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13 The Secretary to the Government of India, Ministry of Home Affairs, Foreigners Division (FCRA Wing) "First Floor NDCC-II Building," 1,JAI SINGH Road New Delhi Form FC-4 [See rule 17(1)] Subject: Account of Foreign Contribution for the year ending on the 31st March, Association FCRA registration number and name (i). Number : (ii). Name : Professional Assistance For Development Action 2. Details of receipt and utilisation of foreign contribution : i. Foreign Contribution received in cash/kind(value): a) Brought forward foreign contribution at the beginning of the year(rs.) b) Interest or other receipt during the year c) Foreign Contribution received during the financial year i) Directly from a foreign source ii) as transfer from a local source d) Total Foreign Contribution (a+b+c) (Rs.) *i.e. interest accured on foreign contribution, or any other income derived from foreign contribution, e.g. sale proceeds from assets created from contribution, or interest thereon during the year ii (a). Donor wise detail of foreign contribution received in excess of rupees 20,000: Sl.No Name of donors /Individu al 1 Freedom from Hunger India Trust 2 Lutheran World Relief Inc 3 International Center for Research on Women ICRW 4 Share and Care Foundation 5 European Commission Delegation of the European Union to India Detail of the donor: official Address; address; website address: B5 155, First Floor Safdarjung Enclave, New Delhi , United States of America, Id:, Website Address : Purposes for which received Ministry of Home Affairs Amount (Rs.) Social Nicole Hark, 700 Light Street, Baltimore, MD 21230, United States of America, United States of America, Id:, Website Address : Social C - 59, South Extension Part II, New Delhi , United States of America, Id:, Website Address : 676 Winters Avenue Paramus NJ 07652, United States of America, Id:, Website Address : 65 Golf Links New Delhi , Netherlands, Id:, Website Address : Social Social Social FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 1 of 7
14 Sl.No Name of donors /Individu al 6 Bill and Melinda Gates Foundation Detail of the donor: official Address; address; website address: 1432 Elliot Avenue West, P. O. Box Seattle, WA Seattle, WA 98102, USA, United States of America, Id:, Website Address : 7 Learn With All Inc 32 West 39th Street 4th Floor New York 10018, United States of America, Id:, Website Address : 8 Hindustan Unilever Foundation 9 Humanist Institute for Cooperation Hivos 10 Bharat Ratna Dr Ambedkar University Delhi 11 The Institute for Fiscal Studies Unilever House B.D.Sawant Marg Chakala Andheri (East) Mumbai , India, Id:, Website Address : Flat No. 402, Eden Park, No. 20, Vittal Mallya Road, Banglore , Netherlands, Id:, Website Address : Lothian Road Kashmiri Gate Delhi , India, Id:, Website Address : 7 Ridgemount Street London, WC 1E 7AE United Kingdom, United Kingdom, Id:, Website Address : 12 Bank of America NA 16 - F Express Towers, Nariman Point, Mumbai , India, Id:, Website Address : 13 RBS Foundation 414 Senapati Bapat Marg, Lower Parel West, Mumbai , United