OX SATWIK MINI INDIA EDUCATION SOCIETY (A Charitable 80 (G) Registered Society under SR Act 1860 bearing Regd. No. 22293/21 of 06-07) Administrative Office : 10, Khandagiri Square, Opposite Xavier School Tel. No. : 9437407277 == Bhubaneswar - 751030, Dist.- Khurda, Odisha Website : www.smiescharity.com | EQ | wy _ ate. To, Sri, Ravindra Kumar Tyagi Chairman Power Grid Corporation of India (Power Grid) Gurugram Haryana Sub- Sir, We are a Registered Charitable Education Society in the State of Odisha, Bhubaneswar. We are providing Education & Health Services to the needy and poor people. We are in the intent to venture into Construction of a Charitable Hospital in Bhubaneswar, in the state of Odisha. Thereby we require funding from various Government, Private Ltd. Company, Public Limited Companies, Individuals, and Various Corporates all across the Country and Globally. Thereby I would request your good self to allocate us a Kind Donation to the Extent of Rs/-44,000 Crores (Rupees Forty Four Thousand Croresonly) for our Project, Sai Satwik Cancer Research Institute to be established in Bhubaneswar Dist. Khurda Odisha. We have all the necessary Documents associated with our organization “Satwik Mini India Education Society” which has a project for the Construction of “Sai Satwik Cancer Research Institute” and “Satwik Institute of Professional Studies” under our Parent Education Society as mentioned above. For Any Clarifications we have attached our File for your Kind Consideration. We Do request your Esteemed Organization to help us with your kind Consent to help us with suitable Donations from time to time so that we grow under your kind patronage and guidance. Looking forward for a Kind Consent from your Good self eae ‘You ‘Aurobindo Mohapatra President Satwik MipiJadia, Education Society ‘SATWIK MINI INDIA EDUCATION SOCIETYAPPLICATION FOR FUNDING UNDER CSR = FOR SATWIK MINI INDIA EDUCATION SOCIETY KHANDAGIRI SQUARE BHUBANESWAR ODISHA 751030 SUBMITTEDTO Sri. Ravindra Kumar Tyagi Chairman Power Grid SUBMITTEDBY [AUROBINDO MOHAPATRA, Tel:+91-9137804703/9437407277 E-Mail: aurobindomoha76@gmail.com Website:www.smiescharity.com eas He rate PRESIDENT Pagel ofS. SATWIK MINI INDIA EDUCATION SOCIETY(A) GENERAL INFORMATION S.No. | Item Details 1. | Project title for which SAI SATWIK CANCER RESEARCH INSTITUTE funding is sought 2. | Applying Organization SATWIK MINI INDIA EDUCATION SOCIETY (name) 3. | Registered as SOCIETY (Society/ Foundation/ ‘Trust/Others- kindly specify) 4, _| Year of Registration 2006 5. | Registered Address KHANDAGIRI SQUARE BHUBANESWAR ODISHA 751030 6. | Correspondence Address | KHANDAGIRI SQUARE BHUBANESWAR ODISHA 751030 7. | Phone No. ‘919137804703 / 9437407277 8._| Email Address furobindomoha76@gmail.com satwikinstitutions(@yahoo.co.in 9. | Website(if any) [www smiescharity.com 10. | PANNo, ofthe applying | AACASS736N organization II. | Details of Authorized ‘AUROBINDO MOHAPATRA Signatory (with name, PRESIDENT SMIES designation, PAN No., ALGPMO105K ‘Aadhar no. & identity proof — Aadhar Card - 555378422669 Aadhar/Passport/Driving License) 12. | Details of Contact person, if | Same as above different then the authorized signatory (with name, designation & identity proof) 13. | Function /Responsibility of _| President SMIES contact person 14. | Organization’s legal status | Education Society 12 (aa), 80(g), FORA , Neti Aayog , CSR (Certified, LEI Certified Organization Page os Aerectinde botobol PRESIDENT ‘SATWIK MINI INDIA EDUCATION SOCIE115. | Other Registration u/s 12A of [Available and Updated Income tax Act 16. | Income Tax exemption for [Available and Updated donation w/s 80G 17._| Registration for CSR (CSROO020939 (CSR-1 Registration No. with | Dated 21/01/2022 date) 18. | Project Location [Bhubaneswar Odisha 19. | Target Group Health Related Patients Edueation Students 20. | Project's duration 05 Years 21. | Project’s budget(in INR) __| 44,0000 Crores Forty Four Thousand Crores 22. | CSR funding requested 10,000 Crores or as applicable (in INR) 23. | Any other information Will be furnished as and when deemed necessary (B) OTHER INFORMATION S.No. | Ttem ‘Remarks 1. | Geographical area of | Bhubaneswar Odisha project execution with | For construction of Medical College and Hospital for the purpose of reason for selecting the Education Students and for the Health of Deprived and Destitute area. 2. | Details of Target Students and Health related Patients from all across India and SAARC| Beneficiaries Countries sincluding number of _ | File Attached herewith beneficiaries & background.(Mention Annexure, if any) 3._| Detailed project [Project Report and File attached herewith execution methodology along with milestone based timelines. (Mention Annexure, if any) harold bole PRESIDENT ‘SATWIK MINI INDIA EDUCATION SOCIETY Page 3 of 54. Estimation of project | Financial Year | Amount(in INR) cost 2023-24 10,000 Gr 2025-26 18,000 Cr 2026-27 16,000 Cr Total 44,000 Cr Cost(in INR) CSR funding [40,000 Cr sought from (in INR) SIGNED, STAMPED AND VERIFIED COPIES OF FOLLOWING DOCUMENTS SHOULD BE PROVIDED TO DIFFERENT ORG. ALONG WITH THE APPLICATION/PROPOSAL: CSR-1Registration Certificate. Certificate of Registration as Society/Foundation/Trust. Trust Deed/Memorandum of Association. List of Board Members /Trustees with qualification &PAN numbers Details of Beneficiaries Annual Report of last 3 Financial years. Acknowledgements of IT Return filed for last3 years. Auditor's Report, Balance Sheet and Income & Expenditure Account of last3 years. Income Tax exemption certificates: 80G etc. along with certification that the validity of the certificate has not been withdrawn by Department of Revenue/IT Department, Govt. of India. Registration certificates under sections12A & 80G of Income tax Act. Bank Account Details, including cancelled cheque fort the account Details of major completed project(s) during last 3 years along with project completion certificates issued from the funding agencies. Please provide impact assessment report of the same, if available. As<25e- 4 A i} Bx x Page 4 of 5 ae en) pets PRESIDENT ‘SATWIK MINI INDIA EDUCATION SOCIETYXII. Proposal should also carry brief description of the Organization, experience & sources of funding. XIV. Each page of the proposal and annexure should be stamped with Organization’s seal and counter signed by authorized signatory of the applicant Organization. This is to certify that the information submitted above is true and correct to the best of my knowledge and belief. ented Liclopehen, Aurobindo Mohapatra PRESIDENT Sd/SATWIK MINI INDIA EDUCATION SOCIETY Signatures of Authorized Signatory (Name: Aurobindo Mohapatra) (Designation: President) (Complete Address: Khandagiri Square Bhubaneswar Odisha India 751030) Page 5 of 5