DSF Ohada English Version

STATISTICS AND TAX RETURN
(STANDARD MODEL)
Period from : to:
Name of the enterprise: _________________________________________

____________________________________________________________________________
Acronym: abbreviated name or emblem: __________________________________________
Street:________________________
Post office box: __________ Town: __________________
Phone:________________ Fax :______________
Taxpayer's card number: ____________________________________
Commercial registration number: ________Town:__________________
LEGAL AND FISCAL STATUS

Legal status: ____________________________________________________________
Special regime: ____________________________________________________________
Fiscal regime: ____________________________________________________________
Approvals obtained: __________________________________________________________
Nature of profits : ________________________________________________________
ENTERPRISE'S ACTIVITIES
Main activity at the beginning and Percentage of
overall turnover
end of the period: ___________________________________________ _______%
Secondary activities at the beginning

and end of the period:_______________________________________ _______%
New activities engaged in

during the period: _______________________________________ _______%
Activities given up
during the period: __________________________________________________ _______%
If the enterprise has ceased

operations, state why: ____________________________________________________________
Statistics and tax return drawn up by: __________________________________________

TABLE 2
Name of the enterprise ---------------------------------------------------------------------------------
Address ---------------------------------------------------------------------------------
Identification number -------------------- Period ending on 31/12/ -------- Duration (in month) --------
STAFF MOVEMENT DURING THE PERIOD
Cameroonians Other CEMAC Other Non
Description nationals OHADA
Total
countries OHADA
countries
PERMANET STAFF
Beginning of the period

Recruitment
Senior Management Departure
End of the period
Senior technicians and middle Recruitment
level managers Departure
End of the period
Technicians, foremen and skilled Recruitment
workers Departure
End of the period
Clerks, unskilled workers, manual Recruitment
labour and apprentices. Departure
End of the period
Total Recruitment
Departure
End of the period
Seasonal workers hired during the period
(Number of days worked)
COMPANIES REGISTERED UNDER CAMEROON LAW( Head office in Cameroon)
Amount of issued share capital at the end of the period: __________________ Francs CFA
Private Public
Allocation of share capital Cameroonian shareholding % %
( in percentage) Foreign shareholding % %
Names of main shareholders ________________________________%

(or partners) and percentage of share capital ________________________________%
held by each of them ________________________________%
________________________________%
________________________________%
________________________________%
Subsidiaries or branches of enterprises with their head offices abroad
Name of the parent company _____________________________________

_____________________________________
Address abroad _____________________________________
BALANCE SHEET (ASSETS) TABLE 3
Address ---------------------------------------------------------------------------------
Identification Number -------------------- Period ending on 31/12/ -------- Duration (in month) --------
Line
Period N . Period
N-1
Depreciation /
Ref. ASSETS Gross val. Provisions Net Amt. Net Amt.
Fixed Assets(1) 01
AA Deferred charges 02
AX Pre-operating costs 03 ................ ................ ................
AY Expenses to be spread over several years 04 …………. …………. ………….
AC Debenture redemption premium 05 ................ ................ ................
AD Intangible assets 06
AE Research and development costs 07 ................ ................ ................ ................
AF Patents, license, software 08 ................ ................ ................ ................
AG Goodwill 09 ................ ................ ................ ................
AH Other intangible assets 10 ................ ................ ................ ................
AI Fixed Assets 11
AJ Land 12 ................ ................ ................ ................
AK Buildings 13 ................ ................ ................ ................
AL Installations, fittings and fixtures 14 ................ ................ ................ ................
AM Equipment 15 ................ ................ ................ ................
AN Transport equipment 16 ................ ................ ................ ................
AP Advances & payment on a/c for fixed assets on order 17 ................ ................ ................ ................
AQ Financial assets 18
AR Investments in shares 19 ................ ................ ................ ................
AS Other financial assets 20 ................ ................ ................ ................
AW (1) of which Outside Ordinary Activity (O.O.A): 21
Gross amount .............. / ....................
Net ............. / ..................... 22
AZ TOTAL FIXED ASSETS (I) 23 ................ ................ ................ ................
CURRENT ASSETS 24
BA Current assets O.O.A. 25 ..................... ..................... ..................... ....................
BB Stocks 26
BC Goods for resale (merchandise) 27 ..................... .................... ..................... .....................
BD Raw materials & consumable goods 28 ..................... ..................... ..................... .....................
BE Products and work in progress 29 ..................... ..................... ..................... .....................
BF Finished goods 30 ..................... ..................... ..................... .....................
BG Debtors and related receivables 31
BH Suppliers: advances paid 32 ..................... ..................... ..................... .....................
BI Customers 33 ..................... ..................... ..................... .....................
BJ Other debtors 34 ..................... ..................... ..................... .....................
BK TOTAL CURRENT ASSETS (II) 35
LIQUID ASSETS 36
BQ Investment in securities 37 ..................... ..................... ..................... .....................
BR Bills for collection 38 ..................... ..................... ..................... .....................
BS Bank, postal cheques, cash in hand 39 ..................... ..................... ..................... .....................
BT TOTAL LIQUID ASSETS (III) 40 ..................... ..................... ..................... .....................
BU Exchange conversion difference (IV) 41 ..................... ..................... ..................... .....................
(probable exhange loss)
BZ GRAND TOTAL (I + II + III + IV) 42 ..................... ..................... ..................... .....................
BALANCE SHEET(LIABILITIES)table 4
Address ---------------------------------------------------------------------------------
Réf. LIABILITIES Period N . Period
Line
(before appropriation) N-1
EQUITY AND LONG TERM LIABILITIES 01
CA Capital 02 ................................. .................................
CB Shareholders- capital not yet called up – 03 ................................. .................................
CC Premiums and Reserves 04

CD Merger, issue and share premiums 05 ................................. .................................
CE Revaluation surplus 06 ................................. .................................
CF Legal reserves 07 ................................. .................................
CG Free reserves 08 ................................. .................................
CH Retained earnings + or – 09 ................................. .................................
CI Profit or loss for the period (profit + or loss –) 10 ................................. .................................
CK Other long term equity 11

CL Investment grants and subsidies 12 ................................. .................................
CM Regulated provisions and related funds 13 ................................. .................................
CP TOTAL EQUITY (I) 14 ................................. .................................

LONG TERM BORROWINGS AND RELATED LIABILITIES (1) 15
DA Long term borrowings 16 ................................. .................................
DB Long term leasing liabilities and related contracts 17 ................................. .................................
DC Sundry long term financial liabilities 18 ................................. .................................
DD Financial provisions for risks and charges 19 ................................. .................................
DE (1) of which O.O.A. : ................... / …………… 20

DF TOTAL LONG TERM LIABILITIES (II) 21 ................................. .................................
DG PERMANENT RESOURCES: TOTAL (I + II) 22 ................................. .................................

CURRENT LIABILITIES 23
DH Current liabilities O.O.A. and related resources 24 ................................... ...................................
DI Customers: advances received 25 ................................... ...................................
DJ Trade suppliers 26 .................................. ...................................
DK Tax liabilities 27 ................................... ...................................
DL Social liabilities 28 .................................. ..................................
DM Other creditors 29 ................................... ...................................
DN Provisions for risks 30 ................................... ...................................
DP CURRENT LIABILITIES:TOTAL (III) 31 .................................. ..................................

BANK ADVANCES & OVERDRAFTS 32
DQ Bank, discount credits 33 ................................... ..................................
DR Banks, treasury credits 34 ................................... ..................................
DS Bank overdrafts 35 ................................... ..................................
DT TOTAL TREASURY LIABILITIES (IV) 36 .................................. ..................................

