FORM FC-3C

(see sub-rule (2) of rule 12)

No:II/21022/70(0268)/2021-FCRA-II Date:29/09/2021
Darpan Id OR/2009/0003055

The Secretary to the Government of India,

Ministry of Home Affairs,Foreigners Division(FCRA Wing)
New Delhi-110002

Subject: Application for 'renewal' under section 16 of the Foreign Contribution (Regulation) Act, 2010 (42 of 2010) for the acceptance
of foreign contribution by a persona/association having definite cultural, economic, educational, religious or social programme:

I/We Minati Bindhani as an individual/Hindu Undivided Family / person/association / company registered under Companies Act
1956 / Companies Act, 2013 furnish the following details and apply for approval of the Central Government for Renewal of registration
certificate granted under sub-section (1) of section 11 of the Foreign Contribution (Regulation) Act, 2010 (42 of 2010).

1. Details of the applicant/person/association:

(a) Name in full:
i
Women And Child Welfare Society
r s
(b) Address:
fa
At: Gamhandia New Colony, Post:
f
Buxibazar Cuttack Cuttack Orissa

(c) Telephone number of person/association(with STD

753001
671-2414810
e A
Code):
(d) e-mail address of the person/association:
o m
wcwsodisha1994@gmail.com
(e) Official website, if any:
f Hhttp://www.wcwsodisha.simplesite.com
(f) Telephone and mobile (with STD code) of chief
functionary :
y o 671-2414810 | 9337252333

s t r
ni
2. Details of registration:-

Mi
(a) Name of the Act (i.e the Societies Registration Act, Societies Registration Act, 1860
1860, the Indian Trust Act, 1882, the Companies Act, 1956 /
Companies Act, 2013) under which the person/association
is registered:
(b) Number, date and place of Registration: 19815/43of1995-96 | 23 Sep 1995 |
(Self- certififed copy of registration certificate to be enclosed) Cuttack
(C) PAN (Permanent Account Number) of the XXXXXX620Q
person/association:
(d) Foreign Contribution (Regulation) Act registration 104860173 | 22/09/2009
number and date( in case of renewal)
- copy of certificate to be enclosed

(e) Amount of foreign contribution received during last three financial years:-

Sl. No. Financial Year Amount (Rs)

(1) (2) (3)
1. 2017-2018 0.00
2. 2018-2019 35745.00
3. 2019-2020 0.00

3. Nature of person/association: Educational,Social

Note: If a religious person/association, state whether
(a) Hindu (b) Sikh (c) Muslim (d) Christian (e)
Buddhist (f) Others.

File Number : 7002682021 Page 1 of 9

 4. Main Aim(s) and Object(s) of the Association Aim: TO IMPROVE THE QUALITY
(enclose self-certified copy of relevant pages of the OF LIFE OF DEPRIVED CLASSES
memorandum of person/association and/or the WITH EMPHASIS ON
articles of person/association, showing aims and WOMEN,CHILDREN AND YOUTHs.
OBJECTIVES: 1)TO IDENTIFY THE
objects of person/association): PROBLEMS OF THE WEAKER
SECTIONS OF THE
COMMUNITY.2)TO PRIORITIES THE
NEEDS OF THESE CLASSES.3)TO
RESOLVE THEM WITH AVAILABLE
RESOURCES.4)TO PURSUE AN
ORGANIZED, SYSTEMATIC AND
HOLISTIC APPROACH IN
RESOLVEING SUCH ISSUES.

5 (a) Details of all office bearers or directors or other key functionaries of the person/association:

Name Name of Nationality Aadhaar PAN Occupatio Designatio Relationshi Contact

Father/spo Number n n in the p with Details:
use Association other Office
Members Address;
of Residential
Executive Address; e-
Council/ mail
Governing Address,
body / Landline
Office no; mobile
bearers no.
(1) (2) (3) (4) (5) (6) (7) (8) (9)
Minati
Bindhani
Late
Banshidhar
India Adhaar
Verified
XXXXXX90 Social
9N Service
Chief

i r s
Functionary
Other Office
Address:-

fa
Bindhani 2021-07- Women
09T12:02:31.
782+05:30
A f Child
Welfare
SocietyGama

m e handia New
ColonyPost

H o BuxibazarDi
st City
Cuttack

o f 753001
Odisha

t r y Residential
Address:-

ni s Gamahandia
New

Mi
ColonyPost
BuxibazarCit
y Cuttack
753001 e-
mail
address:-
wcwsminati
@gmail.com
Landline:-
671-2414810
mobile no:-
9337252333

