Regulations > Schedules > First Schedule

.........................................................Society

Financial year ended 31st December 19.....

GENERAL AND STATISTICAL INFORMATION

1.	Registered address of Society ..........................................................................................

2.	Name and address of the person for the time being at the head of the managing body

.........................................................................................................................................

3.	Name of principal officer ..................................................................................................

4.	Name and address of the auditor of the Society ................................................................

5.	Number of branches

6.	Statistics of members—

(a)	Number of members at end of previous financial year	.................................
(b)	Number of members admitted during the financial year to which this statement relates	................................
(c)	Number of persons whose membership terminated during the year to which this statement relates	................................
(d)	Number of members at end of the financial year to which this statement relates	................................

7.	Particulars of benefits

Type of Benefit	Amount*
Type of Benefit	Benefits in respect of previous year paid out this year.	Benefits in respect of this year paid out	Claims received but not paid and provision for unintimated claims at end of year.
Medical benefits
Sick pay benefits
Death benefits
Funeral benefits
Other benefits (specify)
TOTAL
TOTAL

* Ex gratia payments and donations should not be included in these amounts.

8. Ex gratia payments to members

Nature of Award		Amount
(a)	Towards medical expenses
(b)	Towards loss of remuneration
(c)	Towards funeral and death expenses
(d)	Towards other expenses (specify)
	TOTAL

Donations

Friendly Societies Act, 1956 (Act No. 25 of 1956)