Kingdom, Id:, Website Address : 14 Paul Hamlyn Foundation 18 Queen Annes Gate London SW1H9AA, United Kingdom, Id:, Website Address : 15 IKEA Foundation PO BOX 11134, 2301 EC, LEIDEN, NETHERLANDS, Netherlands, Id:, Website Address : Purposes for which received Ministry of Home Affairs 16 Other Interest Individual India, India, Id:, Website Address : 17 Income on Foreign Corpus Investment India, India, Id:, Website Address : 18 Axis Bank Foundation Axis House, C 2 Wadia International Centre Pandurang Budhkar Marg, Worli, Mumbai , India, Id:, Website Address : 19 Indian Overseas Bank Yusuf Sarai Branch C-1 Green Park Extension New Delhi , India, Id:, Website Address : 20 Australian Centre for International Agriculture Research GPO Box 1571 Canberra ACT 2601 ACIAR House, 38 Thynne Street Fern Hill Park, Bruce ACT 2617 Australia, Australia, Id:, Website Address : 21 Revolving Fund Individual India, India, Id:, Website Address : Amount (Rs.) Social Social Social Social Social Social Social Social Social Social Social Social Social Social Social Social FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 2 of 7
15 (b). Cumulative purpose-wise amount of all foreign contribution donation received : Sl.No Purpose Amount 1 Social (iii). Details of Utilization of foreign contribution: a. Total Utilization* for projects as per aims and objectives of the association (Rs.) b. Total Administrative Exprenses as provided in Rule 5, FCRA 2011 (Rs.) c. Total invested in term deposits(rs.) Total Purchase of fresh assets(rs.) Total utilzation in the year(rs.) (a+b+c+d) * It is affirmed that the utilisation of foreign contribution is not in contravention of the provisions contained in proviso to Sction 9(e) and Section 12(4)(f) of the Act which states that the acceptance of foreign contribution is not likely to affect prejudically. (A) the soverignty and integrity of india; or. (B) the security, strategic, scientific or echnomic interest of the state; or (C) the public interest; or (D) freedom or fairness of election to any legistature; or (E) friendly relations with any foreign state; or (F) harmony between religious, racial, social, lingusitic or relgional groups, castes or communities iv. Balance of unutilized foreign contribution, in cash/bank, at the end of the year(rs.) : v. Total number of foreigner working(salaried/ in honorary capacity. : (a) Details of designated Fc bank account for receipt of Foreign Contribution ( As on 31st March of the year ending): Sl.No Name of Bank Branch Address( With pincode) 1 Indian Overseas Bank C-1, Green Park Extn., Yusuf Sarai, New Delhi, New Delhi, Delhi, Delhi IFSC Code IOBA Ministry of Home Affairs Account No XXXXXXXXXX (b) Details of all utilization bank accounts for utilization of Foregin Contribution (As on 31st March of the year ending) Sl.No Name of Bank Branch Address( With pincode) 1 Indian Overseas Bank At PO-Jaykaypur Dist- Rayagada Odisha, Rayagada, Orissa, Rayagada 2 Axis Bank Ground Floor Khasra No 78-79, Plot No. 2 A and B Mount Road Near Shantikunj Abu Road Rajasthan, Abu Road, Rajasthan, Sirohi 3 Axis Bank M P College Road Betul Madhya Pradesh, Betul, Madhya Pradesh, Betul 4 Axis Bank Plot No 509 Opp Civil Court NH 33 Hazaribagh Jharkhand, Hazaribagh, Jharkhand, Hazaribagh IFSC Code IOBA UTIB UTIB UTIB Account No XXXXXXXXXXX8792 XXXXXXXXXXX5021 XXXXXXXXXXX6249 XXXXXXXXXXX4130 FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 3 of 7
