FORM D

( See Rule 5 )

Annual Return – Bonus paid to employees for the accounting year ending on the 2016 – 17

1. Name of the establishment and its complete SAI URJA INDO VENTURES PVT . LTD., At UG - 2, Office floor,
postal address : J. K. Complex, Nanaji Nagar, Nagpur Road, Chandrapur (M.S.) 442401

2. Nature of Industry : Housekeeping of Operation Main Plant Area

3. Name of the Employer : GMR Warora Energy Limited

4. Total No of employees : 72

5.  Number of employees benefited by bonus

payments : 72

Whether bonus
Total amount payable as bonus under section Settlement, if any, reached under section 18 (1) of Percentage of Total amount of Date on which has been paid to
10 or 11 of the Payment of Bonus Act, 1965 as 12(3) of the Industrial Dispute Act, 1947 with date bonus bonus actual to be paymet made all the employees, Remarks
the case may be declared to be paid if not, reason for
paid non payment

1 2 3 4 5 6 7

4,38,994 ….. 8.33% 4,38,994 4/21/2017 Yes ….

Signature of the employer or his agent