File Number : 7002682021 Page 2 of 9

 Name Name of Nationality Aadhaar PAN Occupatio Designatio Relationshi Contact
Father/spo Number n n in the p with Details:
use Association other Office
Members Address;
of Residential
Executive Address; e-
Council/ mail
Governing Address,
body / Landline
Office no; mobile
bearers no.
Kalpalata Baikuntha India Adhaar XXXXXX49 Social President Other Office
Prusty Nath Verified 8H Service Address:-
Senapati 2021-07- WOMEN
09T10:34:55. AND
377+05:30 CHILD
WELFARE
SOCIETY
AT-
GAMAHAN
DIA NEW
COLONYPO
ST
BUXIBAZA
RCUTTACK
753001
ODISHA
Residential
Address:-
At:Nuapatna,
Post:Buxibaz

i r s ar e-mail
address:-

fa
wcwsminati

A f @gmail.com
Landline:-
+91-2414810

m e mobile no:-
8249169902
MANASI
PRIYADAR
GIRIJA
SANKAR
India Adhaar
Verified
H
3L o
XXXXXX03 Social
Service
Vice
President
Other Office
Address:-
SHINI
MOHAPAT
SRICHAND
AN
o f
2021-04-
17T21:02:58.
WOMEN
AND
RA MOHAPAT
RA
t ry
504+05:30 CHILD
WELFARE

ni s SOCIETY
GAMAHAN

Mi
DIA NEW
COLONY
POST
BUXIBAZA
R
CUTTACK
753001
ODISHA
Residential
Address:-
WO-
BASANT
SUTAR AT-
SUJAUDIN
NAGARPAT
N POST-
MANIJANG
A DIST-
JAGATSIN
GHPUR-
754160 e-
mail
address:-
manasipriyad
arshinisutar
@gmail.com
Landline:-
671-2414810
mobile no:-
9348743877

File Number : 7002682021 Page 3 of 9

 Name Name of Nationality Aadhaar PAN Occupatio Designatio Relationshi Contact
Father/spo Number n n in the p with Details:
use Association other Office
Members Address;
of Residential
Executive Address; e-
Council/ mail
Governing Address,
body / Landline
Office no; mobile
bearers no.
RUPA PRABIN India Adhaar XXXXXX01 Social Others Other Office
BHAYANI KUMAR Verified 2H Service Address:-
BHAYANI 2021-04- GAMAHAN
18T16:22:20. DIA NEW
593+05:30 COLONY
POST
BUXIBAZA
R
CUTTACK
753001
ODISHA
Residential
Address:-
NEAR
SHIVA
TEMPLE
BADABAZ
AR
CHANDBA
LI DIST-

i r s BHADRAK
H-756133 e-

fa
mail

A f address:-
gensecywcw
s1@hotmail.

m e com
Landline:-

H o 671-2414810
mobile no:-

MINATI LATE India

o f
Adhaar XXXXXX25 Social Treasurer Other
7005661865
Office
MOHANTY NIMAIN
CHARAN
t ry
Verified
2021-04-
1M Service Address:-
WOMEN
DAS

ni s 18T16:38:54.
535+05:30
AND
CHILD

Mi
WELFARE
SOCIETY
GAMAHAN
DIA NEW
COLONY
POST
BUXIBAZA
R
CUTTACK
753001
Residential
Address:- B-
58 CH-58(1)
REBAGALI
REBA
COLONY
POST-
CHANDINI
CHOWK
CUTTACK-
753002
ODISHA e-
mail
address:-
mianitim196
8@gmail.co
m Landline:-
671-2414810
mobile no:-
7377011119

File Number : 7002682021 Page 4 of 9

 Name Name of Nationality Aadhaar PAN Occupatio Designatio Relationshi Contact
Father/spo Number n n in the p with Details:
use Association other Office
Members Address;
of Residential
Executive Address; e-
Council/ mail
Governing Address,
body / Landline
Office no; mobile
bearers no.
URBASEE SUMIT India Adhaar XXXXXX85 Social Others Other Office
PANI PRIYADAR Verified 2N Service Address:-
SHI 2021-04- WOMEN
18T16:51:39. AND
275+05:30 CHILD
WELFARE
SOCIETY
GAMAHAN
DIA NEW
COLONY
POST
BUXIBAZA
R
CUTTACK
753001
ODISHA
Residential
Address:-
SADHANA
KUTIR

i r s GAMAHAN
DIA NEW

fa
COLONY

A f POST
BUXIBAZA
R CITY-

m e CUTTACK
753001

H o ODISHA e-
mail

o f address:-
gensecywcw
s1@hotmail.

