Under Section 18, FCRA 2010 read with Rule 17 FCRA 2011, submission of AR is mandatory.

However,after cancellation/expiry of registration

certificate, it is optional and does not entitle for any claim whatsoever.

Form FC-4
[See rule 17]
Darpan ID*** : TN/2018/0211658

The Secretary to the Government of India,

Ministry of Home Affairs,
Foreigners Division (FCRA Wing)
Major Dhyan Chand National Stadium, India Gate
New Delhi - 110002

Subject: Account of Foreign Contribution (FC) for the year ending on the 31st March, 2022

1. (a) Name and address of person/association: Uranthai Annai Theresa Samugapaniiyakkam(social Service Organisation)
267-a,thiyagaraja Nagar, Woraiyur, Tiruchirapalli-620003

irs
(b) FCRA registration/prior permission number and date: 076040270 12/03/2001

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2. Details of receipt of foreign contribution :

A
(i) Foreign Contribution received in cash/kind(value):
e
(a) Brought forward foreign contribution at the beginning of the year(Rs.) 459.49
om
(b) Income During the year*:
(i) Interest: 0.00
H

(ii) Other receipts from projects/activities:

Sl. No Name and location of project/activity Year of commencement of the project / Income during the year (Rs.)
of

activity
ry

(c) Foreign contribution received from foreign source during the financial year (Rs.):
t

(i) Directly from a foreign source: 0.00

is

(ii) as transfer from a local source: 0.00

in

(d) Total Foreign Contribution (a+b+c) (Rs.): 459.49

M

*i.e. interest accrued on foreign contribution, or any other income derived from foreign contribution,
e.g. sale proceeds from assets created from foreign contribution, or interest thereon during the year, income from projects/activities.

(ii) (a). Donor wise detail of foreign contribution received:

Sl.No Name of donors Institutional/Individ Detail of the donor: Purposes for which Specific activity / Amount Rs
ual official address; received project
email address; (social,cultural,educ
website address: ational,economic,rel
igious)
(1) (2) (3) (4) (5) (6) (7)

(b) Cumulative purpose-wise (social, cultural, educational, economic, religious) amount of all foreign contribution donations
received:

3. Details of Utilisation of foreign contribution:

FCRA Annual Returns for the financial year 2021-2022 has been Submitted on 23/11/2022 Page 1 of 4
Under Section 18, FCRA 2010 read with Rule 17 FCRA 2011, submission of AR is mandatory. However,after cancellation/expiry of registration
certificate, it is optional and does not entitle for any claim whatsoever.

(a) Details of activities/projects for which foreign contribution has been received and utilised (in rupees)

Sl. No. Name of Address/L Previous Balance Receipt during the year Utilised Balance
project/acti ocation
vity
In cash In Kind In cash In Kind In cash In Kind In cash In Kind
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
1 SOCIAL TRICHIR 459.49 0.00 0.00 0.00 459.49 0.00 0.00 0.00
APALLI ,
TAMILN
ADU -
620003
Tiruchirap
ali Tamil
Nadu6200
03
Total 459.49 0.00 0.00 0.00 459.49 0.00 0.00 0.00

(b) Details of utilisation of foreign contribution:

irs
(i) Utilisation** for projects as per aims and objectives of the person/association(Rs.): 0.00

ffa
(ii) Total administrative expenses as provided in rule 5 of the Foreign Contribution (Regulation) Rules, 2011 (Rs.)
:459.49

A
(iii) Total utilisation of foreign contribution (Rs.) (i+ii):459.49
e
** It is affirmed that the utilisation of foreign contribution is not in contravention of the provisions contained in the Foreign
om
Contribution(Regulation) Act, 2010 (42 of 2010) and more particularly in section 9 and section 12 of the Act which, inter-alia, states that
the acceptance of foreign contribution is not likely to affect prejudicially:
H

(A) the soverignty and integrity of india; or.

(B) the security, strategic, scientific or economic interest of the state; or
of

(C) the public interest; or

(D) freedom or fairness of election to any Legistature; or
(E) friendly relations with any foreign state; or
ry

(F) harmony between religious, racial, social, lingusitic or relgional groups, castes or communities.
t
is

(c) Total purchase of fresh assets (Rs.)

in

Sl. No. Name of project/activity Details of fresh assets Objective of Cost of fresh assets
acquiring fresh (In Rs.)
M

assets

(d) Foreign contribution transferred to other person/associations before 29.09.2020 (The Foreign Contribution (Regulation)
Amendment Act, 2020):

Sl. No. Name of the person/association Date Purpose Amount

(1) (2) (3) (4) (5)

(e) Total utilisation in the year (Rs.)(b+c+d) 459.49

4. Details of unutilised foreign contribution:

(i) Total foreign contribution invested in term Deposits (Rs.):

Sr. No. Details Total( in Rs.)

