Name of Organization

Email ID

Mobile No.

Landline No.

Address of Organization

Act under which the Organization is Registered.

Registration No. Under the Charitable Trust Act.

Registration No. under the Societies Registration Act 1960.

Registration No. Under S.12AA of the Income Tax Act 1961

Registration No. Under the Companies Act 1956 / 2013 i.e. Company Identification Number (CIN).

Exemption Certificate No. under the Income Tax Act 1961 with Validity Period and the Section under which it is granted.

Date of Registration or Incorporation

Permanent Account No. of the Organization.

TDS / TCS NO. of the Organization.

Main Objects of the Organization

Predominant Activities of the Organization i.e. Whether Charitable, Religious, Educational, Medical Relief, Relief of Poverty, etc.

Number of Directors / Trustees / Office Bearers / Managing Committee Members

Name, Designation, Contact No., Email id, WhatsApp No. of the First Key Person i.e. Executive / Managing Trustee or Executive / Managing Director.

Address of the First Key Person i.e. Executive / Managing Trustee or Executive / Managing Director.

Name, Designation, Contact No., Email id, WhatsApp No. of the Second Key Person i.e. Vice Chair Person / President

Address of the Second Key Person i.e. Vice Chair Person / President

Name, Designation, Contact No., Email id, WhatsApp No. of the Third Key Person i.e. the Secretary, whether Secretary General, Chief / Executive / Main Secretary, Additional / Deputy / Joint Secretary

Address of the Third Key Person i.e. the Secretary, whether Secretary General, Chief / Executive / Main Secretary, Additional / Deputy / Joint Secretary

Name, Designation, Contact No., Email id, WhatsApp No. of the Fourth Key Person i.e. the Treasurer and Joint Treasurer

Address of the Fourth Key Person i.e. the Treasurer and Joint Treasurer

Category / Type of the Membership applied for:

Category / Type of Membership Founder Member Donor Member Chief Patron Member Patron Member Annual (Ordinary) Member

Corporate Membership Fee (Amount in Rs.) 5,00,000 2,50,000 1,00,000 50,000 2,500

Chapter Membership Fee (Amount in Rs.) 2,50,000 1,25,000 50,000 25,000 1,250

Bank Account Details:

The Anxieties, Apprehensions, Biases, Botheration, Complaints, Concerns, Difficulties, Differences, Discrimination, Disputes, Doubts, Fears, Harassment, Injustice, Issues, Grievances, Ill-Treatment, Maltreatment, Nuisances, Objections, Oppression, Partialities, Persecution, Prejudices, Problems, Quarrels, Questions, Tax Terrors, Troubles, Unfairness, Worries, Wrongs, etc. you are facing and want us to Guide & Help you.

Any other Information your Organization would Like to Share

Whether Payment made by / through Account Payee Cheque / Demand Draft or via Electronic Transfer, viz. IMPS / NEFT / RTGS