DU Exchange difference (V) .................................. ..................................
37
(probable gain on exchange)
DZ GRAND TOTAL(I + II + III + IV + V) 38 ................................. ................................
TABLE 5
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PROFIT AND LOSS ACCOUT: EXPENSES

Ref. Headings Period N . Period
N-1
ORDINARY ACTIVITIES 01
RA Purchases of merchandise 02 ................................. .................................
RB -Stock variations (– or +) 03 ................................. .................................
(Gross margin on merchandise see TB) 04
RC Purchases of raw materials and related supplies 05 ................................. .................................
RD – Stock variations (– or +) 06 ................................. .................................
(Gross margin on raw materials see TG) 07
RE Other purchases 08 ................................. .................................
RH – Stock variations (– or +) 09 ................................. .................................
RI Transport 10 ................................. .................................
RJ External Services 11 ................................. .................................
RK Taxes and levies 12 ................................. .................................
RL Other expenses 13 ................................. .................................
(Value Added see TN) 14
RP ................................. .................................
Personnel expenses(1) 15
(1) Of which external personnel............. /............ 16
RQ (Gross operating margin see TQ) 17
RS Allowances for depreciation and provisions 18 ................................. .................................
RW Total operating expenses 19 ................................. .................................
(Operating profit or loss see TX) 20
FINANCIAL ACTIVITIES 21
SA Financial charges 22 ................................... ...................................
SC Exchange Losses 23 ................................... ...................................
SD Allowances for depreciation and provisions 24 ................................... ...................................
SF Total financial charges 25 ................................... ...................................
(Profit or loss from financial activities see UG) 26
SH Total expenses linked to ordinary activities 27 ................................... ...................................
(Profit or loss from ordinary activities see UI) 28
OUTSIDE ORDINARY ACTIVITIES(O.O.A.) 29
SK Book value of fixed assets sold 30 ................................... ...................................
SL Expenses O.O.A. 31 ................................... ...................................
SM Provisions O.O.A. 32 ................................... ...................................
SO Total charges O.O.A. 33 ................................... ...................................
(Profit or loss O.O.A. see UP) 34
SQ Workers participation 35 ................................... ...................................
SR Company income tax 36 ................................... ...................................
SS Total workers participation and income tax 37 ................................... ...................................
ST TOTAL EXPENSES 38 ................................... ...................................
(Net Profit or loss see UZ) 39
TABLE 6
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PROFIT AND LOSS ACCOUNT – REVENUE

Ref. Headings Period N Period N - 1
ORDINARY ACTIVITIES 01
TA Sales of merchandise 02 ..................... .....................
TB GROSS MARGIN ON MERCHANDISE .................. .................. 03
TC Sales of manufactured products 04 ................... ...................
TD Works and services sold 05 ................... ...................
TE Output stocked (or destocking) (+ or –) 06 ................... ...................
TF Output capitalised 07 ................... ...................
TG GROSS MARGIN ON RAW ................. ................. 08
MATERIALS
TH Accessory products 09 ................... ...................
TI TURNOVER (1) (TA + TC + TD + TH) ............ /............ 10
TJ (1) Of which exported ............ /............ 11
TK Operating subvention 12 ................... ...................
TL Other income 13 ................... ...................
TN VALUE ADDED ................. .................. 14
TQ GROSS ORDINARY MARGIN ................. .................. 15
TS Provisions written back 16 ................... ...................
TT Transfer of expenses 17 ................... ...................
TW Total operating revenue 18 ..................... ......................
TX PROFIT OR LOSS Profit (+) ; Loss (–) ................. .................. 19
FINANCIAL ACTIVITY 20
UA Financial revenue 21 ...................... ......................
UC Exchange gains 22 ...................... ......................
UD Provisions written back 23 ...................... ......................
UE Transfer of expenses 24 ...................... ......................
UF Total of financial revenue 25 ...................... ......................
UG FINANCIAL PROFIT OR LOSS (+ or —) ....................... …………. 26
UH Total revenue from ordinary activities 27 ...................... ......................
UI PROFIT OR LOSS FROM ORDINARY ACTIVITIES(1) ……………… ........................... 28
(+ or —)
UJ (1) Of which related taxes............ / ............ 29
OUTSIDE ORDINARY ACTIVITIES (O.O.A.) 30
UK Proceeds of sale of fixed assets 31 ...................... ......................
UL Income from O.O.A. 32 ...................... ......................
UM Write-back from O.O.A. 33 ...................... ......................
UN Transfer of expenses 34 ...................... ......................
UO Total revenue O.O.A. 35 ...................... ......................
UP PROFIT OR LOSS O.O.A. (+ or –) ........................... ........................... 36
UT TOTAL REVENUE 37 ...................... ......................
UZ NET PROFIT OR LOSS Profit (+) ; loss (–) ........................... ........................... 38
TABBLE 7A
Address ---------------------------------------------------------------------------------
Identification name -------------------- Period ending on 31/12/ -------- Duration (in month) --------
CASH FLOW STATEMENT

NB : All receivables and payables adjusted for unrealised exchange gains or losses (Positive and negative conversion
differences) and shown at their "historical" amounts(cost). Procedure to be applied to captions BH, BI, BJ, DI, DJ,
DK, DL, DM, DN, FD, FI, FQ, FR of the following table, as well as to the first two lines of the control table at the
end of the table.
PART 1-DETERMINATION OF CASH FLOW FROM ORDINARY ACTIVITIES IN

YEAR- N
 GLOBAL SELF- FINANCING CAPACITY (G.S.F.C.)
 Outs tan ding disbursables exp enses

GSFC  GCO excluding sales of fixed assets;
 outs tan ding collectible income
G.C.O. ..............................
(SA) Financial expenses 01 .............................. (TT) Transfer of operating expenses ..............................
(SC) Exchange losses 02 .............................. (UA) Financial revenue ..............................
(SL) Expenses 03 .............................. (UE) Transfer of financial expenses ..............................
(SQ) Participation 04 .............................. (UC) Exchange gains ..............................
(SR) Company Income tax 05 .............................. (UL) Revenue O.O.A. 06 ..............................
(UN) Transfer of expenses O.O.A. 07 ..............................
Total (I) 08 .............................. Total (II) ..............................
GSFC : Total (II)  Total (I) = 09 ................... (N  1) : ................................


 SELF FINANCING (S.F.)
SF = GSFC  Payment of dividends during the period (1)

SF = 10 ...........  ............ = ................... (N  1) : ................................
 CHANGES IN REQUIREMENT OF FINANCING OPERATIONS (R.F.O.)
Chan. R.F.O. = Var. Stocks2 + Chan. Debtors ² + Chan. Current liabilities ²

Stock variations : N  (N1) Application- increase Source- decrease
(+) ()
(BC) Merchandise 11 ......................................... Or ........................................................
(BD) Raw materials 12 ......................................... Or ........................................................
(BE) Items in progress 13 ......................................... Or ........................................................
(BF) Finished goods 14 ......................................... Or ........................................................
(A) Total net variation in stock 15 ......................................... Or ........................................................
1
() Dividends paid during the year including interim dividend
2
()Excluding the items O.O.A.
TABLE 7B
Address ---------------------------------------------------------------------------------
CASH FLOW STATEMENT

(Cont'd)
Application -increase Source- decrease

Changes in debtors : N – (N – 1) (+) (–)
(BH) Suppliers: advances paid 16 ................................... Or ...................................
(BI) Customers 17 ................................... Or ...................................
(BJ) Other debtors 18 ................................... Or ...................................
(B) Total net changes in debtors 19 ................................... or ...................................
Application increase Source decrease

Changes in current liabilities : N – (N – 1) (–) (+)
(DI) Customers: deposits received 20 ................................... Or ...................................
(DJ) Trade Suppliers 21 ................................... Or ...................................
(DK) Tax liabilities 22 ................................... Or ...................................
(DL) Social liabilities 23 ................................... Or ...................................
(DM) Other creditors 24 ................................... Or ...................................
(DN) Provisions for risks 25 ................................... Or ...................................
(C) Total variation in current liabilities 26 ................................... Or ...................................
CHANGES IN R.F.O. = (A) + (B) + (C) 27 ................................... Or ...................................
 Cash surplus from operations (C.S.O..)

