Suggested format; no separate MCA form
Legal reference: Sections 378B and 378E
When applicable: For member produce and transactions used to measure patronage.
Completion instructions: Maintain transaction-level records and reconcile to purchases, stock, payments and approved patronage policy. Do not equate shareholding with patronage.
Editable preparation format. It is not a verbatim reproduction of a prescribed MCA form or a filing service. Where a statutory form is prescribed, reconcile all fields and use its current prescribed layout for the formal register. Maintain required authentication, access controls and retention.
| Company name | |
|---|---|
| CIN | |
| Registered office | |
| Period / register volume | |
| Custodian and authority |
| Date and voucher | |
|---|---|
| Member name and folio | |
| Commodity / service | |
| Quantity and unit | |
| Quality / grade | |
| Rate (INR) | |
| Gross value (INR) | |
| Deductions and explanation | |
| Amount withheld (INR) | |
| Net payable (INR) | |
| Payment date and reference | |
| Patronage measure and period | |
| Active-member assessment reference | |
| Authentication |
Prepared 24 September 2026. Review against the latest Rules and company Articles before statutory adoption. Source: Companies Act, 2013 and the Rules identified above. MCA · India Code