ANNEXURE

Statement of particulars

Basic Details

1.

PAN of the auditee

A

B

C

D

E

1

2

3

4

F

2.

Name of the auditee

3.

Assessment Year

4.

Previous Year

d

d

m

m

y

y   y

y

To

d

d

m

m

y

y   y

y

5.

Registered Address of the auditee

6.

Other addresses, if applicable

< refer note*>

Legal

7.

Type of the auditee

Trust

Society

Company

Others

8.

Whether the auditee is established under an instrument?

Yes/No

Registration Details

9.

Details of registration/provisional registration or approval/ provisional approval or notification of the auditee under the Income-tax Act

(details of all the registration/provisional registration/approval/provisional approval/notification which are valid during the previous year should be provided, however where the auditee has got the registration/approval after provisional registration/approval the details of provisional registration/approval need not be provided)

Section under which registered/provisionally registered or approved/ provisionally approved

/notified (refer note **)

Date of

registration/provisional registration or approval/ provisionally approval/ notification

Registration/Approval/ Notification/ Unique Registration No. (URN), if available

Authority granting registration/provisi onal registration or approval/provisiona l approval or

notification

Date from which registration//provisional registration/approval/provi sional approval/notification is effective

(dd/mm/yyyy)

(dd/mm/yyyy)

(1)

(2)

(3)

(4)

(5)

Management

10.

(a) Details of all the Author (s)/ Founder (s)/ Settlor (s)/Trustee (s)/ Members of society/Members of the Governing Council/ Director (s)/ shareholders

holding 5% or more of shareholding / Office Bearer (s) of the auditee at any time during the previous year

Name of person

Relation

< refer note#>

Percentage of shareholding in case of

shareholder

Unique Identification Number

Id Code

< refer

note##>

Address

Whether there is any change in relation during previous year of audit

Yes/No

If yes, specify the change

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(b) In case if any of the persons [as mentioned in row 10(a)] is not an individual, then provide the following details of the natural persons who are

beneficial owners (5% or more) of such person at any time during the previous year

Sl. No.

Name

Unique Identification Number

ID code

< refer note##>

Address

Non- individual person  [as mentioned in row no 10(a)] in which beneficial ownership held

Percentage of beneficial ownership

Whether there is any change during previous year of audit Yes/No

If yes, specify the change

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Objects

11.

Objects of the auditee

Refer Note$

12.

(i)

Whether the auditee, being a trust or institution referred to in section 11 or 12, has adopted or undertaken modification of the objects which do not conform to the conditions of registration?

Yes/No

(ii)

If yes, please furnish following information:-

(A)

date of such modification/ adoption (DD/MM/YYYY)

(B)

Whether an application for registration has been made in the prescribed form and manner within the stipulated period of thirty days from the date of said adoption or modification, as per sub-clause (v) of clause (ac) of sub-section (1) of section 12A.

Yes/No

(C)

If yes provide the following details regarding application for registration under sub-clause (v) of clause (ac) of sub-section (1) of section 12A

S.No

Date of Applicatio

n

Status of registration in pursuance of application

Date of Registration or cancellation based on

such application

URN of such registration

(Pending/ Registration granted/Registration cancelled)

( dd/mm/yyyy)

Commencement of activities

13.

(i)

Where the auditee has been granted provisional registration or provisional approval, whether activities have commenced during the previous year

Yes/No

(ii)

If yes in 13 (i) , date of commencement of activities

d

d

m

m

y

y

y

y

(iii)

If the answer to 13(i) is yes, whether application for registration under section sub-clause (iii) of clause (ac) of sub-section (1) of section 12A or application for approval under clause (iii) of the first proviso to  clause (23C) of section 10 has been filed?

Yes/No

(iv)

If yes in 13(iii) above, provide the following details regarding application for registration under section sub-clause (iii) of clause (ac) of sub- section (1) of section 12A or application for approval under clause (iii) of the first proviso to clause (23C) of section

S.No

Date of Application

Status of registration in pursuance to application

Date of Registration /Cancellation based on such application

URN of such

registration

(Pending/ Registration

granted/Registration cancelled)

( dd/mm/yyyy)

Details of Place where books of accounts and other documents have been maintained

14.

(i)

Whether the books of account and other documents have been kept and maintained in the form and manner and at such place as prescribed under rule 17AA by the auditee

Yes/No

(ii)

Provide the following details of the books of account and other documents

S.

No

Nature of

Books of Account

<Refer Note$$>

Whether maintained by the auditee

(Yes/No)

Whether maintained in a computer system, (Yes/No)

Whether maintained at registered office (Yes/No)

If maintained at any place other than the registered place

Whether the books of account have

been audited (Yes/No)

Address of such Place

Date of decisio n     by

manag ement to keep accoun t at

such place

Date of

intimation to Assessing Officer that

books of

accounts are kept at such place under proviso to sub- rule (3) of rule 17AA

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Advancement of General Public Utility

15.

Where, in any of the projects/institutions run by auditee, one of the charitable purposes is advancement of any other object of general public utility then,-

—

(A)

Whether any activity is being carried on by the auditee which is in the nature of trade, commerce or business referred to in proviso to clause (15) of section 2?

Yes/No

(B)

If yes, then percentage of receipt from such activity vis-à-vis total receipts

%

(C)

Whether such activity in the nature of trade, commerce or business is undertaken in the course of actual carrying out of such advancement of any other object of general public utility

Yes/No

(D)

Whether there is any activity of rendering any service in relation to any trade, commerce or business for any consideration as referred to in proviso to clause (15) of section 2?

Yes/No

(E)

If yes, then percentage of receipt from such activity vis-à-vis total receipts

%

(F)

Whether such activity of rendering service is undertaken in the course of actual carrying out of such advancement of any other object of general public utility

Yes/No

16.

If ‘A’ or ‘D’ in 15 is Yes, the aggregate annual receipts from such activities in respect of that project/institution

S.No

Name of Project/ Institution

Amount of aggregate annual receipts from activities referred in 15A and 15D (In Rs.)

Total

Business Undertaking

17.

(i)

Whether the auditee has any business undertaking as referred to in sub-section (4) of section 11

Yes/No

(ii)

If yes, then provide the following details of the business undertaking:

(a)

Nature of Business Undertaking

(b)

Business Code

(c)

Whether separate books of account have been maintained for the business undertaking <refer note^>

Yes/No

(d)

Income from the business undertaking for the previous year which is not to be included in the total income of the auditee as per sub-section (4) of section 11

Amount in Rs.

(e)

Income from the business undertaking for the previous year which is to be included in the total income of the auditee as per sub-section (4) of section 11

Amount in Rs.

Business Incidental to Objects

18.