CSO = GCO — Changes in RFO — Fixed assets produced for own account
N N-1
Gross cash from operations 28 ................................... ...................................
– Changes in RFO. (– if application ;+ if source) (–or +) 29 ................................... ...................................
– Fixed assets formation for own account 30 –................................... –..................................
CASH SURPLUS FROM OPERATIONS 31 ................................... ...................................

TABLE 8
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CASH FLOW STATEMENT : Cont'd
PART 2 : TABLE
REF HEADINGS Period N Period N - 1
Application Sources (E – ; R +)
I. INVESTMENTS AND DISINVESTMENT 01
............................ ///////////////////////// .........................
FA Capitalised expenses (increase during the year) 02
Internal Growth 03
FB Purchases/Sales of intangible fixed assets 04 ............................ ............................ ............................
FC Purchases/ Sales of tangible fixed assets 05 ............................ ............................ ............................
External Growth 06
FD Purchases/Sales of financial fixed assets 07 ............................ ............................ ............................
FF TOTAL INVESTMENTS 08 ................... ................. .....................
FG II. CHANGES IN REQUIREMENTS OF FINANCING OPERATIONS (cf. Supra : Var. R.F.O.) 09 ........................or .......................... ...........................
FH A – OPERATING APPLICATIONS TO BE FINANCED (FF + FG) 10 ............................ ............................ ............................
FI III. APPLICATIONS/ SOURCES (B.F., O.O.A.) 11 ........................or .......................... ..........................
FJ IV. COMPULSORY FINANCING APPLICATION(1) 12 ............................ ////////////////////// ...........................
Reimbursement of long term loans and long term financing liabilities

13
FK B — TOTAL APPLICATIONS TO BE FINANCED 14 ......................... ......................... ........................
V. INTERNAL FINANCING 15
FL Dividends (application) / G.S.F.C.. (source) 16 ........................... ............................ ............................
VI. FINANCING BY EQUITY 17
FM Increases due to new capital introduced 18 //////////////////////// ........................... ...........................
FN Capital subvention 19 //////////////////////// ........................... ...........................
FP Drawings on capital (including withdrawals by operator) 20 ............................ ///////////////////////// ............................

VII. FINANCING BY NEW LOANS 21
FQ Borrowings (2) 22 ............................ ............................ ............................
FR Other Financial Liabilities (2) 23 ............................ ............................ ............................
FS C – NET FINANCING SOURCES 24 ........................... ............................ ............................

FT D – SURPLUS OR DEFICIT OF FINANCING RESOURCES (C – B) 25 ........................or ........................... ............................
VIII. VARIATION IN LIQUID ASSETS 26
Net Liquidity 27
FU At the close of the period + or — ................... 28
FV At the beginning of the period + or — ................... 29
FW Changes in liquid assets: (+ Application ; — Source) ................... 30 ....................... or ............................ ............................
Control : D = VIII with opposite sign 31

(1) Excluding redemption before due date shown in VII
(2) Redemption before due date booked separately as applications
CONTRÔL (from balance sheet totals of N and N — 1) 32 Applications sources
Changes in working capital (WC) : WC(N) – WC(N – 1) 33 ..................... or ..........................
Changes global financing requirement (F.F.O.) : R.F.O(N) – R.F.O(N – 1) 34 ......................or ..........................
Changes in treasury (T) : T(N) – T(N – 1) 35 ..................... or ..........................
TOTAL 36 ...................……. = ..........................
TABLE 9
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FIXED ASSETS
A INCREASES B DECREASES C D =A+ B – C
SITUATION AND MOVEMENTS Opening Assets brought Transfers As the result of Disposals, Transfers Closing balances
balance of in during the between revaluation during the divestments out between of fixed assets
fixed assets period accounts period of service accounts a/c(at cost)
a/c(at cost)
HEADINS
Deferred charges : total lines 2 and 3 01
Pre-operating costs and expenses spread over several years 02
Debenture redemption premium 03
INTANGIBLE ASSETS :Lines 5 to 8 04
Research and development costs 05
Patents, Licenses, Software 06
Goodwill 07
Other intangible assets 08
Tangible Fixed assets : lines 10 to15 09
Land 10
Buildings 11
Installations, Fixtures and fittings 12
Equipment 13
Transport Equipment 14
ADVANCES & PAYMENTS ON A/C. OF 15

FIXED ASSETS ON ORDER
FINANCIAL ASSETS : lines 17 to 18 16
Investments in shares 17
Other Financial assets 18
GRAND TOTAL :Lines 1, 4, 9 and 16 19
NB : Include at the bottom of this table, if significant, the amounts of tangible and intangible fixed assets in progress at the close of the year.
TABLE 10
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DEPRECIATION
SITUATION AND MOVEMENTS A B C D=A+B-C
Lines
Opening balance of depreciation Depreciation charge for the Depreciation relating to fixed Closing balances of
A/C (Cumulative) period assets written off depreciation
account(Cumulative)
HEADINGS
DEFERRED CHARGES 01
Pre-operating costs & expenses to be spread 02

Debenture redemption premium 03
TOTA LINES 2 and 3 04

INTANGIBLE ASSETS 05
Research and development costs 06
Patents, licenses, software 07
Goodwill 08
TOTAL (I) : lines 6 and9 10
TANGIBLE FIXED ASSETS 11
Land 12
Buildings 13
Installations, Fixtures and Fittings 14

Equipment 15
TOTAL (II) : lines12 and 16 17
TOTAL ( I + II ) 18
Total Depreciation charge for the year 19

Deferred depreciation in case of a loss
Previously deferred depreciation Deferred depreciation for the period Previously deferred depreciation Deferred depreciation at the end of period
allocated for the period
20 + + =
TABLE 11
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Identification Name -------------------- Period ending on 31/12/ -------- Duration (in month) --------
PROFIT OR LOSS ON DISPOSAL OF ASSETS (1)
HEADINGS ORIGINAL VALUE ACCUMULATED NET BOOK VALUE PRICE PROFIT OR LOSS
DEPRECIATION REALISED
A C =A– B ON DISPOSAL
B E=D-C
D
Reseach and development costs 01
Patents, Licenses and Software 02
Goodwill 03
Intangible Fixed Assets :Total lines 1 to 4 05
Land 06
Buildings 07
Equipment 09
Tangible Fixed Assets : Total lines 6 to 10 11
Investment in shares 12
Other Financial Assets 13
Financial Assets: Total lines 12 to 13 14
Total: totals of lines 5, 12 and 14 15
______________
(1) By each caption of the balance sheet
TABLE 12
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TABLE OF PROVISIONS
SITUATIONS AND MOVEMENTS A B C D=A+ B –C
Lines
Opening balances PROVISIONS MADE DURING THE PROVISIONS WRITTEN BACK Closing
of Provisions PERIOD DURING THE PERIOD balances of
account Operation Financial Outside Outside Provisions
HEADINGS Operation Financial
Ordinary Ordinary account
activities activities
1. Statutory provisions 01
2. Financial provisions for risks and charges 02
3. Provisions for loss in value of Fixed & Long term assets 03
TOTAL (I) : lines 1 to 3 04
4. Provisions for loss in value of stocks 05
5. Provisions for losses in respect of third party accounts 06
6. Provisions for losses in respect of financial accounts 07
TOTAL (II) : lines 5 to 7 08
TOTAL (I) + (II) 09
TABLE 13
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Identification number -------------------- Period ending on31/12/ -------- Duration (in month) --------
GOODS ON LEASING AND SIMILAR CONTRACTS
SITUATIONS AND MOVEMENTS NATURE OF A INCREASES : B DECREASES :C D = A+ B – C

