Form FC-4
[See rule 17(1)]
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
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 :
105527.21000
0.00000
A
74659300.89000
ffa
9860423.36000
e
84625251.46000
om
a) Brought forward foreign contribution at the beginning of the
year(Rs.)
b) Interest or other receipt during the year
c) Foreign Contribution received during the financial year
i) Directly from a foreign source
ii) as transfer from a local source
d) Total Foreign Contribution (a+b+c) (Rs.)
irs
i. Foreign Contribution received in cash/kind(value):
H
*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
of
ii (a). Donor wise detail of foreign contribution received in excess of rupees 20,000:
Name of donors
Institutional/Individu
al
1
Americares Foundation Institutional
Inc
2
Sanofi India Limited
Institutional
M
in
is
t
ry
Sl.No
3
Novartis Healthcare
Pvt Ltd
Institutional
4
BARD India
Healthcare Pvt Ltd
Institutional
Detail of the donor:
official Address;
Email address;
website address:
88 Hamilton Avenue,
Stamford, CT 06902,
USA , United States of
America, Email Id:
rgranger@americares.o
rg, Website Address :
54/A, Sir Mathuradas
Vasanji Road, Andheri
East, Mumbai 400 093
, India, Email Id:
Kavita.Chaudhari@san
ofi.com, Website
Address :
Sandoz House,
Shivsagar Estate, Dr
Annie Besant Road,
Worli, Mumbai 400
018 , India, Email Id:
mandar.deo@sandoz.c
om, Website Address :
Unit no. 501, 5th
Floor,Hubtown Solaris,
Village Gundivali,
N.S.Phadke Marg,
Andheri East, Mumbai
400069 , India, Email
Id:
Shilpa.Ramanathan@cr
bard.com, Website
Address :
Purposes for which
received
Amount (Rs.)
Social
31029512.89
Social
855057.70
Social
1950000.00
Social
300000.00
Institutional/Individu
al
5
BARD India
Healthcare Pvt Ltd
Institutional
6
United Way of India
Institutional
7
Becton Dickinson India Institutional
Pvt Ltd
8
Quest Diagnostics
India Pvt Ltd
Institutional
9
United Way of
Mumbai
Institutional
10
Novartis India Limited
Institutional
11
Novartis India Limited
Detail of the donor:
official Address;
Email address;
website address:
Unit no. 501, 5th
Floor,Hubtown Solaris,
Village Gundivali,
N.S.Phadke Marg,
Andheri East, Mumbai
400069 , India, Email
Id:
Shilpa.Ramanathan@cr
bard.com, Website
Address :
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, Email
Id:
murli_sundrani@bd.co
m, Website Address :
A-17 Info City, Sector
34 Gurgaon-122001,
Haryana , India, Email
Id:
Reshma.X.Mathur@qu
estdiagnostics.com,
Website Address :
309, Nirman Kendra,
Famous Studio Lane,
Dr. E. Moses Road,,
Mahalaxmi, Mumbai,
Maharashtra 400011 ,
India, Email Id:
anil@unitedwaymumb
ai.org, Website
Address :
Sandoz House,
Shivsagar Estate, Dr
Annie Besant Road,
Worli, Mumbai 400
018 , India, Email Id:
svetlana.pinto@novarti
s.com, Website
Address :
Sandoz House,
Shivsagar Estate, Dr
Annie Besant Road,
Worli, Mumbai 400
018 , India, Email Id:
svetlana.pinto@novarti
s.com, Website
Address :
L.B.S Marg, Mulund
(W), Mumbai- 400 080
, India, Email Id:
Icontrib@Its.jnj.com,
Website Address :
First floor, Silver
jubilee block , unity
building complex,
Mission road,
Bangalore, India ,
India, Email Id:
sharma_rajesh@allerga
n.com, Website
Address :
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 :
Purposes for which
received
Amount (Rs.)
