The Secretary to the Government of India,

Ministry of Home Affairs, Foreigners Division (FCRA Wing) "First Floor NDCC-II Building," 1,JAI SINGH Road
New Delhi - 110001
Form FC-4
[See rule 17(1)]
Subject: Account of Foreign Contribution for the year ending on the 31st March
1. FCRA registration/prior permission number and date : 083990173, Date30/09/2010
2. Details of receipt and utilisation of foreign contribution :
i. Foreign Contribution received in cash/kind(value):
*i.e. interest accured on foreign contribution, or any other income derived from foreign contribution, e.g. sale proceeds from assets
created from contribution, or interest thereon during the year
ii (a). Donor wise detail of foreign contribution received in excess of rupees 20,000:
a) Brought forward foreign contribution at the beginning of the year(Rs.) 9860423.36000

b) Interest or other receipt during the year 105527.21000

c) Foreign Contribution received during the financial year
i) Directly from a foreign source 74659300.89000
ii) as transfer from a local source 0.00000
d) Total Foreign Contribution (a+b+c) (Rs.) 84625251.46000
Sl.No Name of donors Institutional/Individu al Detail of the donor: official
Address; Email address;
website address:

1 Americares Foundation Inc Institutional 88 Hamilton Avenue,Stamford, CT 06902, USA , United States

2 Sanofi India Limited Institutional 54/A, Sir Mathuradas Vasanji

Road, Andheri East, Mumbai
400 093
, India, Email Id:
Kavita.Chaudhari@san
ofi.com, Website Address :

3 Novartis Healthcare Pvt Ltd Institutional Sandoz House, Shivsagar Estate, Dr Annie Besant Road, Worli, Mumbai 400 01

4 BARD India Healthcare Pvt Institutional Unit no. 501, 5th

Ltd Floor,Hubtown Solaris, Village
Gundivali, N.S.Phadke Marg,
Andheri East, Mumbai
400069 , India, Email Id:
Shilpa.Ramanathan@cr
bard.com, Website Address :

5 BARD India Healthcare Pvt Institutional Unit no. 501, 5th

Ltd Floor,Hubtown Solaris, Village
Gundivali, N.S.Phadke Marg,
Andheri East, Mumbai
400069 , India, Email Id:
Shilpa.Ramanathan@cr
bard.com, Website Address :
6 United Way of India
7 Becton Dickinson India Pvt Ltd Institutional
8 Quest Diagnostics India Pvt
Ltd
9 United Way of Mumbai
10 Novartis India Limited
11 Novartis India Limited
12 Johnson and Johnson Pvt Ltd
13 Allergan India Pvt Ltd
14 Baxter India Pvt Ltd
15 Glaxo SmithKline
Pharmaceuticals Limited
Institutional 309, Nirman Kendra, Famous
Studio Lane, Dr. E. Moses
Road,, Mahalaxmi, Mumbai,
Maharashtra 400011 , India,
Email Id:
anil@unitedwaymumb ai.org,
Website Address :
6th Floor, Signature Towers B, South City I, Gurgaon 122001, Haryana , India
Institutional A-17 Info City, Sector 34
Gurgaon-122001, Haryana ,
India, Email Id:
Reshma.X.Mathur@qu
estdiagnostics.com, Website
Address :
Institutional 309, Nirman Kendra, Famous
Studio Lane, Dr. E. Moses
Road,, Mahalaxmi, Mumbai,
Maharashtra 400011 , India,
Email Id:
anil@unitedwaymumb ai.org,
Website Address :
Institutional Sandoz House, Shivsagar
Estate, Dr Annie Besant Road,
Worli, Mumbai 400 018 , India,
Email Id:
svetlana.pinto@novarti s.com,
Website Address :
Institutional Sandoz House, Shivsagar
Estate, Dr Annie Besant Road,
Worli, Mumbai 400 018 , India,
Email Id:
svetlana.pinto@novarti s.com,
Website Address :
Institutional L.B.S Marg, Mulund (W), Mumbai- 400 080, India, Email Id: I
Institutional First floor, Silver jubilee
block , unity building complex,
Mission road, Bangalore,
India , India, Email Id:
sharma_rajesh@allerga n.com,
Website Address :
Institutional 2nd Floor, Tower-C, Building
No.8,
DLF Cyber City, DLF Phase-II,
Gurgaon-122 002, Haryana ,
India, Email Id:
shabnam_bose@baxter. com,
Website Address :
Institutional 252, Gsk House, Dr Annie Besant Road, Worli, Mumbai - 400
16 Abbott Healthcare Pvt Ltd Institutional 3-4 Corporate park,Sion Trombay road,Mumbai-400071 , India, Email Id: jasra