CONTRACT
Opening balance (at Acquisitions Transfers From the results of Disposals Transfers Closing balance (at
(I ; M ; A) (1) cost) Revaluation carried
between costs)
between divestments
HEADINGS out during the
accounts
period out of service
accounts
IINTANGIBLE ASSETS
Patent, Licences and Software 01

Goodwill 02
Other Intangible Assets 03
Total lines 1 to 3 04
ITANGIBLE FIXED ASSETS
Land 05
Buildings 06
Equipment 08
Total lines 4 and 10 11
(1) I : Fixed asset leasing ; M : Equipment leasing; A : Other contracts (split the caption if amounts are significant)
TABLE 14
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AGE ANALYSIS OF DEBTORS AT THE END OF THE PERIOD
ANALYSIS BY DUE DATE OTHER ANALYSIS

GROSS VALUE ONE YEAR AND ABOVE MORE THAN MORE THAN AMOUNTS IN AMOUNTS OWED AMOUNTS
ONE YEAR BUT TWO YEARS FOREIGN BY RELATED REPRESENTED
DEBTS Amount due BY BILLS
LESS THA TWO CURRENCIES COMPANIES
YEARS
LONG TERM DEBTS
Loans(1) 01
Debts related to investments 02
Other financial assets 03

Total lines 1 to3 04
SHORT TERM DEBTS
Suppliers 05
Customers and related accounts 06
Personnel 07
Social Insurance and other social 08

organisations
The State 09
International Organisations 10
Shareholders and Group companies 11
Other Debtors 12
Debts O.O.A. 13
Expenses recorded in advance 14
1)
Loans granted during the period 17
Repayments received during the period 18
TABLE 15
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DUE DATES OF LOANS AT THE END OF THE PERIOD
ANALYSIS BY DUE DATE OTHER ANALYSIS
GROSS ONE YEAR AND ABOVE ABOVE ONE YEAR ABOVE TWO AMOUNTS IN AMOUNTS TO AMOUNTS
BUT LESS TWO RELATED REPRESENTED
BORROWINGS VALUE DONT ÉCHUES YEARS FOREIGN COMPANIES
YEARS CURRENCIES BY BILLS
Convertible debentures (1) 01

CURRENT LIABILITIES FINANCIAL LIABILITIES & RELATED RESOURCES
Other debenture loans (1) 02

Loans and debts of financial establishments (1) 03
Other financial debts (1) (2) 04
Debts relating to Fixed asset leasing 06
Debts relating to equipment leasing 07
Related contract debts 08
Suppliers and related accounts 10

Customers 11
Personnel 12
Social Insurance and Social organizations 13
State 14
Shareholders and Group companies 16
Other Creditors 17
Debts O.O.A. 18
Income recorded in advance 19
Total lines 5, 9 and 20 21
(1) Loans taken during the period 22

Loans repaid during the period 23
(2) Total loans to shareholders (individuals) 24
TABLE 16
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Identification number -------------------- Period ending on 31/12/ -------- Duration(in month) --------
INTERMEDIATE CONSUMPTIONS DURING THE PERIOD

(specific accounts of)
NATURE Account N° Amount (in thousand of

legal currency)
WATER 01 6051
ÉLECTRICITY 02 6052
OTHER POWER 03 6053
CONSUMABLE MAINTENANCE SUPPLIES 04 6054
CONSUMABLE OFFICE STATIONERY 05 6055
SMALL MATERIALS AND TOOLS 06 6056
THIRD PARTY TRANSPORT 07 613
PERSONNEL TRANSPORT 08 614
MAINTENANCE, RÉPAIRS OF FIXED ASSETS 09 6241
MAINTENCE, RÉPAIRS OF EQUIPMENT 10 6242
PUBLICITY , ADVERTISEMENTS, PUBLIC RELATIONS 11 627
TÉLÉCOMMUNICATION CHARGES 12 628
RÉMUNÉRATION OF INTERMEDIARIES & CONSULTANTS 13 632
TABLE 17
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APPROPRIATION OF PROFITS AND OTHER ITEMS FOR THE LAST FIVE PERIODS
PERIODS CONCERNED (1) N N–1 N–2 N-3 N-4
NATURE OF INDICATIONS
CAPITAL STRUCTURE AT THE END OF THE PERIOD (2) 01
Share Capital ----------------------------------------------------------------------------------------- 02
Ordinary Shares ----------------------------------------------------------------------------------- 03
Non voting preference shares----------------------------------- 04
New shares issued ------------------------------------------------------------------------ 05
By conversion of debentures ----------------------------------------- 06
By exercise of pre-emptive subscription rights------------------------------- 07
OPERATIONS AND THE RESULTS OF THE PERIOD(3) 08
Turnover net of taxes -------------------------------------------------------------------- 09
Result of ordinary activities (R.O.A.) before write back and charging of depreciation (operating and 10
financial ).
Workers' participation in the profits------------------------------------------------------ 11
Company tax ---------------------------------------------------------------------------------- 12
Net profit after tax (4) --------------------------------------------------------------------------------------- 13
Profit per share -------------------------------------------------------------------------------------- 14
Profit distributed(5)--------------------------------------------------------------------------------- 15
Dividend per share --------------------------------------------------------------- 16
PERSONNEL AND WAGES POLICY------------------------------------------------------------------ 17
Average staff during the period (6) -------------------------------------- 18
Average external staff ---------------------------------------------------------- 19
Total personnel costs during the period (7) -------------------------------------------- 20
Social benefits in kind paid during the period (8) {Social Insurance, Social 21
advantages}-
External personnel costs invoiced to the company (9) --------------------------------------------- 22
1) Including the period whose financial statements are submitted for approval by shareholders 6) Permanent staff
2) In case capital has been partly called up the amount not yet called up. 7) Total of accounts 661, 662, 663.
3) The items here are those figuring in the profit and loss account. 8) Total of accounts 664, 668.
4) The result, in case of a loss, is shown in parenthesis. 9) Account 667.
5) Period N corresponds to dividend proposed in the previous period.
TABLE 18
Address ---------------------------------------------------------------------------------
PROPOSED APPROPRIATION OF THE RESULT OF THE PERIOD
APPROPRIATIONS AMOUNT (1) ORIGINS AMOUNT (1)

Legal Reserves 01 Loss brought forward
Statutory or contractual Reserves 02 Profits brought forward
Other Reserves (available) 03 Net profit/( loss) for the period
Dividends (2) 04 Transfers from reserves(3)
Other appropriations 05
Retained earnings 06
TOTAL (A) 07 Control : Total A = Total B TOTAL (B)
1) Losses are shown in parenthesis (–)

