PAN : AAATT5321P Acknowledgement Number : 365222380310521

FORM NO. 10A

(See rule 17A/11AA/2C/5CA)

Application for registration or provisional registration or intimation or approval or provisional approval

Incorporation/constitution details

1. PAN AAATT5321P

Name THE MARY S ALIAN SOCI ETY

Address

Flat/Door/Building ST MARYS CONVENT

Name of premises/Building/Village

Road/Street/Post Office

Area/Locality CHAMRAJPET

Town/City/District BANGALORE

State KARNATAKA

Country INDIA

Pin Code/Zip Code 560018

2 Section Code 01-Sub clause (i) of clause (ac) of sub -section

(1) of section 12A

3 Nature of Activities Charitable

4 Type of Constitution Society

Please specify

4a. Whether the applicant is established under an instrument? Yes

4b. Date of Incorporation/Creation/Registration 19/07/1965

4c. Registration or Incorporation Number 63/65-66

4d. Authority Granting Registration/Incorporation REGISTRAR OF SOCIETI ES IN MYSO RE

5 Objects of the Applicant

* Relief of the Poor

* Education

* Medical Relief

6 Whether the trust deed contains clause that the trust is irrevocable? Yes

Other Registration Details

7. Whether the applicant is registered on DARPAN portal or under FCRA Act or any provision of Yes

Income-tax Act?

Sl.No Relevant Law/Portal Registration No. Date of Registration Authority Granting Date from which

Registration registration is effective

1 Registration u/ 718/10A / 05/02/1981 DIT EXEMP TIONS 05/02/1981

s 12A/AA/AB of VOL.AI I/M-314 BAN GALORE

Income-tax Act, 1961

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PAN : AAATT5321P Acknowledgement Number : 365222380310521

8a. Whether any application for registration made by the applicant in the past has been No

rejected?

8b. Whether claiming exemption under clause 21 of section 10 of the Income-tax Act ? No

Details of Key Persons

9a. 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) as on the date of application:

Sl.No Name Relation Perce ID Name Unique Address Mobile no. Email

ntage code of the Ident Flat/ Name Road/ Area/ Town/ State Country PIN Add ress

of Unique ification Door/ of Street/ Locality City/ Code/

share Ident Number Block Prem Post District ZIP

holding ifier No ises / Office Code

in Buil

case of ding /

share Village

holder

(%)

1 JECIN Principal 01- AYPPJ NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 88617 jessy

THA J Officer Permanent 7309C 29 7/1 MA RAJPE LORE LORE 21080 smmi@

OSEPH Account RYS T gmail .com

MUTT Number C

ANNA ONVEN

2 MARY Member 01- BSRPA NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 94814 josit

A O A of the Permanent 7663P 29 7/1 MA RAJPE LORE LORE 77013 aja@g

LIAS Governing Account RYS T mail.

JOSIT Council Number C com

A ONVEN

3 CHINN Member 01- ABEPC NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 76191 chimm

AMMA of the Permanent 6780C 29 7/1 MA RAJPE LORE LORE 21569 amma@

Governing Account RYS T gmail .com

Council Number C

ONVEN

4 FLORAMember 01- AAXPF NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 97430 sr.jo

of the Permanent 9298E 29 7/1 MA RAJPE LORE LORE 16861 ycefl

Governing Account RYS T ora@g

Council Number C
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PAN : AAATT5321P Acknowledgement Number : 365222380310521

ONVEN mail.

T com

5 LOUIS Member 01- AIMPL NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 98456 suman .loui

A PHI of the Permanent 3920E 29 7/1 MA RAJPE LORE LORE 85614 sa@gm

LOMENGoverning Account RYS T ail.c om

A MIR Council Number C

ANDA ONVEN

6 LILLY Member 01- AHGPL NO ST CHAMRBANGABANGAKARNATAKA INDIA 560018 81052 regin

RAJI of the Permanent 0564K 29 7/1 MA AJPET LORE LORE 02063 asmmi

NA C Governing Account RYS @gmai

Council Number C l.com

ONVEN

7 JAYA Member 01- AOTPJ NO ST CHAMABANGABANGAKARNATAKA INDIA 560018 99729 smmik

FELIX of the Permanent 6671D 29 7/1 MA RAJPE LORE LORE 61880 uniga

AMMA Governing Account RYS T l@gma

Council Number C il.co m

ONVEN

9b. In case if any of persons (as mentioned in row 9a) is not an individual then provide the following details of the natural persons who are beneficial owners

(5% or more) of such person as on the date of application:

Sl.No Name Address ID code Name Unique Perce

Flat/ Name of Road/ Area/ Town/ State Country PIN of the Ident ntage

Door/ Premises / Street/ Locality City/ Code/ Unique ification of

Block No Building / Post District ZIP Code Ident ifier Number share

Village Office holding

in

case of

share

holder

(%)

Details of Assets and Liabilities

10. Has return of income been filed for the last assessment year for which the due date has Yes

expired?

Provide following details as on the date of application:

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PAN : AAATT5321P Acknowledgement Number : 365222380310521

11. Corpus

12. Funds/reserves and surplus other than corpus

13. Long term liabilities

14. Other liabilities

Total Liabilities

15. Land and Building

16. Other fixed assets

17. Investments/deposits made into one or more of the forms or modes specified in sub-section

(5) of section 11

18. Investments/deposits other than mentioned in row number 17 above

19. Other Assets

Total Assets

20. Income received in three previous years immediately preceding the previous year in which application is made:

Sl.No Financial Year Grants received Grants received Other Specific Grants Other Income Total

from Central or from Companies

State Government under Corporate

Social Responsibility

1 0

Religious activities details

21a. Whether the fund or the institution has incurred any expenditure of religious nature?

21b. If yes, please provide the following details for three previous years immediately preceding the previous year in which application is made:

Sl.No Financial Year Total Income Expenditure of Percentage to

Religious Nature Total Income(%)

Verification

I JECINTHA JOSEPHMUTTANNA son/ daughter of JOSEPHMUTTANNA hereby declare that the details given in the form are true and correct to the

best of my knowledge and belief. I undertake to communicate forthwith any alteration in the terms of the SOCIETY , or in the rules governing the Institution,

made at any time hereafter. I further declare that I am filing this form in my capacity as PRESIDENT (designation) having Permanent Account Number (PAN)

AYPPJ7309C and that I am competent to file this form and verify it.

Signature

Name JECINTHA J OSEPHMUTTA NNA

Place BANGALORE

Date 31/05/2021

Attachments Uploaded

This form has been electronically verified by JECINTHA JOSEPHMUTTANNA having PAN AYPPJ7309C on 31/05/2021 from IP address 49.207.210.99 and has
been electronically verified using Electronic Verification Code CYL8NRMYHI generated through Aadhaar OTP mode.

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