(i)

Whether the auditee has any income being profits and gains from any business as referred in seventh proviso to Clause (23C) of section 10 or sub-section (4A) of section 11, as the case may be

Yes/No

(ii)

If yes, then provide the following details of such business:

Yes/No

(a)

Nature of Business

(b)

Business Code

(c)

Whether separate books of account have been maintained for the business <refer note^>

Yes/No

(d)

Whether the business is incidental to the attainment of the objects of the auditee

Yes/No

(e)

Profits and gains from the business during the previous year

Amount in Rs.

TDS on receipts

19.

Details of the receipts of the auditee on which tax has been deducted at source referred to in sections 194C or 194J or 194H or 194Q :

S. No.

Name of the deductor

TAN of deductor

Amount on which tax has been deducted at source (In Rs.)

Amount of tax deducted at source

Section under which tax

has been deducted at source

Category of income/receipt

Income/receipt in column 7 or 8 which is from business incidental to the attainment of the objects of the auditee.

(In Rs.)

Whether separate books of account have been

maintained for activities income/receipt

which is mentioned in column 10 (Yes/No)

Trade, commerce or business (Rs.)

Activity of rendering any service in relation to any trade, commerce or business (Rs.)

Others (specify the nature) (Rs.)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

20.

Whether the provisions of twenty second proviso to clause (23C) of section 10 or sub-section (10) of section 13 are applicable.

Yes/No

Voluntary contributions

21.

Whether auditee has filed Form No. 10BD for the previous year < If No then skip to row 23 >

Yes/No

22.

Total Sum of donations reported in Form No. 10BD furnished by the auditee for the previous year

(Amount in Rs..)

23.

Donations not reported in Form No 10BD /Not required to fill Form No. 10BD

(i)

Donations received by fund or trust or institution of the auditee which is approved under clause (b) of sub-section (2) of section 80G

Amount in Rs.

(ii)

Donations received by fund or trust or institution of the auditee which qualifies for deduction under section 80G (other than those donations qualifying under clause (b) of sub-section (2) of section 80G or sub-clause (iv) of clause (a) of sub-section (2) of section 80G )

Amount in Rs.

(iii)

Donations received by fund or trust or institution   of the auditee approved under sub-clause (iv) of clause (a) of sub-section (2) of section 80G and which are not eligible under sub-section (5) of section 80G

(a)

Cash donations exceeding Rs. 2000

Amount in Rs.

(b)

Donations received from other charitable trusts and institution or from any fund or institution or trust or any university or other educational institutions or any hospital or other medical institution not eligible for deduction

Amount in Rs.

(c)

Others < Specify the nature>

Amount in Rs.

(d)

Total (a)+(b)+(c)

Amount in Rs.

(iv)

Donations which could not be reported in Form No 10BD due to non-availability of identification of donor as required under Form No 10BD

Amount in Rs.

(v)

Donations received in kind

Amount in Rs.

(vi)

Anonymous Donations referred to in section 115BBC

(a)

Amount of anonymous donation not taxable under section 115BBC on account of applicability of clause (i) of sub-section (1) of section 115BBC

Amount in Rs.

(b)

Amount of anonymous donation not taxable under section 115BBC on account of applicability of clause (a) of sub-section (2) of section 115BBC

Amount in Rs.

(c)

Amount of anonymous donation not taxable under section 115BBC on account of applicability of clause (b) of sub-section (2) of section 115BBC

Amount in Rs.

(d)

Other anonymous donations taxable @ 30 % under section 115BBC

Amount in Rs.

(e)

Total (a+b+c+d)

Amount in Rs.

(vii)

Any other voluntary contribution not part of Form No. 10BD

<Please specify the nature>

Amount in Rs.

(viii)

Total donation not reported in Form No 10BD [23(i)+23(ii)+23(iii)(d) +23(iv)+23(v)+23(vi)(e)+23(vii)]

Amount in Rs.

24.

Total voluntary contributions received by the auditee during the previous year [22+23(viii)]

Amount in Rs.

25.

Total foreign contribution out of the total voluntary contributions stated in 24

Amount in Rs.

< Fill Schedule FC>

26.

Voluntary Contribution forming part of corpus (which are included in 24)

Amount in Rs.

(A)

Corpus representing donations received for the renovation or repair of places notified under clause (b) of sub-section (2) of section 80G eligible for exemption under Explanation 1A to the third proviso to clause (23C) of section 10 or Explanation 3A to sub-section (1) of section 11

Amount in Rs.

< Fill Schedule Corpus>

(B)

Corpus donations as referred to in clause (d) of sub-section (1) of section 11 or Explanation 1 to the third proviso to section 10 (23C) eligible for exemption and invested in modes specified under sub-section (5) of section 11

Amount in Rs.

< Fill Schedule Corpus>

27.

Voluntary Contributions required to be applied by the auditee during the previous year [24-{23(vi)(d)+26A+ 26B}]

Amount in Rs.

Income to be applied

28.

Income other than voluntary contributions derived from property held under trust referred to in section 11 or income of fund or institution or trust or any university or other educational institution or any hospital or other medical institution (other than the contribution reported in serial number 24)

Amount in Rs.

29.

Income applied outside India which is eligible under clause (c) of sub-section (1) of section 11

Amount in Rs.

< Fill Schedule Int App>

30.

Income required to be applied in India by the auditee during the previous year [27+28-29]

Amount in Rs.

Application of Income

31.

Application of Income (excluding application not eligible and reported under serial number 37)

(i)

Total amount applied for charitable or religious purposes in India during the previous year

+Electronic ( In Rs)

Other than Electronic ( In Rs.)

Amount in Rs.

(a)

Contribution or donation to any other person during the previous year

Amount in Rs.

Object wise application other than the application provided in (a)

(I)

Religious

Amount in Rs.

(II)

Relief of poor

Amount in Rs.

(III)

Education

Amount in Rs.

(IV)

Medical relief

Amount in Rs.

(V)

Yoga

Amount in Rs.

(b)

(VI)

Preservation of environment (including watersheds, forests and wildlife)

Amount in Rs.

(VII)

Preservation of monuments or places or objects of artistic or historic interest

Amount in Rs.

(VIII)

Advancement of any other objects of general public utility

Amount in Rs.

(IX)

Application which cannot be specifically categorised under (I) to (VIII)

Amount in Rs.

(X)

Total

Amount in Rs.

(c)

Total application [(a) + (b)(X)]

Amount in Rs.

(ii)

Details of application out of (i) (a) and (i) (b) resulting in payment in excess of Rs. 50 lakh during the previous year to any person

S.No.

Name of person to whom amount paid or credited

PAN of such person

Amount of application

(Rs)

Mode of application

TDS

+Electroni c modes (Rs.)

Other than Electronic modes (Rs.)

Total

Whether any TDS has been deducted

Yes/No

Section under which TDS has been deducted

(iii)

Amount which was not actually paid during the previous year [if included in (i)(c)]

Amount in Rs.