2) If there are several categories of entitled beneficiaries to dividends, show amount for each of them.
3) Indicate the types of Reserves from which transfers were effected.
TABLE 19A
Address ---------------------------------------------------------------------------------
PERSONNEL, TOTAL COSTS AND EXTERNAL PERSONNEL
PERSONNEL AND TOTAL COSTS PERSONNEL TOTAL COSTS

NATIIONAL OTHER OHADA OUTSIDE TOTAL NATIONAL OTHER OHADA OUTSIDE OHADA TOTAL
COUNTRIES OHADA COUNTRIES
CATEGORIES M F M F M F M F M F M F
1 2 3 4 5 6 7 8 9 10 11 12 13 14
a. Own Personnel
1. Senior Management 01
2. Senior technicians & middle level managers 02
3. Technicians, foremen and skilled workers 03
4. Clerks, unskilled workers, manual labour and 04
apprentices
PERMANENT 06
CASUAL 07
b. External Personnel BILLED TO THE COMPANY
4. Clerks, unskilled workers, manual labor and 11
apprentices
PERMANENT 13
CASUAL 14
TABLE 19B
Address ---------------------------------------------------------------------------------
Identification number -------------------- Period ending on 31:12/ -------- Duration (in month) --------
PERSONNEL, TOTAL COSTS AND EXTERNAL PERSONNEL, OTHER CEMAC COUNTRIES
PERSONNEL AND TOTAL COSTS

Personnel Total costs
QUALIFICATIONS M F M F
1 2 3 4
a. Own Personnel
4. Clerks, unskilled workers, manual labour and apprentices 04
Totals lines 1 to 4 05
Permanent 06
CASUAL 07
b. Own Personnel
4. Clerks, unskilled workers, manual labour and apprentices 11
Totals lines 8 to 11 12
Permanent 13
CASUAL 14
Totals lines 5 and 12 15
M : Male
F : Female
TABLE 20
Address ---------------------------------------------------------------------------------
OUTPUT FOR THE PERIOD
( Value in thousand of local currency)
Classification of product Quantity in Sales within Sales in OHADA states Sales outside Output stocked Stock at the Stock at the end
unit chosen Cameroon OHADA states beginning of of period
period
Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value
Unclassified sundry goods

TOTAL
OUTPUT OF THE PERIOD SOLD : OTHER CEMAC COUNTRIES

Classification of products Quantity in unit OUTPUT
chosen Quantity Value
Unclassified
Total
TABLE 21
Address ---------------------------------------------------------------------------------
COST OF GOODS SOLD

(Value in thousand of local currency)
Classification of raw Quantity in unit PURCHASES DURING THE PERIOD Stock variations
materials and products chosen Made in Cameroon Products imported (in value)
Bought in Cameroon Bought outside Cameroon
Quantity Value Quantity Value Quantity Value
Unclassified
TOTAL
TABLE 22
Address ---------------------------------------------------------------------------------
Identification name -------------------- Period ending on 31/12/ -------- Duration (in month) --------
DETERMINATION OF PROFIT OR LOSS BEFORE TAXATION

Line AMOUNTS
BALANCE OF NET PROFIT OR LOSS NET PROFIT BEFORE TAX 01
BEFORE TAXATION
NET LOSS BEFORE TAX 02
Depreciation charges not deductible 03

Depreciation charges recorded but deferred because of loss 04
Provisions not deductible 05
Interest on shareholders current account not deductible 06
Head office charges and technical assistance 07
Taxes not deductible ( Other than income tax) 08
Fines and penalties 09
Gratuities and donations not deductible 10
Taxation at source on income from securities 11
1 Sundry --------------------------------------------------------- 12
2 Sundry--------------------------------------------------------- 13
3 Sundry -------------------------------------------------------- 14
BLE TO BE ADDED BACK FOR COMPUTATION OF THE FISCAL PROFIT OR
LOSS
AMOUNTS ADDED BACK : Total lines 3 to 14 15

Intermediate POSITIVE TOTAL: LINES 15 + line 1 or line 15 – line 2 16
Intermediate NEGATIVE TOTAL : Line 2 – line 15 17
Depreciation formerly deferred & allocated for the period 18

Provisions previously taxed or definitively exonerated reintegrated during the period 19
EXPENSES OR LOSSES, REVENUE OR PROFITS FISCALLY DEDUCTIBLE
Untaxed part of gains on disposal of fixed assets 20

Subsidiaries net income (after deduction of expenses and losses) 21
Other income from securities deductible 22
Head office and technical assistant charges deductible 23
1 Sundry -------------------------------------------------------- 24
2 Sundry-------------------------------------------------------- 25
26
AMOUNTS DEDUCTED : Total lines 18 to 26 27
FISCAL FISCAL PROFIT FOR THE PERIOD : line 16 – line 27 28

PROFIT OR
LOSS
FISCAL LOSS FOR THE PERIOD: line 27 – line 16 or line 18 + line 27 29
HEADINGS Li
Bases of Assessment Rate Principal tax
ne
SITUATION OF THE COMPANY WITH RESPECT TO MINIMUM TAX.
Fixed minimum tax Minimum proportional to turnover 30 1%

Company tax 31 35%
ICP & PE 32 22%
Industrial 33
business Profits from handicraft 34 11%
income tax 35
36
Profit from Agriculture 37
Tax based on Proportional tax 38 15%

fiscal profit
for the period
(line 30)
Proportional tax
TABLE 23
Address ---------------------------------------------------------------------------------
DETERMINATION OF INCOME TAX

HEADING Line AMOUNTS
DETERMINATION OF FINAL FISCAL PROFIT
TRANSFER OF FISCAL PROFIT OF THE PERIOD 01

DEDUCTIONS ON ACCOUNT OF REINVESTMENTS MADE IN THE PAST
Period N-3 Period N-2 Period N-1
HEADINGS
Allowed reinvestments brought forward 02
Deductible reinvestments- 50% x line 2 03
Total line 4
Reinvestment actually deducted 04
Reinvestments to be carried forward = 2 x (line 3 – line 4) 05
DEDUCTIONS FROM REINVESTMENTS OF THE PERIOD

Reinvestments of the period allowed 06
Reinvestment deductible = 50% x line 6 07
Total l line 8
Reinvestment deducted = 50% x line 1 08
Reinvestment to be carried forward = 2x(line 7 – line 8) 09
ALLOCATION OF LOSSES BROUGHT FORWARD

Period N-4 Period N-3 Period N-2 Period N-1
HEADINGS
Losses brought forward 10
Total line 11
Losses allocated for the period 11
Loses to be carried forward 12
DEFINITIVE FISCAL PROFIT (Total line 1, 4, 8 and 11) 13

COMPUTATION OF TAX BASED ON DEFINITIVE FISCAL PROFIT
HEADINGS Tax basis Rate Li Amounts
ne
Company tax 14
Proportional tax on income from securities not taxed at source 15
Proportional tax on technical assistance not deductible 16
Principal tax for the period(line 14+line15+line 16) 17
Additional council tax 18
TOTAL INCOME TAX (Line 17 + Line 18) 19
Withholding tax on technical assistance not deductible 20
TOTAL INCOME TAX FOR THE PERIOD (Line 19-Line 20) 21
Minimum tax paid (Line 13 Table 25 col.6) 22
Proportional tax on income from securities 23
Other deductions 24
Net tax due ( Line 21( Lines 22, 23, and 24) 25
Tax credit ( Lines 22, 23, 24) –Line (21) 26
Account 89 : Income tax payable