t ry com
Landline:-

ni s 671-2415756
mobile no:-

Mi
6371790137

File Number : 7002682021 Page 5 of 9

 Name Name of Nationality Aadhaar PAN Occupatio Designatio Relationshi Contact
Father/spo Number n n in the p with Details:
use Association other Office
Members Address;
of Residential
Executive Address; e-
Council/ mail
Governing Address,
body / Landline
Office no; mobile
bearers no.
SHUBHASH ADITYA India Adhaar XXXXXX40 Social Others Other Office
REE NARAYAN Verified 9N Service Address:-
DIBYADAR MAHARAN 2021-04- WOMEN
SHINI A 18T17:04:54. AND
MAHARAN 127+05:30 CHILD
A WELFARE
SOCIETY
GAMAHAN
DIA NEW
COLONY
POST
BUXIBAZA
R
CUTTACK
753001
ODISHA
Residential
Address:-
WO-
ADITYA

i r s NARAYAN
MAHARAN

fa
A PLOT

A f NO-141
SAHID
NAGAR

m e NEAR BMC
KALYAN

H o MANDAP
BHUBANES

o f WAR-
751007
DIST-

t r y KHORDHA
e-mail

ni s address:-
shubhashree

Mi
maharana9@
gmail.com
Landline:-
mobile no:-
9778704584

(b) if any of the above is a foreigner (including PIO/OCI card holder), details thereof:

(c) Details of changed Key functionaries on account of addition/ deletion/ removal/ resignation/ death etc., vis-a-vis
the original application:-

Name addition/deletion/rem Effective Date Reasons Remarks

oval/resignation/deat
h etc.
(1) (2) (3) (4) (5)
Minati Bindhani Modify 01/01/1994 CONTINUED AS CONTINUED AS
General Secretary-cum- GENERAL
Chief FunctionaryAS SECRETARY-cum
PER GENERAL BODY Chief Functionary AS
MEETING PER GENERAL BODY
RESOULATION MEETING
APPROVED ON 14-02- RESOULATION
2021 APPROVED ON 14-02-
2021
Kalpalata Prusty Modify 14/02/2021 As per General Body As Asst.Secretary Active
Meeting Resoulation From 01.01.1994 till
Approved on General Body Meeting
dated.14.02.2021 on Dated.14.02.2021
File Number : 7002682021 Page 6 of 9
 MANASI Addition 14/02/2021 VICE-PRESIDENT AS ACTIVE FROM 01-01-
PRIYADARSHINI PER GENERAL BODY 2010 AS MEMBER
MOHAPATRA MEETING
RESOULATION
APPROVED ON 14-02-
2021
RUPA BHAYANI Addition 14/02/2021 ASSISTANT ACTIVE FROM 01-01-
SECRETARY AS PER 2017 AS ASSISTANT
GENERAL BODY SECRETARY
MEETING
RESOULATION
APPROVED ON 14-02-
2021
MINATI MOHANTY Addition 14/02/2021 TREASURER AS PER ACTIVE FROM 01-01-
GENERAL BODY 1994 AS MEMBER
MEETING
RESOULATION
APPROVED ON 14-02-
2021
URBASEE PANI Addition 14/02/2021 GOVERNING BODY ACTIVE FROM 01-01-
MEMBER AS PER 2016 AS MEMBER
GENERAL BODY
MEETING
RESOULATION
APPROVED ON 14-02-
2021
SHUBHASHREE Addition 14/02/2021 GOVERNING BODY ACTIVE FROM 01-04-
DIBYADARSHINI MEMBER AS PER 2014 AS MEMBER
MAHARANA GENERAL BODY
MEETING
RESOULATION

r s
APPROVED ON 14-02-
2021
i
f fa
6. Amount of fee paid (Rs.): 5000.00
e A
o m
7. Whether any current office bearers or directors or other key functionaries of the person/association has, in the
discharge of his official functions or private conduct:
H
(a) been convicted by any court of law;

y
(b) under prosecution for any offence pending against of No
No
him/her;
t r
is
(c) been found guilty of diversion or mis-utilisation of funds of No
the person/association or any other person/association in the
past.
i n
M
(d) has been prohibited from accepting foreign contribution.
(e) is a current key functionary of any other
person/association.
No
No

(f) is a current Key functionary of any other No

person/association against whom an order under sections 13 or
14 of the Foreign Contribution (Regulation) Act, 2010 (42 of
2010) has been passed:
Note : If any of the replies to (a) to (f) above is "Yes", then full
details of the case must be given.

8. Whether the applicant person/association.

(a) is a branch / unit / associate of foreign based organisation No

or another person/association already registered or granted
prior permission under the Act. If so, name, address of the
organisation and registration number/prior permission
number and date;
(b) attracts section 10 of the Act and if so, detail of the order No
passed by Central Government under sub-section (3) of section
11 of the Act:
(c) has been directed in term of caluse(d) of section 9 of the Act No
to seek prior permission by the Central Government. If so, the
number and date of the relevant order;
(d) had earlier been proceeded against as per provision of the No
Foreign Contribution (Regulation) Act, 1976 (49 of 1976)/
Foreign Contribution (Regulation) Act 2010 (42 of 2010), if so,
the details thereof.