Social
177867.50
Social
908485.00
Social
1532750.00
irs
Name of donors
Social
51650.00
Social
10716823.00
Social
340000.00
Social
2710808.43
Social
2328373.75
Social
446177.77
Social
300000.00
ry
of
H
om
e
A
ffa
Sl.No
Johnson and Johnson
Pvt Ltd
Institutional
13
Allergan India Pvt Ltd
Institutional
14
Baxter India Pvt Ltd
Institutional
M
12
in
is
t
Institutional
Institutional/Individu
al
15
Glaxo SmithKline
Pharmaceuticals
Limited
Institutional
16
Abbott Healthcare Pvt
Ltd
Institutional
17
Pfizer Limited
Institutional
18
Ravi K Kumar
Individual
19
Morgan Stanley India
Company Pvt Ltd
Institutional
20
Merck Limited
Institutional
Detail of the donor:
official Address;
Email address;
website address:
252, Gsk House, Dr
Annie Besant Road,
Worli, Mumbai 400018 , India, Email
Id:
garima.a.dutt@gsk.com
, Website Address :
3-4 Corporate
park,Sion Trombay
road,Mumbai-400071 ,
India, Email Id:
jasraj.virdi@abbott.co
m, Website Address :
Patel Estate Rd, Momin
Nagar, Jogeshwari
West, Mumbai , India,
Email Id:
Sandhya.Menon@pfize
r.com, Website
Address :
1009 Coachford Ct,
Lutherville -Timonium,
MD 21093 , United
States of America,
Email Id:
raviindukumar@yahoo.
com, Website Address :
Athena, Bldg. No. 5,
Sector 30, Mindspace,
Goregaon West
Mumbai 400090 ,
India, Email Id:
anand.hariharan@morg
anstanley.com, Website
Address :
Shiv Sagar Estate A ,
Dr. Annie Besan Road
Worli, Mumbai 400018
, India, Email Id:
shilpa.arora@merckgro
up.com, Website
Address :
Purposes for which
received
Amount (Rs.)
Social
1103308.16
Social
10161827.78
Social
806204.93
Social
63000.00
irs
Name of donors
ffa
Sl.No
7750000.00
Social
1127453.98
of
H
om
e
A
Educational
(b). Cumulative purpose-wise amount of all foreign contribution donation received :
Purpose
Educational
Social
Amount
7750000.00000
66909300.89000
is
t
ry
Sl.No
1
2
in
(iii). Details of Utilization of foreign contribution:
M
a. Total Utilization* for projects as per aims and
objectives of the association (Rs.)
b. Total Administrative Exprenses as provided in Rule
5, FCRA 2011 (Rs.)
c. Total invested in term deposits(Rs.)
Total Purchase of fresh assets(Rs.)
Total utilzation in the year(Rs.) (a+b+c+d)
54372317.00000
13439002.17000
0.00000
507080.00000
68318399.17000
* 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
(F) harmony between religious, racial, social, lingusitic or relgional groups, castes or communities
iv. Balance of unutilized foreign contribution, in
cash/bank, at the end of the year(Rs.) :
v. Total number of foreigner working(salaried/ in
honorary capacity.
:
11325229.29000
0.00000
3. (a) Details of designated Fc bank account for receipt of Foreign Contribution ( As on 31st March of the year ending):
Sl.No
Name of Bank of donors
1
HongKong and Sanghai
Bank
Branch Address( With
IFSC Code
pincode)
F-43, South Extension, Part HSBC0110004
- I, New Delhi-110049, New
Delhi, Delhi, Delhi
Account No
053285722001
1
HongKong and Sanghai
Bank
Branch Address( With
IFSC Code
pincode)
F-43, South Extension, Part HSBC0110004
- I, New Delhi-110049, New
Delhi, Delhi, Delhi
Account No
053285722001
ffa
Name of Bank of donors
om
e
Declaration
A
Sl.No
irs
3. (b) Details of all utilization bank accounts for utilization of Foregin Contribution (As on 31st March of the year ending)
I hereby declare that the above particulars furnished by me are true and correct
M
in
is
t
ry
of
H
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 utilized for the purpose(s) for which the association was granted registration/ prior permission by the Central
Government.
Signature of the Cheif Functionary
VCK & ASSOCIATES
'/iren I{fian[wala
CHARTERED ACCOUNTANTS
Khandwala's Bunglow, Behind Sagar Plaza
42 M.G.Road, Next to Bank of Baroda,
Ghatkopar (West),Mumbai - 400 086
rel. 2514 8021 - 2516 5334
Bcom. F.C.A.