(iv)

Amount actually paid during the previous year which accrued during any earlier previous year but not claimed as application of income in earlier previous year

Amount in Rs.

(v)

Total amount to be allowed as application [31(i)(c)- 31(iii) +31(iv)]

Amount in Rs.

(vi)

Bifurcation of application in 31( v) into Revenue or Capital

Amount in Rs.

(a)

Revenue

Amount in Rs.

(b)

Capital

Amount in Rs.

(vii)

Amount invested or deposited back in corpus which was applied during any preceding previous year and not claimed  as application during that previous year.

Amount in Rs.

< fill Schedule Corpus>

(viii)

Repayment of loan or borrowing during the previous year which was earlier applied and not claimed as application during that previous year during that previous year.

Amount in Rs.

< fill Schedule LB>

Amount to be disallowed from application

(ix)

Amount disallowable under thirteenth proviso to clause (23C) of section 10 or Explanation 3 to sub- section (1) of section 11 read with sub-clause (ia) of clause (a) of section 40

Amount in Rs.

< fill schedule TDS>

(x)

Amount disallowable under thirteenth proviso to section 10(23C) or Explanation 3 to sub-section (1) of section 11 read with sub-section (3) or (3A) of section 40A

Amount in Rs.

< fill schedule 40A(3)/schedule 40A(3A)>

(xi)

Donation to any fund or institution or trust or any university or other educational institution or any hospital or other medical institution referred to in sub - clauses (iv), (v), (vi) or (via) of clause (23C) of section 10 of the Act or any trust or institution referred to in sections 11 or 12 of the Act towards Corpus

Amount in Rs.

(xii)

Donation to Any fund or institution or trust or any university or other educational institution or any hospital or other medical institution referred to in sub - clauses (iv), (v), (vi) or (via) of clause (23C) of section 10 of the Act or any trust or institution referred to in sections 11 or 12 of the Act not having

Amount in Rs.

same objects

(xiii)

Donation to any person other than any fund or institution or trust or any university or other educational institution or any hospital or other medical institution referred to in sub - clauses (iv), (v), (vi) or (via) of clause (23C) of section 10 of the Act or any trust or institution referred to in sections 11 or 12 of the Act

Amount in Rs.

(xiv)

Application outside India for which approval under proviso to clause (c) of sub-section (1) of section 11 has not been obtained

Amount in Rs.

(xv)

Application outside India for which approval under proviso to clause (c) of sub-section (1) of section 11 has been obtained

(xvi)

Applied for any purpose beyond the objects of the auditee

Amount in Rs.

(xvii)

Any other disallowance (Please specify)

Amount in Rs.

(xviii)

Total allowable application [ {31(v)+31(vii)+31(viii) – {31(ix) to 31(xvii) }]

Amount in Rs.

(xix)

Amount deemed to have been applied during the previous year under clause (2) of Explanation 1 to sub- section (1) of section 11

Amount in Rs.

< fill Schedule DI>

(xx)

Income accumulated as per the provisions of Explanation 3 to the third proviso to clause (23C) of section 10 or sub-section (2) of section 11

Amount in Rs.

< fill Schedule AC>

(xxi)

Income accumulated or set apart for application to charitable or religious purposes or stated objects of trust or institution to the extent it does not exceed 15 % of the income

Amount in Rs.

32.

Taxable Income [30- {31(xviii) to 31(xxi)}]

Amount in Rs.

Section 115BBI

33.

Income taxable under section 115BBI

(a)

Whether the auditee has any deemed income referred to in sub-section (1B) of section 11 which is chargeable to tax @ 30 % under section 115BBI and the amount of such deemed income?

Yes/No If yes fill

Schedule DI

Amount in Rs.

(b)

Whether the auditee has any deemed income referred to in Explanation 4 to third proviso to clause (23C) of section 10 or sub-section (3) of section 11 which is chargeable to tax @ 30 % under section 115BBI and the amount of such deemed income?

Yes/No If yes fill

Schedule AC

Amount in Rs.

(i)

Whether income accumulated is applied for the purposes other than charitable or religious purposes or ceases to be accumulated or set apart for application thereto

Yes/No

Amount in Rs.

(ii)

Whether such income accumulated ceases to remain invested or deposited in any of the forms or modes specified in sub-section (5) of section 11

Yes/No

Amount in Rs.

(iii)

Whether such income accumulated is not utilised for the purpose for which it is so accumulated or set apart during the period referred to in clause (a) of Explanation 3 to third proviso to clause (23C) of section 10 or clause (a) of sub-section (2) of section 11

Yes/No

Amount in Rs.

(iv)

Whether such income accumulated is credited or paid to any trust or institution registered under section 12AA or section 12AB or to any fund or institution or trust or any university or other educational institution or any hospital or other medical institution referred to in sub-clause (iv) or sub-clause

(v) or sub-clause (vi) or sub-clause (via) of clause (23C) of section 10

Yes/No

Amount in Rs.

(c)

(i)

Whether the auditee has any income which is income not to be excluded from the total income under twenty first proviso to clause (23C) of section 10 or clause (c) of sub-section (1) of section 13 which is chargeable to tax @ 30 % under section 115BBI and the amount of such income

Yes/No

Amount in Rs.

(ii)

Whether the auditee has any income which is not to be excluded from the total income under clause (b) of third proviso to clause (23C) of section 10 or clause (d) of sub-section (1) of section 13 which is chargeable to tax @ 30 % under section 115BBI and the amount of such income

Yes/No

Amount in Rs.

(d)

Whether the auditee has any income accumulated or set apart in excess of fifteen per cent. of the income where such accumulation is not allowed under any specific provision of the Act and which is chargeable to tax @ 30 % under section 115BBI and the amount of such income ?

Yes/No

Amount in Rs.

(e)

Whether the auditee has made any application out of India which is not excluded from total income under clause (c) of sub-section (1) of section 11

Yes/No

< If yes fill schedule Int App>

Amount in Rs.

34.

Anonymous donation which is chargeable to tax @ 30 % under section 115BBC

Amount in Rs.

Other Income

35.

Other Income

Amount in Rs.

(a)

Whether the auditee has any income chargeable under section 12(2) and the amount of such income.

Yes/No

Amount in Rs.

(b)

Income as per Explanation 3B to sub-section (1) of section 11 in case of violation of clause (a) or (b) or (c) or (d) of Explanation 3A to sub-section (1) of section 11 read with clause (b) of sub-section (2) of section

Amount in Rs.

< Fill Schedule Corpus>

80G

(c)

Income as per Explanation 1B to the third proviso to clause (23C) of section 10 in case of violation of clauses (a) or (b) or (c) or (d) of Explanation 1A to the third proviso to clause (23C) of section 10 read with clause (b) of sub-section (2) of section 80G

Amount in Rs

< Fill Schedule Corpus>

(d)

Income chargeable under sub-section (4) of section 11

Amount in Rs.