Headings Amounts
891 Income tax of the period 27
892 Tax demands on prior periods 28
895 Minimum tax 29
899 Tax relief and tax reduction on prior periods 30
Total 31
TABLE 24
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DETERMINATION OF INCOME TAX
HEADINGS Amounts
TRANSFER OF FIXED MINIMUM TAX 01
TAX REDUCTION FROM REINVESTMENTS MADE IN THE PAST
Allowed reinvestments Basis of tax reduct. Actual basis of tax Reinvestment to be
PERIODS brought forward 50% X column 1 reduction C/F.
2 x col. 2 – col. 3
n-3 and past 02
n-2 03
n-1 04
TOTAL 05
x (tax rate)
06
TAX REDUCTION FROM REINVESTMENT OF THE PERIOD
Reinvestments of the period allowed 07
Basis of tax reduction (50% x line 7) 08
X (tax rate)
Actual basis of the tax reduction 09
Reinvestments to be C/F.2 x (line 8 – line 9) 10
HEADINGS
Proportional tax on income from securities not taxed at source 15%
11 +
Graduated surtax due by companies or other corporate bodies for undisclosed remuneration paid 60%
12 +
Capital not taxed at source 13 25%
Deductions Proportional tax on income from securities 14 -

Others 15 -
COMPUTATION OF FIXED MINIMUM TAX

Basis Rate Amounts
Fixed minimum tax 16
Proportional tax on income from securities not taxed 17
Proportional tax on technical assistance not deductible 18
Theoretical principal tax (Line 16+Line 17+ Line 18) 19
Additional council tax 20
TOTAL THEORETICAL INCOME TAX (Line 19 + line 20) 21
Special tax on technical assistance not deductible 22
TOTAL COMPANY TAX FOR THE PERIOD (Line 21-Line 22 23
Minimum tax paid (Line 13 Table 25 col. 6) 24
Proportional tax on income from securities 25
Other deductions 26
Net tax due (Line 23- Lines 24, 25, 26) 27
Tax credit (Lines 24, 25, 26)- Line 23) 28
STATEMENT OF LOSSES BROUGHT FORWARD FOR FIRMS NOT ASSESSED ACCORDING TO ACTUAL PROFIT
Transfer of fiscal profit of the period 29
Transfer of fiscal loss of the period 30
Allocation of losses brought forward
Headings N–4 N–3 N–2 N-1
Losses brought f/d 31
Losses allocated 32
Losses to be carried f/d 33
Definitive fiscal profit 34
Definitive fiscal loss 35
Account 89 : Income tax payable
Headings Amounts
891 Income tax of the period 36
892 Tax demands on prior periods 37
895 Minimum tax 38
899 Tax relief and tax reduction on prior periods 39
Total 40
TABLE 25
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Payments made during the period
Month Lines Advance tax on Advance company tax on Enterprise's Other TOTAL
CRTV
purchases at 1% revenue (1,1% of TO) contribution deductions
6=1+2+3+4+5
Principal ACT 5
1 4
2 3
January 01
February 02
March (or 1st quarter) 03
April 04
May 05
June (or 2nd quarter) 06
July 07
August 08
September (or 3rd quarter ) 09
October 10
November 11
December (or 4th quarter ) 12
Totals lines 1 à 12 13
TABLE 26
Address ---------------------------------------------------------------------------------
VALUE ADDED TAX AND EXCISE DUTY
COMPUTATION OF EXCISE DUTY
Nature of product Gross taxable basis Deduction Net taxable basis Rate Amount of duty
1 2 Rate 3 A mount 4 = (2x3) 5 = (2 – 4) 6 7 = (5x6)
01
02
03
04
05 TOTAL
VALUE ADDED TAX – YEARLY RETURN

TAX BASIS OF ASSESSMENT TAXABLE BASIS NON TAXABLE CUMULATIVE
(NET TURNOVER) BASIS
1
GENERAL RATE Specific Rate Zero rated 5 6
2 3 4
Delivery of goods 06
Delivery to oneself 07
Supply of services 08
Supply of services to oneself 09
Real estate 10
BASIS OF TAXATION Disposals not exempted 11
Rent of undeveloped Land 12
Rent of unfurnished premises 13
Export of taxable goods 14
Other taxable operations 15
Non taxable operations 16
Total operations 17
Excise duty 18
TOTAL of taxable basis : Total lines 6 to 18 19
COMPUTATION OF GROSS Amount of tax 20
II VAT Additional council tax 21
TOTAL GROSS VAT : Total lines 20 and 21 22
COMPUTATION OF THE Turnover giving rise to deduction 23
III PRORATA AT THE OF
THE PERIOD
Total turnover 24
Pro rata regularisation at end of the period 25

VAT TO BE DEDUCTED VAT ON INVOICES DEDUCTIBLE VAT
Deductions subject to pro rata:
On goods & services not part of fixed assets 26
On goods & services which are part of fixed assets 27
IV DEDUCTIONS Deductions not subject to pro rata:
On goods & services not part of fixed assets 28
On goods & services which are part of fixed assets 29
Additional VAT to deduct 30
VAT credit of preceding period 31
TOTAL DEDUCTIONS : TotaL lines 26 to 31 32
TABLE 27
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VALUE ADDED TAX – YEARLY RETURN

PAYMENTS MADE AND RETENTIONS SUSTAINED DURING THE PERIOD
IV
L
Period under reference Amount of Receipt N° Date on receipt VAT retained at TOTAL
1 payment 3 4 source 6=2+5
2 5
January 33
February 34
March (or 1st quarter) 35
April 36
May 37
June (or 2nd quarter) 38
July 39
August 40
September (or 3rd quarter) 41
October 42
November 43
December (or 4th quarter) 44
TOTAL lines 33 to 44 45
NET VAT SITUATION

V VAT payable 46
Total gross VAT (line 22 col. 5 + line 46) 47
VAT deductible (line 32 col. 4) 48
Net total VAT 49
VAT paid during the period (line 45 col. 5) 50
Net VAT payable (line 49 >line 50) 51
VAT credit carried forward (line 50 > line 49) 52
NET EXCISE SITUATION

VI Period of reference Amount Receipt
1 N° Date
January 53
February 54
PAYMENT OF March (or 1st quarter) 55
EXCISE DUTY April 56
DURING THE May 57
PERIOD June (or 2nd quarter) 58
July 59
August 60
September (or 3rd quarter) 61
October 62
November 63
December (or 4th quarter) 64
Net situation (line 5 col. 7– line 65 col. 1) 66
TABLE 28
Address ---------------------------------------------------------------------------------
Table of analysis of ordinary expense accounts
Account 60 (except 603) : Purchases
Lines
HEADINGS Group Non Group
N° of Cameroon Abroad Total Cameroon Abroad Total
nomenclature 10=6+7+8+9
1 Other Other Other 5=1+2+3+4 6 Other Other OHADA Other
OHADA states
States 8 9
2 4
3 7
601 Purchases of merchandise 01
602 Purchases of raw materials and related supplies 02
604 Stocked purchases of materials and consumable materials 03
605 Other purchases 04
608 Purchases of packing materials 05
Account 61 : Transport
Accounts
Lines
Subject of transport Transport costs borne in Cameroon Incurred abroad Total

Land transport Related transport 6 7=1+2+3+4+5+6
Road Railway By River By Air services
1 2 3 4 5
611 Transport on purchases 07
612 Transport on sales 08
613 Transport chargeable to third parties 09
614 Personnel transport 10
616 Transport of parcels 11
618 Other transport costs 12
TABLE 29
Address ---------------------------------------------------------------------------------
Account 62 : External Services A
Lines
Classification Cameroon
HEADINGS Number Abroad Total
1 Other Other Outside 5=1+2+3+4
OHADA
2 States 4
3
621 01
Sub contractors' charges
622 02
Rents and rental charges
623 Rents on lease and related contracts 03
624 04
Repairs and maintenance costs
625 05
Insurance premiums
626 06
Studies, research and documentation
627 07
Publicity, publication, public relations
628 08
Telecommunication costs
09
Total lines 1 to 8
Account 63 : External Services B

