Client: Prepared By: Date

Subject: Donation Reviewed By: Date

Year Ended:

Amounts in Rupees
CBR WHETHER DIRECTOR BOD IN ACCORDANCE
APPROVAL/ OR HIS SPOUSE IS APPROVAL WITH THE NAME OF
DATE OF RECEIPT PAID TO RENEWAL INTERESTED IN DONEE DATE OBJECTS OF THE INTERESTED NATURE OF DONEE IS / IS NOT A IS THERE ANY
PAYMENT NO. (DONEE) ADDRESS AMOUNT NUMBER YES NO. COMPANY DIRECTOR INTEREST POLITICAL PARTY COMMITMENT

NOTE: Ensure that if aggregate amount is greater than the limits defied by Income Tax law, the difference should be added in the taxable income.