Capital Asset

36.

Details of capital asset transferred under sub-section (1A) of section 11

(1)

Whether a capital asset being property held under trust wholly for charitable or religious purpose is transferred and the net consideration for which it is transferred?

Yes/No

Amount in Rs.

(2)

Whether deemed application is claimed as per clause (a) of sub-section (1A) of section 11 and the amount of such deemed application?

Yes/No

Amount in Rs.

(3)

Whether a capital asset being property held under trust in part only for charitable or religious purpose is transferred and the net consideration for which it is transferred?

Yes/No

Amount in Rs.

(4)

Whether deemed application is claimed as per clause (b) of sub-section (1A) of section 11 and the amount of such deemed application?

Yes/No

Amount in Rs.

Application of income out od different sources

37.

Application of income out of the following sources during the previous year

(A)

Income accumulated under third proviso to clause (23C) of section 10 or under sub-section (2) of section 11 during any earlier previous year

+Electronic modes

(Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

< Fill schedule AC>

(B)

Income deemed to be applied in any preceding year under clause (2) of Explanation 1 to sub-section (1) of section 11 during any earlier previous year

+Electronic modes (Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

< Fill schedule DI>

(C)

Income of earlier previous years up to 15% accumulated or set apart

+Electronic modes (Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

(D)

Corpus

+Electronic modes (Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

< Fill Schedule Corpus>

(E)

Borrowed fund

+Electronic modes (Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

< Fill Schedule LB>

(F)

Any other (Please specify)

+Electronic modes (Rs.)

Other than Electronic modes (Rs.)

Total Amount (Rs.)

< Fill Schedule LB>

38.

Details of application resulting in payment or credit in excess of Rs. 50 lakh during previous year to a single person out of 37

S.no

Name of person

PAN

Amount of application (Rs.)

Mode of Application

TDS

+Electroni c modes

Other than Electronic modes

Total

Whether any TDS has been deducted (Yes/No)

Section under which TDS has been deducted

Amou nt of TDS

13(10) and 22nd proviso to section 10(23C)

39.

(i)

Whether provisions of twenty second proviso to clause (23C) of section 10 or sub-section (10) of section 13 are applicable?

Yes/No

(ii)

If yes in (i) specify the reason why the provisions of twenty second proviso to clause (23C) of section 10 or sub-section (10) of section 13 are applicable?

(a)

Provision of proviso to clause (15) of section 2 is applicable

Yes/No

(b)

condition specified in clause (a) of tenth proviso to clause (23C) of section 10 or sub-clause (i) of clause (b) of sub-section (1) of section 12A have been violated

Yes/No

(c)

condition specified in clause (b) of tenth proviso to clause (23C) of section 10 or sub-clause (ii) of clause (b) of sub-section (1) of section 12A have been violated

Yes/No

(d)

condition specified in twentieth proviso to clause (23C) of section 10 or sub-clause (ii) of clause (ba) of sub-section (1) of section 12A have been violated

Yes/No

(iii)

If yes in (i), please provide computation of income chargeable under  twenty second proviso to clause (23C) of section 10 or sub-section (10) of section 13

(a)

Income for the previous year

Amount in Rs.

(b)

Total Expenditure incurred in India, for the objects of the auditee,

Amount in Rs.

(c)

Expenditure to be disallowed

(i)

Expenditure from the corpus standing to the credit of the trust or institution as on the end of the financial year immediately preceding the previous year relevant to the assessment year for which income is being computed

Amount in Rs.

(ii)

Expenditure from any loan or borrowing

Amount in Rs.

(iii)

Depreciation in respect of an asset, acquisition of which has been claimed as application of income, in the same or any other previous year; and

Amount in Rs.

(iv)

Expenditure in the form of contribution or donation to any person.

Amount in Rs.

(v)

Capital expenditure

Amount in Rs.

(vi)

Amount disallowable under Explanation to sub-section (10) of section 13 or Explanation to twenty second proviso to clause (23C) of section 10 read with sub-clause (ia) of clause (a) of section 40

Amount in Rs.

< fill schedule TDS

disallowable >

(vii)

Amount disallowable under Explanation to sub-section (10) of section 13 or Explanation to twenty second proviso to clause (23C) of section 10 read with sub-sections 3 or 3A of section 40A

Amount in Rs.

< fill schedule 40A(3)/Schedul e 40A(3A)>

(viii)

Any other disallowance

Amount in Rs.

(ix)

Total expenditure to be disallowed (i)+(ii)+(iii)+(iv)+(v)+(vi)+(vii))+(viii))

Amount in Rs.

(d)

Income chargeable to tax under twenty-second proviso to clause (23C) of section 10 or sub-section (10) of section 13 [ a – b+c(ix)}]

Amount in Rs.

Expenditure Incurred for Religious Purposes

40.

In case auditee is approved under second proviso to sub-section (5) of section 80G, please provide the following details

(a)

Whether any amount of expenditure incurred during the previous year which is of a religious nature and the amount of such expenditure

Yes/No

If yes  specify amount

in Rs.

(b)

Total income of auditee during the previous year

Amount in Rs.

(c)

Percentage of expenditure which is of religious nature to the total income [ Amount in (a)/(b)]

%

Person referred to in 13(3)

41.

Details of specified person* as referred to in sub-section (3) of section 13

Code of Person referred to in sub-section (3) of section 13

<Refer Note^^>

Name of such person

PAN of such person

Aadhar number of such person, if allotted

Address of such person

If code 2 selected in column (1) specify the amount of contribution made to the auditee

42.

Details of transactions referred to in section 13 (2)

(a)

Whether any part of the income or property of the auditee is, or continues to be, lent to any specified person for any period during the previous year without either adequate security or adequate interest or both

Yes/No

< If yes, fill Schedule SP-a>

(b)

Whether any land, building or other property of the auditee is, or continues to be, made available for the use of any specified person, for any period during the previous year without charging adequate rent or other compensation;

Yes/No

< If yes, fill Schedule SP-b >

(c)

Whether any amount is paid by way of salary, allowance or otherwise during the previous year to any specified person out of the resources of the trust or institution for services rendered by that person to such auditee and the amount so paid is in excess of what may be reasonably paid for such services;

Yes/No

< If yes, fill Schedule SP-c >

(d)

Whether the services of the auditee are made available to any specified person during the previous year without adequate remuneration or other compensation;

Yes/No

< If yes, fill Schedule SP-d >

(e)

Whether any share, security or other property is purchased by or on behalf of the auditee from any specified person during the previous year for consideration which is more than adequate;

Yes/No

< If yes, fill Schedule SP-e1/e2

>

(f)

Whether any share, security or other property is sold by or on behalf of the auditee to any specified person during the previous year for consideration which is less than adequate;

Yes/No

< If yes, fill Schedule SP-f1/f2

>

(g)

Whether any income or property of the auditee is diverted during the previous year in favour of any specified person

Yes/No

< If yes, fill Schedule SP-g >

(h)

Whether any funds of the auditee are, or continue to remain, invested for any period during the previous year, in any concern in which any specified person has a substantial interest.