631 10
Bank charges and commissions
632 11
Remuneration to intermediaries &
advisers
633 12
Personnel training expenses
634 Patents, licences, software and assimilated 13
dues
635 Contributions 14
637 Remuneration of external personnel 15
638 16
Other external expenses
TABLE 30
Address ---------------------------------------------------------------------------------
Details of payments to third parties : Accounts 62, 63 et 66

Names of beneficiaries Address Nature of remuneration Taxpayer's Amount
number paid
Beneficiaries of rents paid : Account 62

Name and References of Lease and additional clauses Period Amount Payments of rent tax
address of Registration date Vol. Folio Box From To Receipt Amount
beneficiaries Date Number
TABLE 31
Address ---------------------------------------------------------------------------------
Account 64 : RATES AND TAXES
lines
Paid in the State Paid to International TOTAL
organisations Paid abroad
HEADINGS
1 2 3 4=1+2+3
6411 Land and related taxes 01

6412 Patent, Licences and related taxes 02
6413 Employer's portion of Land Bank rate 03
6414 Apprenticeship tax (National employment Fund) 04
6415 Continuous professional training 05
6418 Other rates and taxes 06
641 Rates and Taxes : Total lines 1 to 6 07
645 Customs duties not included in the cost price 08
645 VAT not recoverable 09
645 Excise duty 10
645 Other duties and indirect taxes 1 11
645 Other duties and indirect taxes 2 12
645 Indirect rates and taxes: Total Lines 8 to 12 13
6461 Registration taxes 14
6462 Stamp duty 15
6463 Company vehicles taxes 16
6464 Windscreen licences 17
6468 Other duties 1 18
6468 Other duties 2 19
646 Duties and registration taxes : total lines 14 to 19 20
6471 Assessment penalties: Direct taxes 21
6472 Assessment penalties :Indirect taxes 22
6473 Recovery penalties : Direct taxes 23
6474 Recovery penalties: Indirect taxes 24
6478 Other fiscal penalties and fines 25
647 Fiscal penalties and fines : total lines 21 to 25 26
648 Other rates and taxes 27
Total rates and taxes : Total lines 7, 13, 26 and 27 28
Account 65 : Other Expenses

Account N°
Classification
Lines
Headings Cameroon Abroad Total

Number
1 Other CEMAC Other OHADA None OHADA 5=1+2+3+4
States
2 3 4
651 Bad debts 29
652 Contribution to results of joint operations 30
653 Cancelled contributions to results of partially executed long 31
term contracts
654 Book value of fixed assets sold on recurrent basis 32
658 Sundry charges 33
659 Other operating provisions 34
Particulars of non-salaried administrators' remunerations

Surname and first name Address Nationality Percentage of Remuneration
capital held
Total remunerations
TABLE 32
Address ---------------------------------------------------------------------------------
TABLE OF PERSONNEL EXPENSES : Account 66
Classification INCURRED IN CAMEROON INCURRED TOTAL
Other CEMAC States Other OHADA States None OHADA states ABROAD
Cameroonians TOTAL 7=5+6
1 2 3 4 5=1+2+3+4 6
Ppermanent Staff
Senior Management 01
Senior Technicians and middle level management 02
Technicians, Foremen and skilled workers 03
Clerks, Unskilled workers ,Manual Labour and apprentices 04
Casual staff 05
Transport and Housing allowance 07
Other social benefits 08
Wages and Social allowances: Total lines 6 to 8 09
NSIF Contributions 10
Other Social Contributions 11
Food 12
FRINGE Water, electricity, gas 13
BENEFITS IN Housing 14
KIND Vehicle 15
Domestic servant 16
Other taxable benefits in kind 17
TOTAL BENEFITS IN KIND: lines 12 to 16 18
Uniforms, medicines 19
OTHER Leave transport allowance 20
BENEFITS IN Medical and Sundry services 21
KIND NOT Unclassified Sundry 22
TAXABLE
TOTAL OF OTHER BENEFITS: LINES 18 TO 22 23
TOTAL lines 9, 10, 11, 17 and 23 24
Transfer of remuneration of external staff 25
MEMORANDUM OF SUMS RECEIVED BY STAFF
Total line 9 carried down 27
Lump sum or proportional business travelling allowances 28
Lump sum entertainment allowances 29
Other sums received shown elsewhere in the return 30
SUMS RECEIVED BY STAFF : Total lines 27 to 30 31
TABLE 33
Address ---------------------------------------------------------------------------------
Account 67 : Financial charges and related expenses

Account N°
Lines
HEADINGS Paid in Paid to Paid Abroad TOTAL
International
Cameroon Organisations
1 3 4=1+2+3
2
671
Interest on loans 01
672 Interest on lease rentals and related contracts 02
673
Discounts granted 03
674
Other interests 04
675
Discount of commercial papers. 05
676
Exchange losses 06
677 Losses on disposal of trade investments 07
678
Losses on financial risks 08
679
Financial charges provided for 09
Account 83 : Expenses outside ordinary activities(O.O.A)

Headings Amounts
831 O.O.A. charges incurred 11
834 O.O.A. bad debt losses 12
835 Gifts and donations granted 13
836 Bad debts written off 14
839 O.O.A. charges provided for 15
Account 87 : Workers' participation

Headings Amounts
871 Legal participation in profits 17
874 Contractual participation in profits 18
878 Other participation 19
1 Sundry : …………………………………….. 20
2 Sundry: …………………………………….. 21
3 Sundry : …………………………………….. 22
TABLE 34
Address ---------------------------------------------------------------------------------
Identification number -------------------- Period ending o 31/12/ -------- Duration (in month) --------
Account 70 : Sales
Lines
Headings Group Outside group
Classification N° Cameroon Cameroon
Abroad Total Abroad Total Grand
1 Other Other None OHADA 5=1+2+3+4 6 Other Other None 10=6+7+8+9
OHADA OHADA
States 4 states
9 11=5+10
7 8
2 3
701 Sales of goods 01
702 Sales of finished goods 02
703 Sales of intermediary goods 03
704 Sales of residual goods 04
705 Invoiced jobs 06
706 Services sold 07
707 Accessory products 09
TABLE 35
Address ---------------------------------------------------------------------------------
Account 71 : Operating Subventions

lines Classification N° The State of International Given by third
Headings Total Account
Cameroon, Public Organisations parties
organisations 2 3 71
1 4= 1+2+3
711 01
On output for exportation
712 02
On output for importation
713 03
Equalisation output
718 Other operating subsidies 04
Account 72 : Output capitalised

Lines Classification Takeover bid for Takeover bid
Headings Amounts Total account
shares (account726)
72
721 06
Intangible fixed assets
722 07
Tangible fixed assets
726 08
Long term Investments
09
Total lines 6 to 8
Account 73 : Variations in stocks of goods and services produced

Accounts
Headings Increases Decreases Variations
2 3=1-2
1
734 Variation in stocks of goods in progress 10
735 Variation of services in progress 11
736 Variation in finished goods 12
737 Variation in intermediary and residual goods 13
Account 75 : Sundry revenue and profits