(i) Opening
FCRA Annual ReturnsBalance of FD year 2021-2022 has been Submitted on
for the financial 0.00
23/11/2022 Page 2 of 4
Under Section 18, FCRA 2010 read with Rule 17 FCRA 2011, submission of AR is mandatory. However,after cancellation/expiry of registration
certificate, it is optional and does not entitle for any claim whatsoever.

(ii) FD made during the year 0.00

(iii) Less: realisation of previous FD 0.00
Closing balance of FD 0.00

(ii) Balance of unutilised foreign contribution, in cash/bank, at the end of the year(Rs):

(a) Cash in hand: 0.00

(b) in FC designated bank account: 0.00
(c) in utilisation bank account(s): 0.00
5. Details of foreigners as Key functionary/working/associated: 0
6. Details of land and building remained unutilised for more than two year:

Sl. No. Location of land and building Year of acquisition Purpose of acquisition Reason of unutilisation
(1) (2) (3) (4) (5)

irs
(7) (a) Details of FCRA Account for receipt of foreign contribution (As on 31st March of the year ending):

Name of the Branch Address( Phone No. e-mail IFSC Code Account number
Date of Opening

ffa
Bank With pincode) Account
(1) (2) (3). (4) (5) (6) (7)
STATE BANK 11Sansad Marg, 011-23374390 [email protected] SBIN0000691 XXXXXXX0211 19/07/2021

A
OF INDIA New Delhi 110 o.in
001
e
(b) Details of another FCRA Account(if any,) for keeping or utilising (As on 31st March of the year ending)
om

Name of the Bank Branch Phone No. e-mail IFSC Code Account Number Date of Opening
Address(with Pin Account
code)
H

(1) (2) (3) (4) (5) (6) (7)

KARUR VYSYA SRINIVASA 0431-2772444 srinivasanagar@kv KVBL0001635 1635135000004935 10/01/2018
of

BANK NAGAR BRANCH bmail.com

,NO. 66 1D,
KUMARAN
NAGAR,VAYALU
R MAIN
ry

ROAD,TRICHY -
620017. TAMIL
NADU TAMIL
t

NADU
is
in
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(c) Details of all utilisation bank accounts (if any) for utilisation of Foregin Contribution (As on 31st March of the year ending):

Name of the Branch Address( Phone No. E-mail IFSC Code Account No Date of Opening
Bank With pincode) Account
(1) (2) (3). (4) (5) (6) (7)

8 *Whether during the period under report:

(i) any foreign contribution was transferred to any FCRA registered association? No
(ii) any foreign contribution was transferred to any Non FCRA registered No
association?
(iii) any functionary of the Association has been prosecuted or convicted under the No
law of the land?
(iv) any asset created out of foreign contribution is registered in names other than the No
name of Association?
(v) any domestic contribution has been created in any FCRA Account? No
(vi) the Association has received any foreign Contribution in an account other than No
FCRA Annual Returns for the
thefinancial yearFCRA
designated 2021-2022 has
receipt been Submitted on 23/11/2022
Account? Page 3 of 4
Under Section 18, FCRA 2010 read with Rule 17 FCRA 2011, submission of AR is mandatory. However,after cancellation/expiry of registration
certificate, it is optional and does not entitle for any claim whatsoever.

(vii) the Association has utilised foreign contribution for any purpose other than the No
defined purposes in the FCRA certificate of registration or prior permission?
(viii) the Association has invested any foreign contribution in any speculative activity No
as defined in rule 4 of the Foreign Contribution (Regulation) Rules, 2011?
(ix) the Association or any of its functionary/office bearer has violated any of the No
conditions as enumerated under sub-section (4) of section 12 of the Act?
(x) the Association has made expenditure on Administrative expenses exceeding 20 No
per cent of the foreign contribution received?
(xi) any fixed asset acquired out of foreign contribution has been sold out? No
(xii) sale proceed of above fixed asset has been diverted / has not been deposited in No
FCRA Account?
(xiii) any FD proceeds has been credited in any account other than FCRA Account? No
(xiv) any organization/entity not belonging to the Association is being No
managed/financially supported by the Association?
(xv) the Association has utilised any foreign contribution outside India? No

*Note: Wherever the answer of above question is in 'yes', brief details must be provided.

irs
Declaration

ffa
I/We FERNANDEZ THOMAS hereby declare that the above particulars furnished by me are true and correct
I also affirm that the receipt of foreign contribution and its utilisation have not been violative of any of the provisions of the Foreign

A
Contribution (Regulation) Act, 2010 (42 of 2010), and the rules, notifications or orders issued thereunder from time to time and the
foreign contribution was utilised for the purpose(s) for which the person/association was granted registration/prior permission by the
e
Central Government.
om

FERNANDEZ THOMAS
[Name of the Chief Functionary
(Chief Functionary)
H
of

(Seal of the Association)

t ry
is
in
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FCRA Annual Returns for the financial year 2021-2022 has been Submitted on 23/11/2022 Page 4 of 4