Yes/No

< If yes, fill Schedule SP-h >

Specified Violation

43.

Specified Violation

Whether the auditee has incurred any specified violation as referred to in Explanation 2 to the fifteenth proviso to clause (23C) of section 10 or Explanation to sub-section (4) of section 12AB and the amount of such violation

Yes/No

Amount in Rs.

(a)

Income of the auditee has been applied, other than for the objects of the trust or institution.

Yes/No

Amount in Rs.

(b)

Whether the auditee has income from profits and gains of business which is not incidental to the attainment of its objectives or separate books of account are not maintained by auditee in respect of the business which is incidental to the attainment of its objectives.

Yes/No

Amount in Rs.

(c)

Whether the auditee, referred to in clause (a) of sub-section (1) of section 13, has applied any part of its income from the property held under a trust for private religious purposes, which does not enure for the benefit of the public.

Yes/No

Amount in Rs.

(d)

Whether the auditee, referred to in clause (b) of sub-section (1) of section 13, has applied any part of its income for the benefit of any particular religious community or caste.

Yes/No

Amount in Rs.

(e)

Whether any activity being carried out by the auditee is not genuine or is not being carried out in accordance with all or any of the conditions subject to which it was registered.

Yes/No

Amount in Rs.

(f)

Whether the auditee has not complied with the requirement of any other law, for the time being in force, and the order, direction or decree, by whatever name called, holding that such non- compliance has occurred, has either not been disputed or has attained finality.

Yes/No

< If yes, fill schedule other law violation>

44.

Whether there is any claim of depreciation or otherwise has been made in terms of Explanation 1 to clause (23C) of section 10 or sub-section (6) of section 11 in respect of any asset, acquisition of which has been claimed as an application of income and the amount of such depreciation?

Yes/No

If yes specify the amount

45.

In view of provisions of nineteenth proviso to clause (23C) of section 10 or sub-section (7) of section 11, please specify whether the trust or institution has claimed deduction under section 10 [other than clause (1), clause (23C) and clause (46) thereof] during the previous year and the amount of such claim?

Yes/No

Amount in Rs.

46.

Whether the auditee has taken or accepted any loan or deposit or any specified sum, exceeding the limit specified in section 269SS during the previous year?

Yes/No

Amount in Rs.

(If yes, fill Schedule 269SS)

47.

Whether the auditee has received an amount exceeding the limit specified in section 269ST, from a person in a day; or in respect of a single transaction; or in respect of transactions relating to one event or occasion from a person during the previous year?

Yes/No

Amount in Rs.

(If yes, fill Schedule 269ST)

48.

Whether the auditee has repaid any amount being loan or deposit or any specified advance exceeding the limit specified in section 269T, during the previous year?

Yes/No

Amount in Rs.

(If yes, fill Schedule 269T)

49.

Whether the auditee is required to deduct or collect tax as per the provisions of Chapter XVII-B or Chapter XVII-BB?

Yes/No

(If yes, fill Schedule TDS/TCS/

Statement of TDS/TCS/ Interest on TDS/TCS as applicable)

Schedules to fill as may be applicable < refer to instructions> Form 10B

Schedule Corpus: Details of Corpus

Type of corpus donation

Openi ng balanc e at

the begin ning of the previo us year (Corp us not applie d till the begin ning of the previo us year) (1)

Received/T reated as corpus during the previous year

(2)

Appli ed durin g the previ ous year (3)

Amoun t investe d or

deposit ed back in to corpus (which was earlier applied and not claime d as

applica tion if such applica tion fulfille d the conditi ons) (4)

Total amou nt invest ed or depos ited back in to corpu s

(5)

Finan cial year in which (4)

was applie d earlie r

(6)

Closin g balanc e

(7)

[(1+2

+5)-3]

Inves ted in mode s specif ied in sectio n 11(5)

(8)

Amou nt taxed in previo us assess ment year (9)

Inves ted in mode s other than specif ied in sectio n 11(5)

as on last day of the previ ous year (10)

If corpus donation is of type

(i) then whether it fulfills the following conditions

Amount applied out of corpus for the purpose other than for which the voluntary contribution was made

Contribution or donation to any person;

Maintained as not separately identifiable

invested or deposited in the forms and modes other those specified under sub-section (5) of section 11.

(i) Represen ting donations received for the renovatio n or

repair of places notified under 80G(2)

(b) on or after 01.04.20 20

Yes/ No

Yes/ No

Yes/ No

Yes/ No

(ii) –

Other than (i) above received on or

after 01.04.20

21

(iii) Other than (i)

and (ii) above

Schedule FC: Details of foreign contribution

Nature of foreign

Amount of foreign contribution

Details of the total application from such contribution during the previous

contribution received during

received during the previous years

year

the previous year

(In Rs.)

Amount In Rs.

(i) orpus

(ii) on- corpus

Total

Schedule LB: Details of Loan and Borrowing

Opening balance

as on 1^st April of the previous year

Loan and borrowings taken for applications towards objectives during the previous year

Applied for the objects of the trust or institution during the previous year

Amount of repayment of loan or borrowing during the previous year (which was earlier applied and not claimed as application if such application fulfilled the conditions as required)

Financial year in which (4) was applied earlier

Total repayment of loan or borrowing during the previous year (In Rs.)

Closing Balance as on 31st March

(1+2-6=7)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

Schedule Int App: Details of income applied outside India

S.No.

Name of the person to whom remittance is made

Taxpayer Identification Number if available

Amount of remittance out of India which is reported in Form No. 15CA (In Rs.)

Amount of remittance outside India other than (4)

(In Rs.)

Charitable or religious purpose for which application is made

Country of application

Whether applied for promoting international welfare in which India is interested and is and not to be included in total  income of the auditee?

If  approval  for  application outside India has been taken

Approval number

General/ special

Date of approval

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

Schedule DI: Details of deemed application under Explanation 1 to sub-section (1) of section 11 and deemed income under sub-section (1B) of section 11

Year in which income is deemed to be applied

(F.Y.)