Accounts Other
Headings Cameroon Other None Total
OHADA
1 CEMAC States 5=1+2+
4
States 3 3+4
2
752 Portion of profit/loss on operations carried out in common 15
753 Contributions to results of partially executed long term 16
contracts
754 Revenue from re-occurring disposal of fixed assets 17
758 18
Sundry revenue
759 19
Operating provisions written back
TABLE 36
Address ---------------------------------------------------------------------------------
Identification number -------------------- Period ending on 31/12: -------- Duration (in month) --------
Account 77: Interest and related income earned

Account N°
Lines
Classific Cameroon Abroad Total
ation N° Other Other None
Headings OHADA 5=1+2+3+4
CEMAC OHADA
1 States
States
States 4
2 3
771 Interest on loans granted 01
772 Income from long term investments 02
773 Discounts obtained 03
774 Income from trade investments 04
776 Gains on exchange 05
777 Gains on sales of trade investments 06
778 Gains on financial risks 07
779 Write back of financial charges provided for 08
1 Sundry : …………………….. 09
2 Sundry : …………………….. 10
3 Sundry: …………………….. 11
Account 78 :Expenses for transfer

781 Transfer of operating expenses 13
787 Transfer of financial expenses 14
Account 84 : Income from outside ordinary activities

Headings Amounts
841 O.O.A income ascertained. 16
845 Gifts and donations received 17
846 Recoveries in respect of debts previously written off 18
848 Transfer of O.O.A. charges 19
849 O.O.A. provisions written back 20
Account 88 : Equalising Subventions

Headings Amounts
881 The State 22
884 Local bodies 23
886 Group 24
888 Others 25
1 Sundry 1: ……………………………………………….. 26
2 Sundry 2: ……………………………………………….. 27
3 Sundry 3: ……………………………………………….. 28
TABLE 37
Address ---------------------------------------------------------------------------------
Debts guaranteed by real securities
Lines
Heading Gross Actual securities
Amount Mortgage Collateral Pledge/Other
s
Leasing Financial debts adn related debts
Convertible debentures 01
Other debentures 02
Loans and debts from financial establishments 03
Other financial debts 04
Debts on fixed asset Leasing 06

Debts on equipment Leasing 07
Debts in respect of related contracts 08
Short term debts
Suppliers and related accounts 10

Customers 11
Personnel 12
Social security 13
Social Organisations 14
State 15
Shareholders 17
Group 18
Other creditors 19
Financial Commitments
Headings Line Commitments given
Commitments, pensions and indemnities 22
Endorsements, securities, guarantees 23
Mortgages, collateral, pledges, others 24
Bills for discount not due 25
Commercial debts surrendered 26
Factored debts due 27
Debts abandoned conditionally 28
Contracts with lien on property

Assets subject to a lien Cost price Amount outstanding
TABLE 38
Address ---------------------------------------------------------------------------------
Advances and loans granted to shareholders and management

Name and surname Due Rate Terms Amount granted during Amount repaid during the period
the period
Agreements entered into between the company and management, shareholders or related companies
Name and surname or Title Due Rate Term Amounts Amounts repaid
granted during during the period
designation the period
Elements of Goodwill Amounts

Customers 01
Custom 02
Leasehold 03
Non commercial 04
Emblems 05
Others 06
TABLE 39
Address ---------------------------------------------------------------------------------
STRUCTURE OF ENTERPRISE: Break-down per establishment

Establishment n° Establishment n° Establishment n° Establishment n° Establishment n° Establishment n°
HEADINGS
Name of establishment 01
Street 02
Town 03
P.O. Box 04
Taxpayer's Number 05
Date of creation of establishment 06
Main activity 07
STAFF
Senior Management 08
CAMEROONIA Senior Technicians and middle level 09
N STAFF management
Technicians, Foremen and skilled manual workers 10
Clerks, Unskilled workers, Manual Labour &Apprentices 11
Senior management 13
OTHER Senior Techicians and middle management 14
STAFF Technicians, Foremen and unskilled manual workers 15
Clerks, Unskilled workers manual labour & apprentices 16
Casual staff (Number of days worked) 18
Investments made per establishment 19
Turnover 20

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STATISTICS AND TAX RETURN

Name of the enterprise: _________________________________________

LEGAL AND FISCAL STATUS

Special regime: ____________________________________________________________

Fiscal regime: ____________________________________________________________

Approvals obtained: __________________________________________________________

Nature of profits : ________________________________________________________

Secondary activities at the beginning

New activities engaged in

If the enterprise has ceased

Statistics and tax return drawn up by: __________________________________________

Beginning of the period

COMPANIES REGISTERED UNDER CAMEROON LAW( Head office in Cameroon)

Names of main shareholders ________________________________%

Subsidiaries or branches of enterprises with their head offices abroad

Name of the parent company _____________________________________

CB Shareholders- capital not yet called up – 03 ................................. .................................

CC Premiums and Reserves 04

CE Revaluation surplus 06 ................................. .................................

CF Legal reserves 07 ................................. .................................

CG Free reserves 08 ................................. .................................

CH Retained earnings + or – 09 ................................. .................................

CI Profit or loss for the period (profit + or loss –) 10 ................................. .................................

CK Other long term equity 11

CM Regulated provisions and related funds 13 ................................. .................................

CP TOTAL EQUITY (I) 14 ................................. .................................

DB Long term leasing liabilities and related contracts 17 ................................. .................................

DC Sundry long term financial liabilities 18 ................................. .................................

DD Financial provisions for risks and charges 19 ................................. .................................

DE (1) of which O.O.A. : ................... / …………… 20

DG PERMANENT RESOURCES: TOTAL (I + II) 22 ................................. .................................

DP CURRENT LIABILITIES:TOTAL (III) 31 .................................. ..................................

DT TOTAL TREASURY LIABILITIES (IV) 36 .................................. ..................................

PROFIT AND LOSS ACCOUT: EXPENSES

PROFIT AND LOSS ACCOUNT – REVENUE

CASH FLOW STATEMENT

PART 1-DETERMINATION OF CASH FLOW FROM ORDINARY ACTIVITIES IN

 GLOBAL SELF- FINANCING CAPACITY (G.S.F.C.)

 Outs tan ding disbursables exp enses

Total (I) 08 .............................. Total (II) ..............................

GSFC : Total (II)  Total (I) = 09 ................... (N  1) : ................................

SF = GSFC  Payment of dividends during the period (1)

 CHANGES IN REQUIREMENT OF FINANCING OPERATIONS (R.F.O.)

Chan. R.F.O. = Var. Stocks2 + Chan. Debtors ² + Chan. Current liabilities ²

CASH FLOW STATEMENT

Application -increase Source- decrease

(BH) Suppliers: advances paid 16 ................................... Or ...................................

(BI) Customers 17 ................................... Or ...................................

(BJ) Other debtors 18 ................................... Or ...................................

(B) Total net changes in debtors 19 ................................... or ...................................

Application increase Source decrease

(DI) Customers: deposits received 20 ................................... Or ...................................

(DJ) Trade Suppliers 21 ................................... Or ...................................

(DK) Tax liabilities 22 ................................... Or ...................................

(DL) Social liabilities 23 ................................... Or ...................................

(DM) Other creditors 24 ................................... Or ...................................

(DN) Provisions for risks 25 ................................... Or ...................................

(C) Total variation in current liabilities 26 ................................... Or ...................................

CHANGES IN R.F.O. = (A) + (B) + (C) 27 ................................... Or ...................................

 Cash surplus from operations (C.S.O..)

Gross cash from operations 28 ................................... ...................................

– Changes in RFO. (– if application ;+ if source) (–or +) 29 ................................... ...................................

– Fixed assets formation for own account 30 –................................... –..................................