking or enterprise styled________________________________________________and belonging to the assessee M/s____________________________________________(Permanent Account No.______________________) as at__________________________and the profit and loss account of the said industrial undertaking or enterprise for the year ended on that date which are in agreement with the books of account maintained at the head office at________________________and branches at_________________
I/We have obtained all the information and explanations which to the best of my/our knowledge and belief were necessary for the purposes of the audit, in my/our opinion, proper books of account have been kept by the head office and the branches of the industrial undertaking or enterprise aforesaid visited by me/us so far as appears from my/our examination of books, and proper returns adequate for the purposes of audit have been received from branches not visited by me/us, subject to the comments given below :
In my/our opinion the undertaking or enterprise satisfies the conditions stipulated in section 80-I/80-IA/80-
IB/80-IC (strike out whichever is not applicable) and the amount of deduction claimed under this section in item 30 is as per the provisions of the Income-tax Act and meets the required conditions.
In my/our opinion and to the best of my/our information and according to explanations given to me/us, the said accounts give a true and fair view—
(i) in the case of the balance sheet, of the state of affairs of the above named industrial undertaking or enterprise as at_______________________; and
(ii) in the case of the profit and loss account, of the profit or loss of the industrial undertaking or enterprise for the accounting year ending on________________
Place
Date Signed
Accountant$
Notes:
1. Delete whichever is not applicable.
2. Here give name and address.
3. Furnish a copy of the agreement with the Central Government or State Government or local authority.
4. Please provide profit and loss account and balance sheet of undertaking/enterprise.
5. Please provide the notification of approval of the industrial park/SEZ.
6. This report is to be given by
(i) a chartered accountant within the meaning of the Chartered Accountants Act, 1949 (38 of 1949); or
(ii) any person who, in relation to any State, is, by virtue of the provisions in sub-section (2) of section 226 of the Companies Act, 1956 (1 of 1956), entitled to be appointed to act as an auditor of companies registered in that State.
7. Where any of the matters stated in this report is answered in the negative or with a qualification, the report shall state the reasons therefor.