Balance Sheet

A. General Information   1. Name of the Entity __________________________________________   2. Entity Type          __________________________________________   3. Registration No      __________________________________________

B. Reference of Audit Report   1. AGM Date      :____________________ 2. Year Ending      :____________________

C. Balance Sheet   1. Balance Sheet Type      :Horizontal   Vertical 2. Authorized Capital (BDT) : 3. Total Shares (No.) :

Source of Funds (BDT) SL. Head Name Present Year Previous Year 1. Capital /Share Holder's Equity           1.1 Paid up Capital           1.2 Reserved and Surplus     2. Loans           2.1 Long Term Secured Loans           2.2 Long Term Un-secured Loans     Total ( Source of Funds )

Application of Funds (BDT) SL. Head Name Present Year Previous Year 1. Non Current Assets   `       1.1 Fixed Assets Net of Depreciation           1.2 Investment     2. Current Asset Loan and Advances           2.1 Inventories           2.2 Sundry Debtors           2.3 Cash in bank           2.4 Cash in hand           2.5 Others Current Assets           2.6 Loans and Advances     3. Less Current Liabilities and Provisions           3.1 Less : Current Liabilities           3.2 Less : Current Provisions     4. Miscellaneous           4.1 Expenditures to the extent not written off           4.2 Debit Balance of Profit an Loss Account     Total (Application of Funds )

D. Forms/Documents Presented for Filing by   1. Name          :__________________________________   2. Position       :__________________________________   3. Organization :__________________________________   4. Address       :__________________________________________________________________   ___________________________________________________District:  _____________________