17 Pfizer Limited Institutional Patel Estate Rd, Momin Nagar,

Jogeshwari West, Mumbai ,
India, Email Id:
Sandhya.Menon@pfize r.com,
Website Address :

18 Ravi K Kumar Individual 1009 Coachford Ct, Lutherville

-Timonium, MD 21093 ,
United States of America,
Email Id:
raviindukumar@yahoo. com,
Website Address :

19 Morgan Stanley India Institutional Athena, Bldg. No. 5, Sector 30,

Company Pvt Ltd Mindspace, Goregaon West
Mumbai 400090 , India, Email
Id: anand.hariharan@morg
anstanley.com, Website
Address :

20 Merck Limited Institutional Shiv Sagar Estate A , Dr. Annie

Besan Road Worli, Mumbai
400018
, India, Email Id:
shilpa.arora@merckgro
up.com, Website Address :
AI SINGH Road

n, e.g. sale proceeds from assets

0
Purposes for which received Amount (Rs.)

Social 31029512.89

Social 855057.70

Social 1950000.00

Social 300000.00

Social 177867.50
Social 908485.00

Social 1532750.00

Social 51650.00

Social 10716823.00

Social 340000.00

Social 2710808.43

Social 2328373.75

Social 446177.77

Social 300000.00

Social 1103308.16
Social 10161827.78

Social 806204.93

Social 63000.00

Educational 7750000.00

Social 1127453.98
(b). Cumulative purpose-wise amount of all foreign contribution donation received :
(iii). Details of Utilization of foreign contribution:
* It is affirmed that the utilisation of foreign contribution is not in contravention of the provisions contained in proviso to Sction 9(e) and
Section 12(4)(f) of the Act which states that the acceptance of foreign contribution is not likely to affect prejudically.
(A) the soverignty and integrity of india; or.
(B) the security, strategic, scientific or echnomic interest of the state; or
(C) the public interest; or
(D) freedom or fairness of election to any legistature; or
(E) friendly relations with any foreign state; or
Sl.No Purpose Amount
1 Educational 7750000.00000
2 Social 66909300.89000
a. Total Utilization* for projects as per aims and objectives of the 54372317.00000
association (Rs.)
b. Total Administrative Exprenses as provided in Rule 5, FCRA 2011 13439002.17000
(Rs.)
c. Total invested in term deposits(Rs.) 0.00000
Total Purchase of fresh assets(Rs.) 507080.00000
Total utilzation in the year(Rs.) (a+b+c+d) 68318399.17000
00000
.89000
(F) harmony between religious, racial, social, lingusitic or relgional groups, castes or communities
iv. Balance of unutilized foreign contribution, in 11325229.29000
cash/bank, at the end of the year(Rs.) :
v. Total number of foreigner working(salaried/ in 0.00000
honorary capacity. :
3. (a) Details of designated Fc bank account for receipt of Foreign Contribution ( As on 31st March of the year ending):
3. (b) Details of all utilization bank accounts for utilization of Foregin Contribution (As on 31st March of the year ending)
Declaration
I hereby declare that the above particulars furnished by me are true and correct
I also affirm that the receipt of foreign contribution and its utilization have not been violative of any of the provisions of the
Foreign Contribution (Regulation) Act, 2010, rules, notifications/ orders issued there under from time to time and the foreign contribution was util
Signature of the Cheif Functionary
Sl.No Name of Bank of donors Branch Address( With pincode) IFSC Code

1 HongKong and Sanghai Bank F-43, South Extension, Part HSBC0110004

- I, New Delhi-110049, New Delhi,
Delhi, Delhi
Sl.No Name of Bank of donors Branch Address( With pincode) IFSC Code

1 HongKong and Sanghai Bank F-43, South Extension, Part HSBC0110004

- I, New Delhi-110049, New Delhi,
Delhi, Delhi
e foreign contribution was utilized for the purpose(s) for which the association was granted registration/ prior permission by the Central Government.

Account No

053285722001

Account No

053285722001
entral Government.