Date of furnishing Form 9A (dd/mm/yyyy)

Amount deemed to be applied during the previous year referred to in column 1

Reason of deeming application

(a) income has not been received during that year

(b) any other reason

Out of the deemed application claimed earlier, amount required to be applied

Amount taxed in any earlier assessment year out of the amount referred to in column (5)

(Fill schedule DA)

Out of the deemed application clamied, amount required to be applied during the financial year pertaining to current assessment year

Amount of deemed application claimed in earlier years, applied during the financial year relating to current AY

Amount which could not be applied and deemed to be income under section 11(1B)

during the previous year

Balance Amount of deemed application

(1)

(2)

(3)

(4)

(5)

(6)

(7) =(5)-

(6)

(8)

(7)-(8) =

(9)

(5)-

(7)=(10)

Dropdowns to be provided

Dropdowns to be provided

Schedule DA: Details of accumulated income taxed in earlier assessment years as per sub-section (1B) of section 11

Assessment year in which the amount referred to in column (4) of schedule DI was taxed

Dropdowns to be provided last five previous years beginning from the previous year preceding the current previous year

Year of accumulation (F.Y.)

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Dropdowns to be provided for last five previous years beginning from the current previous year

Yyyy – yyyy

Total

Schedule AC: The details of accumulation

S.

Year

Date

Amou

Purpos

Amo

Bal

Amo

Balan

Amou

Amou

Amount

Balan

Amo

Amo

Amou

Amo

N

of

of

nt

e of

unt

anc

unt

ce

nts

nt

credited or

ce

unt

unt

nt

unt

o.

accum

furnis

accum

accum

appli

e to

taxed

avail

applie

applie

paid to any

amou

inve

inves

which

deem

ulation

hing

ulated

ulation

ed

be

in

able

d  for

d for

trust or

nt

sted

ted or

is not

ed to

(F.Y.)

Form

in the

for

app

any

for

charita

purpos

institution

avail

or

depos

utilise

be

10

year of

chari

lied

earlie

appli

ble or

es

registered

able

depo

ited

d

inco

accum

table

(3)-

r

catio

religio

other

under

for

sited

in the

during

me

dd/m

ulation

or

(5 )

asses

n

us

than

section

appli

in

mode

the

withi

m/yyy

religi

smen

(6)-

purpos

the

12AB or

catio

the

s

period

n

y

ous/

t

(7)

e

purpos

approved

n

mod

other

of

theme

purp

(Fill

during

e for

under sub-

(8) –

es

than

accum

aning

oses

sched

the

which

clauses

(9) –

spec

speci

ulation

of

up to

ule

previo

such

(iv)or(v)or

(10)

ified

fied

(if

sub-

the

ACA

us

accum

(vi)or(via)

–

in

in

applic

sectio

begi

)

year

ulation

of clause

(11)

secti

sectio

able)

n (3)

nnin

out of

was

(23C) of

on

n

of

g of

previo

made

section 10

11(5

11(5)

sectio

the

us

(if

(if

) out

out

n 11

previ

years’

applic

applicable)

of

of

(if

ous

accum

able)

(12)

(12)

applic

year

ulation

(if

able)

appli

cable

(10)+

)

(11)+

(14)+

(15)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15)

(16)

Provid e dropdo wn

for the last seven financi al years

Total

Schedule ACA: Details of accumulated income taxed in earlier assessment years under sub-section (3) of section 11

Assessment year in which this amount was taxed

Dropdowns to be provided last five previous years beginning from the previous year preceding the current previous year

Year of accumulation (F.Y.)

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Yyyy – yyyy

Dropdowns to be provided for last five previous years beginning from the current previous year Yyyy – yyyy

Total

Schedule SP-a: Whether any part of income or property of the auditee is lent, or continues to be lent, to the specified person during the previous year?

S. No.

Name of specified person

PAN of specified person

Details

Details of Security

Details of interest

Nature         of

income or property which is lent

Amount for which income or property is, or continues to be, lent to specified person for any period during the previous year

Nature of securit y

Value of security

Value of adequate security

Actual rate of interest

that is

charged

Adequate rate of

Interest

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Schedule SP-b: Details of land, building or other property of the auditee which is, or continues to be, made available during the previous year for use of the specified person, during the previous year :

S. No.

Name of specified person

PAN of specifie d person

Details of asset

Duration for which asset is, or continues to be, made available for the use of specified person during the previous year,

Details of rent for the previous year

Details of other compensation for the previous year

Nature of asset

Address

From dd/mm/yy yy

To dd/mm/yyy y

Amount of rent

Adequate rent

Nature

Amount of compensat ion

Adequate compensati on

(1)

(2)

(3)

(4)

< land/ building/ other property >

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

Schedule SP-c: Details of salary, allowance or otherwise which is paid to the specified person out of the resources of the auditee for services rendered by him during the previous year

S. No.

Name of specified person

PAN of specified person

Nature of services rendered by specified person

Details of payment for the previous year

Nature of payment

Amount of payment (in Rs)

Reasonable amount for services

(1)

(2)

(3)

(4)

(5)

(6)

(7)

< Salary/ Allowance/ Otherwise (please specify)>

Schedule SP-d: Details of the services of the auditee are made available to the specified person during the previous year?

S. No.

Name of specified person

PAN of specified person

Details of services

Details of remuneration for the previous year

Details of compensation for the previous year

Nature  of services made available

Value of services made available (In Rs.)

Actual amount of remunerati on for the service

Adequate remunerati on for the service

Nature of compensati on for the service

Actual amount of compensati on for the service

Adequate compensat ion

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Schedule SP- e 1 : Details of any share, security is purchased by or on behalf of the auditee from the specified person during the previous year?

S.

No.

Name of specified person

PAN of specified person

Nature of property purchas ed

Details of Shares or Security

Details of other property being movable

Name of the compan y/ concern of which the shares are purchase d

Number of shares purchase d during the previous year

Price of each share/se curity

Total consider ation paid share or security

Adequat e consider ation for shares or security

Nature of property

Number of property purchase d

Price of property

Total consider ation paid for property during the previous year

Adequ ate Consid eration

< Share/ Security/ Other Property

>

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

Schedule SP- e 2 : Details in case of other property being immovable:

S. No.

Name specified person

of

PAN

specified person

of

Type of asset

Address property

of

Area (in Sq ft)

Stamp value

duty

Details of Consideration

Amount of considertaion paid for asset

Adequate consideratio n for asset

< Land/ Residential/ Commercial Property etc)>

Schedule SP- f 1: Details of any share, security sold by or on behalf of the trust or institution to a specified person during the previous year?

S.

No

.

Name of specifi ed person

PAN of specifi ed person

Nature of propert y sold

Details of Shares or Security

Details of Other Property being Movable

Name of  the Compa ny or Concer n of

which the shares are sold

Numbe r of

shares sold during the previo us year

Price of each share or securit y

Total considerati on share

/security

Adequate considerati on for

share or security

Nature of movab le propert y

Number of movabl e properti es sold

Price of movab le propert y

Total considerati on for

property during the previous year

Adequate considerati on

<Share/ Security/

Other Property

>

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

Schedule SP- f 2: Details in case of other property being immovable:

S.

