Printed from www.taxmann.com FORM NO. 10AA [See rule 18AAAA] Details of accounts under section 80G(5C)(v) of the Income-tax Act, 1961, for providing relief to the victims of earthquake in Gujarat I. GENERAL DETAILS (a) Name and address of the trust/fund/institution : (b) Registration No./Date : (c) Permanent Account No. : (d) Authority granting approval under section 80G : (e) Number and date of approval : II. DETAILS OF PROJECT FOR GUJARAT EARTHQUAKE RELIEF (a) Nature of project : (b) Date of commencement : (c) Date of completion : (d) Amount raised by donation : (e) Branch-wise Bank Account numbers in which donations received : III. DETAILS OF OTHER PROJECTS BEING RUN BY THE TRUST/FUND/INSTITUTION DURING 26-1- 2001 TO 31-3-2003 Name of the project Nature Date of commencement Date of completion (a) IV. DETAILS OF RECEIPTS DURING 26-1-2001 TO 30-9-2001 (in Rs.) (i) Total receipts : Out of which (ii) Amount received through donations : Out of which (iii) Amount received through donations for Gujarat earthquake relief : Out of which (iv) Amount spent on or before 31-3-2003 for the purpose of Gujarat earthquake relief: (v) Amount unutilised, which is transferred to Prime Minister's National Relief Fund on or before 31-3-2003: (vi) Amounts not spent for Gujarat earthquake relief : Printed from www.taxmann.com (vii) Amount unutilised, which is transferred to Prime Minister's National Relief Fund after 31-3-2003: (viii) Amount received through donations for Gujarat earthquake relief after 30-9-2001: (ix) Amount of donations received for Gujarat earthquake relief, which is chargeable to tax under section 12 or section 10(23C) : V. DETAILS OF EXPENDITURE DURING 26-1-2001 TO 30-9-2001 (in Rs.) (Please enclose copy of approval) Item Total amount paid Date of last payment (i) Provision of medical relief: (ii) Construction of houses and buildings: (iii) Towards education & building of schools, etc.: (iv) Infrastructure creation: (v) Any other purpose (please specify): *I/We have examined the books of account including the balance sheet and the profit and loss account of the trust/fund/institution______________________(Permanent Account No._________________) relating to period for which donations were received and utilised by the said trust/fund/institution for the purpose of Gujarat earthquake relief work. *I/We have obtained all the information and explanations which to the best of *my/our knowledge and belief were necessary for the purposes of the audit. In *my/our opinion, separate books of account have been kept by the assessee in respect of donations received and utilised for the purpose of Gujarat earthquake relief work. In *my/our opinion and to the best of *my/our information and according to explanations given to*me/our opinion and to the best of *my/our information and according to explanations given to *me/us, the said accounts give a true and fair view. Place Date Signed Accountant