File Number : 7002682021 Page 7 of 9

9(a)(i) Details of FCRA bank account for receipt of foreign contribution(SBI, New Delhi).

Name of the Branch e-mail IFSC Code Account Number Date of Opening
Bank Address(with Pin Account
code)
(1) (2) (3) (4) (5) (6)
STATE BANK OF 11Sansad Marg, fcra.00691@sbi.co.i SBIN0000691 XXXXXXX2379 27/03/2021
INDIA, New Delhi 110 n
001,NEW
DELHI,Delhi,Delhi,
110001,()

9(a)(ii) Details of another FCRA Account(if any,) for keeping or utilising

Name of the Branch e-mail IFSC Code Account Number Date of Opening
Bank Address(with Pin Account
code)
INDIAN PL 131 A, VIKAS iob1247@iob.in IOBA0001247 124701000003080 27/07/2005
OVERSEAS BANK SADAN, po.college
square .jobra
ORISSA ODISHA
753003
Note:- In case of any change mandatorily intimate by filling FC-6 form
9(b) Details of all utilisation bank accounts for utilisation of foreign contribution (To be filled by applicant applying
for renewal of registration):

i r s
fa
Name of the Branch e-mail IFSC Code Account Number Date of Opening
Bank Address(with Pin
code)
A f Account

INDIAN
(1) (2)
Jobra Branch
(3)
iob1247@iob.in
m
(4)
IOBA0001247e (5)
XXXXXXX0000
(6)
27/07/2005
OVERSEAS
BANK,
College
Square,Cuttack,Oriss
H o
f
a,Cuttack,753001, ()

10. (i) Whether:

y o
s t r
ni
(a) If granted prior permission in past to receive foreign No
contribution, number and date of sanction:

(ii) Whether: Mi
(b) Date of submission of yearly accounts thereof: Not applicable as answer for 10 (i) a is NO

(a) the person/association has received foreign contribution No

without prior permission in the past. if so furnish full particulars :
(b) said violation has been condoned/ compounded by the Central Not Applicable as answer for 10(ii) a is NO
Government, if so, the number and date of the relevant order:
(c) the person/association has been prohibited from accepting Not Applicable as answer for 10(ii) a is NO
foreign contribution, if so, details thereof:
(d) the person/association has earlier been suspended/cancelled, if
so details thereof:
(e) the person/association has earlier been refused renewal: No

11. Whether:

(i) the person/association had applied for registration under the No

Foreign Contribution (Regulation) Act, 1976 (49 of 1976) or the
Foreign Contribution (Regulation) Act, 2010 (42 of 2010) in the
past, and if so details thereof:

(ii) the person/association had applied for prior permission under No

the Foreign contribution (Regulation) Act, 1976 (49 of 1976) or
the Foreign Contribution (Regulation) Act, 2010 (42 of 2010) in
the past, and if so, details thereof:

File Number : 7002682021 Page 8 of 9

 (iii) the person/association has close links with any anoother
person/association, or its unit or branch, which has been,
(a) refused registration/ prior permission: No
(b) prohibited from accepting foreign contribution: No
(c) suspended or whose registration has been cancelled: No
(d) if answer to any of (a) to (c) is yes, please give full particulars: Not applicable as answer for all (a) to (c) are NO

Your Faithfully,

MINATI BINDHANI
[Name of the Chief Functionary
(Chief Functionary)

(Seal of the Association)

i r s
f fa
e A
o m
Declaration and Undertaking

f H
(a) I/We Minati Bindhani hereby, declare that the information furnished above is true and correct; and

o
(b) I/We Minati Bindhani undertake that the receipt of foreign contribution and its utilisation shall not be violative of any of the

y
time to time;
s t r
provisions of the Foreign Contribution (Regulation) Act 2010 (42 of 2010) and the rules, notification or orders issued thereunder from

ni
(c) I/we Minati Bindhani hereby certify that the office bearers and key functionaries and members fulfill all the eligibility criteria laid

Mi
out in sub-section(4) of section 12 of the Foreign Contribution (Regulation) Act, 2010 and an affidavit executed by each office bearer
and key functionary and member in Proforma 'AA' is uploaded with this application form.

Place: Cuttack
Date: 29/09/2021

( Minati Bindhani )
[Name of the Chief Functionary
(Chief Functionary)

(Seal of the Association)

File Number : 7002682021 Page 9 of 9