No.

Name of specified person

PAN of specified person

Type of asset

Address of property

Area (in Sq ft)

Stamp Duty Value

Details of Consideration

Amount of consideration for asset

Adequate consideration for asset

< Land/

Residential/ Commercial Property etc>

Schedule SP-g: Details of any income or property which is is diverted during the previous year in favour of any specified person

S

No

Name of specified person in whose favor income or property diverted

PAN of specified person

Details of Income or property that is diverted

Nature of Income or property that is diverted

Value of income or property that is diverted

(In Rs.)

(1)

(2)

(3)

(4)

(5)

Schedule h : Details of any funds that are, or continue to remain, invested in any concern during the previous year in which the specified person has a substantial interest

S No

Details of the Concern in which funds are, or continue to remain, invested

Details of substantial interest

Nature of concern in which funds are continue to remain invested

Name   of concern

Address of concern

Amount that is or continues to remain invested in concern during the year

(In Rs.)

duration of investment during the previous year

Nature of investment

Income from investment during the year

Name   of specified person having substantial interest in concern

PAN of specified person

Nature of substantial interest

Nature of concern in which funds

are continue to remain invested

From dd/mm/yyyy

To dd/mm/yyyy

<

Company/ Others>

Schedule other law violation

S.no

Name of law under which non-compliance has occurred

Nature of non- compliance

Date of order, direction or decree, holding that such non- compliance has occurred

Whether the order, direction or decree, has been disputed before any court or appellate forum

If yes, whether dispute has attained finality

Has the dispute been finalised in favour of the auditee

(1)

(2)

(3)

(4)

(5)

(6)

(7)

Schedule TDS disallowable: Details of amounts inadmissible amount disallowable under thirteenth proviso to clause (23C) of section 10 or sub- section (1) of section 11 read with sub-clause (ia) of clause (a) of section 40:

(a) Details of payment on which tax is not deducted

Date of payment

Amount of

Nature of payment

Name of

PAN or

Address of Payee

dd/mm/yyyy

payment

Payee

Aadhar of

(in Rs.)

payee, if

available

(1)

(2)

(3)

(4)

(5)

(6)

(b) Details of payment on which tax has been deducted but has not been paid on or before the due date specified in sub- section (1) of section 139

Date of Payment

Amount of

Nature of

Name of

PAN or

Address of

Amount

Amount out of (7)

Dd/mm/yyyy

payment

payment

Payee

Aadhar of

Payee

of tax

deposited, if any

(in Rs.)

payee, if

deducted

available

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

Schedule 40A(3): Details of amount is disallowable under thirteenth proviso to section 10(23C ) or Explanation 3 to sub-section (1) of section 11 read with sub-section (3) of section 40A

S.

No.

Date of payment

Amount of payment (In Rs.)

Nature of payment (In Rs.)

Details of payee

Name

PAN or aadhar, if available

Address

Schedule 40A(3A): Details of Amount disallowable under thirteenth proviso to section 10(23C )/sub-section (1) of section 11 read with sub- section (3A) of section 40A

S.

No.

Date of payment

Amount

Nature

Details of payee

Name

PAN or Aadhar, if available

Address

Schedule 269SS: Details of loan or deposit or any specified sum taken, exceeding the limit specified in section 269SS during the previous year

S.No

Name of

PAN or

Address

Loan or

Amount of

Whether the

Maximum

By cheque or

Whether

the lender

aadhar, if

deposit or

loan or

loan or

amount

Bank draft or use

account

or

available

any

deposit

deposit was

outstanding in

of electronic

payee if by

depositor

specified

taken or

squared up

the account at

clearing system

cheque or

sum

accepted

during the

any time during

through a bank

Bank draft?

previous

the previous year

account or any

year?

other mode

Yes/No

Schedule 269ST: Details of amount received exceeding the limit specified in section 269ST, from a person in a day; or in respect of a single transaction; or in respect of transactions relating to one event or occasion from a person during the previous year?

Details of Payee

Details of Transaction

Mode of Repayment

S.No

Name

PAN, if available

Address

Loan or deposit or any specified advance

Amount

Please specify mode of receipt

[by Cheque or bank draft or use of electronic clearing system through a bank account or any other]

Whether Account payee, if by cheque or bank draft?

Whether squared up?

Maximum amount outstanding

By cheque or Bank draft or use of electronic clearing system through a bank account or nay other mode

Whether Account Payee if by cheque or bank draft?

Schedule 269T: Details of repayment of any amount being loan or deposit or any specified advance exceeding the limit specified in section 269T, during the previous year?

Details of Payee

Details of Transaction

Mode of Repayment

S.No

Name

PAN, if available

Address

Loan or deposit or any specified advance

Amount

Please specify mode of receipt

[by cheque or Bank draft or use of electronic clearing system through a bank account or any other]

Whether Account payee, if by cheque or bank draft?

Whether Squared up?

Maximum amount outstanding

By cheque or Bank draft or use of

electronic clearing system through a bank account or nay other mode

Whether account payee if by cheque or bank draft?

Schedule TDS/TCS

Tax Deduction and Collection Account Number (TAN)

Section

Nature of payment

Total amount of payment or receipt of the nature specified in column (3)

Total amount on which tax was required to be deducted or collected out of (4)

Total amount on which tax was deducted or collected at specified rate out of

Amount of tax deducted or collected out of (6)

Total amount on which tax was deducted or collected at less than specified rate out of (7)

Amount of tax deducted or collected on (8)

Amount of tax deducted or collected but not deposited to the credit of the Central Government out of (6)

and (8)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

Schedule Statement of TDS/TCS

Tax deduction and collection account number (TAN)

Type of Form

Due date for furnishing

Date of furnishing, if furnished

Whether the statement of tax deducted or collected contains information about all transactions which are required to be reported

(1)

(2)

(3)

(4)

(5)

Schedule Interest on TDS/TCS

Tax deduction and collection account number (TAN)

Amount of interest under section 201(1A) or 206C(7) is payable

Amount paid out of column (2)

Date of payment Dd/mm/yyyy

(1)

(2)

(3)

(4)

S. No

Section

Code

(1)

Clause (a) of sub-section (1) of section 12AB of the Act

1

(2)

Clause (b) of sub-section (1) of section 12AB of the Act

2

(3)

Clause (c) of sub-section (1) of section 12AB of the Act

3

(4)

Clause (i) of second proviso to clause (23C) of section 10 of the Act

4

(5)

Clause (ii) of second proviso to clause (23C) of section 10 of the Act

5

(6)

Clause (iii) of second proviso to clause (23C) of section 10 of the Act

6

(7)

Clause (ii) of sub-section (1) of Section 35 of the Act

7

(8)

Clause (iia) of sub-section (1) of Section 35 of the Act

8

(9)

