Annexure I

ANNEXURE
STATEMENT OF PARTICULARS
I. APPLICATION OF INCOME FOR CHARITABLE OR RELIGIOUS PURPOSES

1 Amount of income of the previous year applied to charitable or religious purposes in India during that year*
 
2 Whether the
has exercised the option under clause (2) of the Explanation to section 11(1)?*
 
If so, the details of the amount of income deemed to have been applied to charitable or religious purposes in India during the previous year
 
3 Amount of income
* 
for application to charitable or religious purposes, to the extent it does not exceed 15 per cent of the income derived from property held under trust
* 
only for such purposes.*
 
 
4 Amount of income eligible for exemption under section 11(1)(c) *
 
If so, give details
S.No. Details Amount
1
alt del
5 Amount of income, in addition to the amount referred to in item 3 above, accumulated or set apart for specified purposes under section 11(2) *
6 Whether the amount of income mentioned in item 5 above has been invested or deposited in the manner laid down in section 11(2)(b) ? *
 
If so, the details thereof
7 Whether any part of the income in respect of which an option was exercised under clause (2) of the Explanation to section 11(1) in any earlier year is deemed to be income of the previous year under section11(1B)?*
 
If so, the details thereof
8 Whether, during the previous year, any part of income accumulated or set apart for specified purposes under section 11(2) in any earlier year-
(a) has been applied for purposes other than charitable or religious purposes or has ceased to be accumulated or set apart for application thereto, or*
 
(b) has ceased to remain invested in any security referred to in section 11(2)(b)(i) or deposited in any account referred to in section 11(2)(b)(ii) or section 11(2)(b)(iii), or*
 
(c) has not been utilised for purposes for which it was accumulated or set apart during the period for which it was to be accumulated or set apart, or in the year immediately following the expiry thereof?*
 
If so, the details thereof

Annexure II[1-4]

II. APPLICATION OR USE OF INCOME OR PROPERTY FOR THE BENEFIT OF PERSONS REFERRED TO IN SECTION 13(3)

1 Whether any part of the income or property of the
was lent, or continues to be lent, in the previous year to any person referred to in section 13(3) (hereinafter referred to in this Annexure as such person)?*
 
If so, give details of the amount, rate of interest charged and the nature of security, if any.
S.No. Details Amount Rate of interest charged Nature of security, if any.
1
alt del
2 Whether any part of the income or property of the
was made, or continued to be made,available for the use of any such person during the previous year?*
 
If so, give details of the property and the amount of rent or compensation charged, if any.
S.No. Details of property Amount of rent or compensation charged
1
alt del
3 Whether any payment was made to any such person during the previous year by way of salary, allowance or otherwise?*
 
If so, give details
S.No. Details Amount
1
alt del
4 Whether the services of the
were made available to any such person during previous year?*
 
If so, give details thereof together with remuneration or compensation received, if any
S.No. Name of Person Details Amount of Remuneration/ Compensation
1
alt del

Annexure II[5-8]


5 Whether any share, security or other property was purchased by or on behalf of the
during the previous year from any such person?*
 
If so, give details thereof together with the consideration paid
S.No. Name of Person Details Amount of Consideration paid
1
alt del
6 Whether any share, security or other property was sold by or on behalf of the
during the previous year to any such person?*
 
If so,give details thereof together with the consideration received
S.No. Name of Person Details of property Amount of Consideration received
1
alt del
7 Whether any income or property of the
was diverted during the previous year in favour of any such person?*
 
If so, give details thereof together with the amount of income or value of property so diverted
S.No. Name of Person Details Income or value of property diverted
1
alt del
8 Whether the income or property of the
was used or applied during the previous year for the benefit of any such person in any other manner?*
 
If so, give details
S.No. Name of Person Details Amount
1
alt del

Annexure III

III. INVESTMENTS HELD AT ANY TIME DURING THE PREVIOUS YEAR(S) IN CONCERNS IN WHICH PERSONS
REFERRED TO IN SECTION 13(3) HAVE A SUBSTANTIAL INTEREST


S.No. Name of the concern Country Address of Concern Concern is a company Class of Shares No. of Shares Nominal value of the investment Income from the investment Whether the amount in col. 5 exceeded 5 percent of the capital of the concern during the previous year-say, Yes/No
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
1
 
 
 
 
Total
alt del


Name :*
Address:*
Place:* Membership No.:*
Date:* FRN (Firm Registration Number):