16 Sl.No Name of Bank Branch Address( With pincode) 5 Axis Bank Jagdalpur Raod Near Kothari Park Dhamtari Chhattisgarh, Dhamtari, Chhattisgarh, Dhamtari 6 Axis Bank Ground Floor Ward No 12 Burhar Road Shahdol Madhya Pradesh, Shahdol, Madhya Pradesh, shahdol 7 Axis Bank LD House Opposite - Hanuman Mandir Amlatola PS Sadar Thana Chaibasa Jharkhand, Chaibasa, Jharkhand, Singhbhum 8 Axis Bank Plot No 80 Seth Surajmall Jalan Road Caster Town Deoghar Jharkhand, Deoghar, Jharkhand, Deoghar 9 Axis Bank 7B Motijheel Avenue P O Motijheel Dum Dum Kolkata, Kolkata, West Bengal, Kolkata 10 Axis Bank Ground Floor Vasant Vihar Hanuman Chowk Balaghat Madhya Pradesh, Balaghat, Madhya Pradesh, Balaghat 11 Axis Bank Ground Floor, Hatapada, Hill View Road, Phulbani, Phulbani, Orissa, Phulbani 12 Axis Bank Tagore Nagar,Panchpedi Naka,Pujari Chambers Block B1, NH 43 Raipur Chhattisgarh, Raipur, Chhattisgarh, Raipur 13 Axis Bank Plot No 80 Seth Surajmall Jalan Road Caster Town Deoghar Jharkhand, Deoghar, Jharkhand, Deoghar 14 Bank of India At Post - Ghaghra Gumla Jharkhand, Gumla, Jharkhand, Gumla 15 Bank of India At PO Katoria Dist Banka Bihar, Katoria, Bihar, Banka 16 Axis Bank Plot No. 80, Seth Surajmall Jalan Road, Caster Town, Deoghar, Deoghar, Jharkhand, Deoghar 17 Axis Bank Pattanaik Estate Collage Square Keonjhar Odisha, Keonjhar, Orissa, Keonjhar 18 Bank of India Garg Mansion, Ramgarh Road,Jainamore,Bokaro, Jainamore, Jharkhand, Bokaro 19 Bank of India Court Area Lohardaga Jharkhand, Lohardaga, Jharkhand, Lohardaga IFSC Code UTIB UTIB UTIB UTIB UTIB UTIB UTIB UTIB Ministry of Home Affairs 20 Bank of India AT PO - Petarbar Dist- Bokaro Jharkhand, Petarbar, Jharkhand, Bokaro 21 Axis Bank Near Bajaj Showroom Jagatpur Raigarh Chhattisgarh, Raigarh, Chhattisgarh, Raigarh 22 HDFC Bank HDFC Bank Ltd, Plot No. 1/20, Ward No.10, Kundan Kunj, Main Road, PO- Chakradhapur, Dist- West Singhbhum, Jharkhand, Chakradharpur, Jharkhand, Singhbhum 23 I.D.B.I. Bank Samanta Efifice Near Samanta Kaali Mandir, Ranchi Patna Road, Jhumri Telaiya Koderma, Jhumari Telaiya, Jharkhand, Kodarma 24 Indian Overseas Bank C-1, Green Park Extn., Yusuf Sarai, New Delhi, New Delhi, Delhi, Delhi UTIB BKID Account No XXXXXXXXXXX3024 XXXXXXXXXXX7423 XXXXXXXXXXX7694 XXXXXXXXXXX0802 XXXXXXXXXXX6627 XXXXXXXXXXX4494 XXXXXXXXXXX8884 XXXXXXXXXXX8887 XXXXXXXXXXX0535 XXXXXXXXXXX6120 BKID XXXXXXXXXXX9315 UTIB UTIB BKID BKID BKID UTIB HDFC IBKL IOBA XXXXXXXXXXX5454 XXXXXXXXXXX9150 XXXXXXXXXXX6836 XXXXXXXXXXX3118 XXXXXXXXXXX1375 XXXXXXXXXXX8080 XXXXXXXXXX5428 XXXXXXXXXXXX0706 XXXXXXXXXXX3219 FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 4 of 7