Cell: 98210 64839
CHARTERED ACCOUNTANT REPORT
(Under Section
1.
l3 of the Foreign Contribution (Regulation) Act, 1976)
We have audited the accounts of Americares India Foundation, A-13, Gala No. 101 to 104,
Harihar .Corporation, Village Dapode, Post Kalher, Bhiwandi, Thane; Maharashtra 421302
holding registration number 083990173 dated 30th September 2010 for the year ending tlre 31't
March 2015 and examined all the relevant books and vouchers and certify that according to the
audited account:
The brought forward foreign contribution at the beginning of the year
a
was Rs.98,60,4231-
Foreign Contribution of / worth Rs. 7,46,59,3011- was received by the Association during the
fi nancial y ear 20 | 4-201 5
Interest accrued on foreign contribution and other income derived from foreign contribution or
interest thereon of /worth Rs. 105,5271-was received by the Association during the financial year
2014-20t5
The Balance of unutilized foreign contribution with the Association at the end of the financial
year) l't March 2015 was Rs. 1,63,06,8521-. (inclusive of net interest earned).
d
Certified that the Association has maintained the accounts of foreign contribution and records
relating thereto in the manner specified in section 19 of the Foreign Contribution (Regulation)
Act, 2010 (42 of 2010) read with rule 17 of the Foreign Contribution (Regulation) Rules, 2011.
The information in this certificate and in the enclosed Balance Sheet and statement of Receipt and
Payment is correct as checked by us.
g.
The association has utilized the foreign contribution received for the purpose(s)
granted prior permission under Foreign Contribution (Regulation) Act, 2010
For VCK & Associates
Chartered Accountants
\et(f-"4-"1-,r.,^
Viren C. Khandwala
Membership No: 100152
Firm Regn No: 126959W
Place: Mumbai
Date: December 15.2015
it is registered/
SOURCES OF FUNDS
Foreign Projects Fund
2
'14,05,r01
Current Liabilities
3
'J.,54,96,99r
2,35,209
Fixed Assets
4
42,29,750
53,r9,794
Current Assets, Loans & Advances
5
13,38,7!2
13,01,166
1.,05,96,964
APPTICATION OF FUNDS
Cash and Bank Balances
-ln Cash
-ln Current Account with Scheduled Bank
4,293
t,r3,20,936
42,0t,rtz
Significant Accounting Policies and Notes to Accounts
(As per Note 1 )
As per
our attached Report
of even date
The schedule referred above forms
an integral part of this Balance Sheet
For and on behalf of
VCK & ASSOCIATES
Chartered Accountants
VC-tCt^rl;-tVIREN C. KHANDWALA
Proprietor
Firm Registration No: 126959W
Place: Mumbai
Date: August 07,20t5
For AmeriCares India Foundation
Amount in
Particulars
For the year
Schedule ended March 31,
T
For the year
ended March 31,
2015
20L4
4,06,97,oo9
4,3r,53,160
83,391
2,09,351
1,34,96,229
t,26,62,t93
3,48,67,9L0
3,54,63,930
75,99,t24
20,94,345
(91,81,753)
(68,48,958)
INCOME
Foreign Contribution
Interest on Fixed Deposit
less:
EXPENDITURE
Administration Expenses
Project Expenses
Depreciation
Excess of Income over Expenditure/ (Excess of
Expenditure over Income)
Significant Accounting policies and Notes to Accounrs
(As per Note 1 )
As per our attached Report
of even date
The schedule referred above forms an integral part
of this Income and Expenditure account
For and on behalf of
VCK & ASSOCIATES
Chartered Accountants
[€lQ^----{-L
VIREN C. KHANDWAIA
Proprietor
Firm Registration No: 125959W
Place: Mumbai
Date: August 07,2015
For AmeriCares India
fr//
Trustee
Foundation
U{+f^tw
Trustee
-ln Current Account with Scheduled Bank
42,01,1L2
30,05,193
5,49,42,221
4,31,53,160
Add: Receipts
Foreign Contributions received during the year for :
Supply of free medicine, medical aid, including hearing
aids,
visual aids, family planning aids, Spirit of Humanity,
Disaster Response & Preparedness etc., including
related storage & warehousing expenses
Fixed Deposit Maturity Receipts with Bank
Interest Received
Less : Payments
Grants Utilised for :
Supply of free medicine, medical aid, including hearing aids,
visual aids, family planning aids, Spirit of Humanity,
Disaster Response & preparedness etc., including related
storage & warehousing expenses
90,00,000
1,05,527
4,79,94,63t
2,36,496
5,1L,99,725
TDS Deducted
Significant Accounting Policies and Notes to Accounrs
(As per Note 1 )
As per our attached Report
of.even date
The schedule referred above forms an integral
part of this Receipts and payments Account
For and on behalf of
VCK & ASSOCIATES
Chartered Accountants
For AmeriCares India
Foundation
t,C{C.[^"^-r-/^
VIREN C. KHANDWALA
Proprietor
Firm Registration No: 126959W
Place: Mumbai
Date: August 07,20L5
Trustee