Ashadip PSC

Please Choose any One *

Full Name of Recipient *

Date of Birth *

Name of Father/Spouse *

Full Address with Pin No *

PAN Number

Mobile No

E-Mail Id

Amount of Foreign Contribution Received

No of Bank Draft / Transfer / other communication Bank Details

Relative Details
(plz mention - Name,address,Email id, Passport No, Relation with receipt)

Recipient Signature

Name *
Address *
Email *
Phone No *

Organisation Name *
Organisation FCRA No *
FCRA Login Id *
FCRA Login Password *

Name of Articles
Date of Articles
Person Name
Purpose
Approximate Value
Mode of Utilization/ Disposal
Articles Person Signature

Nature of Security Received
Persons name from whom received
Address
Nominal Value
Market Value
Reserve Bank of India Permission Details
Mode of Utilization/ Disposal
Persons Signature

Miscellaneous License/Registration/Others

Form - Intimation of receipt of foreign contribution by way of gift / as Articles / Securities / by candidate for Election (FC -1)

Total Expenses : Rs 2360/-

:: Contact Person Details ::

APPLICANT DETAILS

ORGANIZATION DETAILS

ARTICLE DETAILS

SECURITIES DETAILS

CANDIDATE FOR ELECTION DETAILS

DOCUMENTS

SPONSORED INFORMATION AND FINAL SUBMISSION

Our Team

ANINDITA ROY

Mousumi Pal

Kiranbala Dey

DEBIKA SUBBA

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ASHADIP INDIA MANAGEMENT (OPC)
PRIVATE LIMITED

Name of Recipient
Name of Father/Spouse
Address
Mobile No
E-Mail Id
Date of Which Duly Nominated
Foreign Contribution Receive as
Mode of Utilization/ Disposal
Value
Signature

FCRA Regd. Certificate
Signature of Doner
Signature of Recepient

Sponsored Name *	Yes No
If Yes, Give the Sponsored Username