17 Sl.No Name of Bank Branch Address( With pincode) 25 Indian Overseas Bank Kailash Colony Branch HS- 31 Kailash Colony Market New Delhi, New Delhi, Delhi, Delhi 26 Rewa Sidhi Gramin Bank Deosar Main Road N H 75 Block Deosar Post Jiyawan Madhya Pradesh, Deosar, Madhya Pradesh, Sidhi 27 Rewa Sidhi Gramin Bank Station Road Sarai Singrauli (M.P), Sarai, Madhya Pradesh, Sidhi 28 Punjab National Bank Near Bus Stand, Bhoura, Bhoura, Madhya Pradesh, Betul 29 Punjab National Bank Dhoolkot Dholpur Rajasthan, Dholpur, Rajasthan, Dholpur 30 Axis Bank Plot No 80 Seth Surajmall Jalan Road Caster Town Deoghar Jharkhand, Deoghar, Jharkhand, Deoghar 31 Bank of India At PO Palkot District Gumla Jharkhand, Palkot, Jharkhand, Gumla 32 Punjab National Bank Karanjiya Dist -Dindori Madhya Pradesh, Karanjia, Madhya Pradesh, Jabalpur 33 Punjab National Bank Argora Colony, Ranchi Jharkhand, Ranchi, Jharkhand, Ranchi 34 State Bank of India At Post Adra Distt Purulia West Bengal, Adra, West Bengal, Purulia 35 State Bank of India At PO Amarpur Dist Dindori Madhya Pradesh, Amarpur, Madhya Pradesh, Jabalpur 36 State Bank of India Machantala Dist Bankura West Bengal, Bankura, West Bengal, Bankura 37 Axis Bank Ground Floor, Patakhanda Street Chowk, Balliguda, Main Road,Kandhamal, Balliguda, Orissa, Kandhamal 38 Axis Bank Satya Nagar Archbishop House, Satya Nagar, Bhubaneswar, Odisha, Bhubaneswar, Orissa, Khurda 39 Bank of India At PO Thakurmunda Dist- Mayurbhanj Odisha, Thakurmunda, Orissa, Mayurbhanj 40 Bank of India Diankel At-Diankel Panchayat P O Torpa Dist- Ranchi, Torpa, Jharkhand, Ranchi IFSC Code IOBA SBIN0RRMBGB SBIN0RRMBGB PUNB PUNB UTIB BKID PUNB PUNB SBIN SBIN SBIN UTIB UTIB BKID BKID Ministry of Home Affairs 41 State Bank of India At-PO-Ambadala Tehsil Muniguda Dist Rayagada Odisha, Ambodala, Orissa, Rayagada 42 State Bank of India Jhansi Rani Chowk Bahadurganj Kishanganj Bihar, Bahadurganj, Bihar, Kishanganj 43 State Bank of India Antagarh Road Bhanupratappur Chhattisgarh, Bhanupratappur, Chhattisgarh, Kankar 44 State Bank of India In the Premises of Shri Shiv Agrawal, Mandla Road, Bilhari, Jabalpur, Madhya Pradesh, Jabalpur, Madhya Pradesh, Jabalpur 45 State Bank of India At PO Jashipur Dist Mayurbhanj Odisha, Jashipur, Orissa, Mayurbhanj 46 State Bank of India PO Kathikund Dist Dumka Jharkhand, kathikund, Jharkhand, Dumka SBIN SBIN SBIN SBIN SBIN SBIN Account No XXXXXXXXXXX7617 XXXXXX9963 XXXXXXX8279 XXXXXXXXXXXX8114 XXXXXXXXXXXX1982 XXXXXXXXXXX9822 XXXXXXXXXXX9691 XXXXXXXXXXXX7715 XXXXXXXXXXXX7794 XXXXXXX4784 XXXXXXX5291 XXXXXXXXXXXXX2034 XXXXXXXXXXX4924 XXXXXXXXXXX8138 XXXXXXXXXXX7759 XXXXXXXXXXX9646 XXXXXXX5114 XXXXXXX7265 XXXXXXX9085 XXXXXXX6757 XXXXXXXXXXXXX3367 XXXXXXX9779 FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 5 of 7
18 Sl.No Name of Bank Branch Address( With pincode) 47 State Bank of India Beligeria At PO - Baligeria P S - Nayagram Dist Jhargram West Bengal, Kharika Mathani, West Bengal, Midnapore 48 State Bank of India RCMP Branch Campus Urjanagar Mahagama PO Mahagama Dist Godda Jharkhand, Mahagama, Jharkhand, Godda 49 State Bank of India Near Janpad Panchayat Narharpur Dist Kanker Chhattisgarh, Narharpur, Chhattisgarh, Kankar 50 State Bank of India At PO Samnapur Dist Dindori Madhya Pradesh, Samnapur, Madhya Pradesh, Jabalpur 51 State Bank of India At PO - Barmasia PS - Shikaripara Dist Dumka Jharkhand, Shikaripara, Jharkhand, Dumka 52 State Bank of India At PO Tokapal Main Road Gandhi Chowk Dist. Bastar, Tokapal, Chhattisgarh, Bastar 53 Syndicate Bank Main Road Jeypore Dist Koraput Odisha, Lamtaput, Orissa, Koraput 54 Union Bank of India LIC Building Gumla - Jharkhand, Gumla, Jharkhand, Gumla 55 Union Bank of India Maypur Bahri Amiliya Road, Post Lauwwa Dist. Sidhi Madhya Pradesh, Sihawal, Madhya Pradesh, Sidhi 56 United Bank of India At PO - Silda, Dist. Medinipore West Bengal, Silda, West Bengal, Midnapore 57 Bank of India Main Road Khunti Jharkhand, Khunti, Jharkhand, Khunti 58 Punjab National Bank Sonari, Jamshedpur, Jamshedpur, Jharkhand, Singhbhum 59 Bank of India Ashiana Ramnagri, Ram Nagri More, R.B. Market, Patna, Bihar, Patna, Bihar, Patna 60 Central Bank of India P O Mohgaon Distt-Mandla Madhya Pradesh, Mohgaon, Madhya Pradesh, Mandla 61 State Bank of India At-Kuirypara, P.O- Jhalda, Dist- Purulia,West Bengal, Jhalda, West Bengal, Purulia IFSC Code SBIN SBIN SBIN SBIN SBIN SBIN SYNB UBIN UBIN UTBI0SIL926 BKID PUNB BKID CBIN SBIN Ministry of Home Affairs 62 State Bank of India LICI Mukutmonipur Road Distt Bankura West Bengal, Khatra, West Bengal, Bankura 63 State Bank of India At PO - Poreyahat Dist- Godda Jharkhand, Poraiyahat, Jharkhand, Godda 64 State Bank of India P O Naraynganj Tehsil Newas Dist Mandla Madhya Pradesh, Narayanganj, Madhya Pradesh, Mandla 65 State Bank of India Semiliguda At PO- Semiliguda Nandapur Road Dist-Koraput Odisha, Semiliguda, Orissa, Koraput 66 Union Bank of India A.D.B Chowk Araria, Bihar, Araria, Bihar, Araria 67 State Bank of India Godda Bazar Near HP Petrol Pump Kargil Chowk Godda Jharkhand, Godda, Jharkhand, Godda 68 State Bank of India At PO Lailunga Dist Raigarh Chhattisgarh, Lailunga, Chhattisgarh, Raigarh SBIN SBIN SBIN SBIN UBIN SBIN SBIN Account No XXXXXXXXXXXXX3597 XXXXXXX6472 XXXXXXX3471 XXXXXXX7136 XXXXXXX3334 XXXXXXX9018 XXXXXXXXXX4695 XXXXXXXXXXX6267 XXXXXXXXXXX1529 XXXXXXXXX2282 XXXXXXXXXXX6434 XXXXXXXXXXXX6091 XXXXXXXXXXX0008 XXXXXX4793 XXXXXXXXXXXXX9448 XXXXXXXXXXXXX0722 XXXXXXX3147 XXXXXXXXXXXXX2268 XXXXXXXXXXXXX7485 XXXXXXXXXXX8608 XXXXXXX3003 XXXXXXX4826 FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 6 of 7
19 Sl.No Name of Bank Branch Address( With pincode) 69 United Bank of India PO: Baghmundi, Dist: Purulia West Bengal, Baghmundi, West Bengal, Purulia IFSC Code UTBI0BAM089 Account No XXXXXXXXX1990 Declaration I hereby declare that the above particulars furnished by me are true and correct I also affirm that the receipt of foreign contribution and its utilization have not been violative of any of the provisions of the Foreign Contribution (Regulation) Act, 2010, rules, notifications/ orders issued there under from time to time and the foreign contribution was utilized for the purpose(s) for which the association was granted registration/ prior permission by the Central Government. Signature of the Cheif Functionary Ministry of Home Affairs FCRA Annual Returns for the financial year has been Submitted on 28/12/2017 Page 7 of 7
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