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Form F10A - Filed Form
Form F10A - Filed Form
Jurisdictional PCIT/CIT(E) :
FORM NO. 10A
[See rule 17A]
clause (aa) or clause (ab) of sub-section (1) of section 12A of the Income-tax Act, 1961
1. PAN AACTC0249D
Address
Name of premises/Building/Village
NATHU COLONY
Road/Street/Post Office
State DELHI
Country INDIA
TIBLE
2. Details of Author(s)/Founder(s)
No.(if Flat/ Name of Road/ Area/ Town/ City/ State Country PIN
No Village
I ESH AMBI
BHARW
ARI
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PAN : AACTC0249D Acknowledgement Number : 161355500201221
Jurisdictional PCIT/CIT(E) :
Sl.No PAN Name Designation Aadhaar Address
No Village Code
TRUSTEE 0 KASIYA
1 ANHPT5129K ANAND 90225237 KASIYA KASIYA Kaush NEW DELHI INDIA 212201
EAST
2236 EAST EAST
KAUSHAM
KUMAR KAUSHA KAUSHA
BI
MBI
BHARWAR
MBI ambi
TRIPAT BHARW BHARW
I
ARI ARI
UP
HI UP
4. In case of Charitable and Religious cum Charitable trusts, please specify the objects of the Trust/Institution (Selection of at least one object
is mandatory.):
* Religious
* Education
5. Is this a case of registration under clause (ab) of sub-section (1) of section 12A : NO
6. Whether the trust deed contains clause that the trust is irrevocable? NO
7. Whether any application for registration made by the applicant in the past has been NO
rejected?
Declaration
I, ANAND KUMAR TRIPATHI ,having PAN AANHPT5129K , son of SANT SARAN TRIPATHI hereby declare that the details given in the application
are true and correct to the best of my knowledge and belief. I undertake to communicate forthwith any alteration in the terms of the trust/society/non-profit
company, or in the rules governing the Institution, made at any time hereafter.I further declare that I am making this application in my capacity as TRUSTEE
Flat/ Name of Road/ Street/ Area/ Town/ City/ State Country PIN Code/
Block Building /
No Village
0
UP 20/12/2021 DIRECTOR SA KASIYA KASIYA KASIYA Kaushamb DELHI INDIA 212201
EAST EAST EAST
KAUSHA KAUSHA KAUSHA
MBI MBI MBI
BHARWA BHARWA BHARW
RI RI ARI
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