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| Name of Society | : |
| Name of Chairman/Secretary | : |
| Address of Society | : |
| Mobile No./Telephone No. | : |
| Type of Society |
: |
| Name of District | : |
| Block | : |
| Registration No. and Date | : |
| Area of Operation Society | : |
| Total No. of Panchayats | : |
| Name of Panchayats | : |
Total Population in Society's area of Operation | : |
| Total members of society | : |
| Members in Society- SC/ST/OTHERS |
| i. SC |
|
| ii. ST |
: |
| iii. OTHERS |
: |
| Total |
: |
|
| Members in Society- Male/Female |
| i. Male |
: |
| ii. Female |
: |
| Total |
: |
|
| Authorised Share Capital of Society |
| i. Share of State Govt. |
: |
| ii. Share of Members |
: |
| Total |
: |
|
Total Minor Forest Produce land under society's area | : |
Name and quantity of minor forest produce available in Society's area society | : |
Date of special general meeting/election of society | : |
| Members of the board of society | : |
| Status of Audit of Society | : |
| Business of society since last 03 years | : |
| Profit of society since last 03 years | : |
| Special Comment(if any) | : |
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