Clause (iii) of sub-section (1) of Section 35 of the Act

9

(10)

Clause (i) of second proviso to sub-section (5) of section 80G of the Act

10

(11)

Clause (ii) of second proviso to sub-section (5) of section 80G of the Act

11

(12)

Clause (iii) of second proviso to sub-section (5) of section 80G of the Act

12

(13)

any other, please specify

13

S. No

Section

Code

(1)

Author

1

(2)

Founder

2

(3)

Settlor

3

(4)

Trustee

4

(5)

Members of society

5

(6)

Members of the Governing Council

6

(7)

Director

7

(8)

Shareholders holding of 5% or more of shareholding

8

(9)

Office Bearer s

9

(10)

Others

10

Type of identification

Code

PAN

1

Aadhar number

2

Type of identification

Code

Taxpayer identification Number of the country

where the person resides;

3

Passport number;

4

Elector's photo identity number

5

Driving License number

6

Ration card number

7

S.no

Object

Code

(1)

Religious

1

(2)

Relief of poor

2

(3)

Education

3

(4)

Medical relief

4

(5)

Yoga

5

(6)

Preservation of environment (including watersheds, forests and wildlife)

6

(7)

Preservation of monuments or places or objects of artistic or historic interest

7

(8)

Advancement of any other objects of general public utility

8

S.No

Nature of books of account or other document as provided in rule 17AA

Code

(1)

Cash book

1

(2)

Ledger

2

(3)

Journal

3

(4)

Copies of bills, whether machine numbered or otherwise serially numbered, wherever such bills are issued by the assessee,

and copies or counterfoils of machine numbered or otherwise serially numbered receipts issued by the assessee

4

(5)

Original bills wherever issued to the person and receipts in respect of payments made by the person

5

(6)

Any other book that may be required to be maintained in order to give a true and fair view of the state of the affairs of the

person and explain the transactions effected

6

(7)

Books of account, as referred in Serial No. 1 to 6, for business undertaking referred in sub-section (4) of section 11 of the Act

7

(8)

Books of account, as referred in Serial No 1 to 6,, for business carried on by the assessee other than the business undertaking

referred to in sub-section (4) of section 11 of the Act

8

(9)

Record of all the projects and institutions run by the person containing details of their name, address and objectives

9

(10)

Record of income of the person during the previous year as per rule 17AA(1)(d)(ii)

10

(11)

Record of application of income etc. out of income during the previous year as per rule 17AA(1)(d)(iii)

11

(12)

Record of application of  income out of the income of any previous year preceding the current previous year as per rule

17AA(1)(d)(iv)

12

(13)

Record of voluntary contribution made with a specific direction that they shall form part of the corpus,  as per rule

17AA(1)(d)(v) ;

13

(14)

Record of contribution received for the purpose of renovation or repair of temple, mosque, gurdwara, church or other place

notified under clause (b) of sub-section (2) of section 80G which is being treated as corpus, as per rule 17AA(1)(d)(vi)

14

(15)

Record of loan and borrowings as per rule 17AA(1)(d)(vii)

15

(16)

Record of properties as per rule 17AA(1)(d)(viii);

16

(17)

Record of specified persons as per rule 17AA(1)(d)(ix);

17

(18)

Any other documents containing any other relevant information as per rule 17AA(1)(d)(x).

18

S.

No

Nature of person

Code

(1)

the author of the trust or the founder of the institution;

1

(2)

any person who has made a substantial contribution to the trust or institution, that is to say, any person whose total

contribution up to the end of the relevant previous year exceeds fifty thousand rupees;

2

(3)

where such author, founder or person is a Hindu undivided family, a member of the family;

3

(4)

any trustee of the trust or manager (by whatever name called) of the institution;

4

(5)

any relative of any such author, founder, person, member, trustee or manager as aforesaid;

5

(6)

any concern in which any of the persons referred above have a substantial interest.

6

ANNEXURE

Statement of particulars

Basic Details

1.

PAN of the auditee

A

B

C

D

E

1

2

3

4

F

2.

Name of the auditee

3.

Assessment Year

4.

Previous Year

d

d

m

m

y

y

y

y

To

d

d

m

m

y

y

y

y

5.

Registered address of the auditee

6.

Other addresses, if applicable

< refer note*>

Legal

7.

Type of the auditee

Trust Society Company Others

8.

Whether the auditee is established under an instrument?

Yes/No

Management

9.

(a) Details of all the Author (s)/ Founder (s)/ Settlor (s)/Trustee (s)/ Members of society/Members of the Governing Council/ Director (s)/ shareholders holding 5% or more of shareholding / Office Bearer (s) of the auditee at any time during the previous year

Name of person

Relation

< refer note#>

Percentage of shareholding in case of

shareholder

Unique Identification Number

Id Code

<refer note##>

Addre ss

Whether there is any change in relation during previous year of audit

Yes/No

If yes, specify the change

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(b) In case if any of the persons [as mentioned in row 9(a)] is not an individual, then provide the following details of the natural persons who are beneficial owners (5% or more) of such person during the previous year

Sl. No.

Name

Unique Identification Number

ID code

< refer note##>

Add ress

Non- individual person [as mentioned in serial number no

9(a)] in which beneficial ownership held

Percentage of beneficial ownership

Whether there is any change during previous year of audit Yes/No

If yes, specify the change

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Commencement of activities

10.

(i)

Where the auditee has been granted provisional registration or provisional approval, whether activities have commenced during the previous year

Yes/No

(ii)

If yes in 10 (i) , date of commencement of activities

d

d

m

m

y

y

y

y

(iii)

If the answer to 10(i) is yes, whether application for registration under section sub-clause (iv) of clause (ac) of sub-section (1) of section 12A or approval under clause (iii) of the first proviso to clause (23C) of section 10 has been filed?

Yes/No

(iv)

If yes in 10(iii) above, the date of application for registration or approval

d

d

m

m

y

y

y

y

Details of Place where books

of accounts and other documents have been

11.

(i)

Whether the books of account and other documents have been kept and maintained in the form and manner and at such place as prescribed under rule 17AA by the auditee?

Yes/No

(ii)

If Yes in (i) above, whether books of account maintained are maintained at registered office?

Yes/No

(iii)

If No in (ii) above, provide the following details regarding any place other than the registered place where the books of account are maintained

(a)

Address of such place where the books are maintained

(b)

Date of decision by management to keep account at such place

dd/mm/yyyy

(c)

Date of intimation to Assessing Officer that accounts are kept at such place under proviso to sub-rule (3) of rule 17AA

dd/mm/yyyy

Voluntary contributions

12.

Whether auditee has filed Form No. 10BD for the previous year < If No then skip to serial number 14 >

Yes/No

13.

Sum total of donations reported in Form No. 10BD furnished by the auditee for the previous year

(Amount in Rs.)

14.