Reg No.

IN-UP06278237708497V

DRONACHARYA HOSPITAL
Reg.Off: Jamdeeh Pandey Colony, Kailly Road- Basti-Uttar Pradesh-272002
Operating Branch: Goithaha, Pasai, Sant Kabir Nagar (U.P)-272175
Email: dstbasti@gmail.com
Tel: +91-6387530602, +91-8707220114,
Ref: DST/2023/01 Date: 30/11/2023

TABLE OF CONTENT

01. REGISTRATION CERTIFICATE 02 - 13

02. MSME ACKNOWLEDGMENT CERTIFICATE 14 - 15

03. MSME REGISTRATION CERTIFICATE 16 - 17

04. COMPANY PAN 18

05. EPF CERTIFICATE 19 - 20

06. GST CERTIFICATE 21 - 23

07. MEMORANDUM OF UNDERSTANDING 24-25

08. UNDERTAKING FOR EXPERIENCE 26

09. UNDERTAKING FOR TURNOVER 27

10. CANCEL CHEQUE 28

11. LABOUR LICENCE 29-30

12. ECS MANDATE FORM 31

13. AFFIDAVIT FOR NON-BLACKLISTING 32

For the Organization,

Name: Dr. Vijay Kumar Tripathi
Designation: Director
(Seal & Signature)
6/30/23, 2:18 PM Print : Udyam Registration Certificate

UDYAM REGISTRATION CERTIFICATE

UDYAM REGISTRATION NUMBER UDYAM-UP-67-0010631

NAME OF ENTERPRISE M/S DRONACHARYA SEWA TRUST

SNo. Classification Year Enterprise Type Classification Date

TYPE OF ENTERPRISE *
1 2023-24 Micro 30/06/2023

MAJOR ACTIVITY SERVICES

SOCIAL CATEGORY OF
GENERAL
ENTREPRENEUR

S.No. Name of Unit(s)

NAME OF UNIT(S)
1 DRONACHARYA HOSPITAL

Name of
Flat/Door/Block DRONACHARYA
101 Premises/
No. HOSPITAL
Building
GOITHAHA
Village/Town Block SANTHA
BAZAR
OFFICAL ADDRESS OF ENTERPRISE MEHDAWAL
Road/Street/Lane City SANT KABIR NAGAR
BANSI ROAD
UTTAR SANT KABEER
State District
PRADESH NAGAR , Pin 272152
Mobile 8707220114 Email: dstbasti@gmail.com

DATE OF INCORPORATION /
13/01/2023
REGISTRATION OF ENTERPRISE

DATE OF COMMENCEMENT OF
01/06/2023
PRODUCTION/BUSINESS

NATIONAL INDUSTRY SNo. NIC 2 Digit NIC 4 Digit NIC 5 Digit Activity
CLASSIFICATION CODE(S)
1 62 - Computer 6209 - Other 62091 - Software Services
programming, information installation
consultancy technology
and related and computer
activities service
activities
2 63 - 6312 - Web 63121 - Operation of web Services
Information portals sites that use a search
service engine to generate and
activities maintain extensive
databases of internet
addresses and content in
an easily searchable format

https://udyamregistration.gov.in/Udyam_User/Udyam_PrintApplication.aspx 1/2
6/30/23, 2:18 PM Print : Udyam Registration Certificate

3 63 - 6312 - Web 63122 - Operation of other Services

Information portals websites that act as portals
service to the Internet, such as
activities media sites providing
periodically updated
content
4 70 - Activities 7020 - 70200 - Management Services
of head offices; Management consultancy activities
management consultancy
consultancy activities
activities
5 74 - Other 7490 - Other 74909 - Other professional, Services
professional, professional, scientific and technical
scientific and scientific and activities n.e.c.
technical technical
activities activities n.e.c.
6 86 - Human 8610 - 86100 - Hospital activities Services
health activities Hospital
activities
7 86 - Human 8690 - Other 86904 - Activities of nurses, Services
health activities human health masseures,
activities physiotherapists or other
para-medical practitioners
8 86 - Human 8690 - Other 86905 - Activities of Services
health activities human health independent
activities diagnostic/pathological
laboratories
9 86 - Human 8690 - Other 86909 - Other human Services
health activities human health health activities n.e.c.
activities (including independent
ambulance activities)

DATE OF UDYAM REGISTRATION 30/06/2023

*
In case of graduation (upward/reverse) of status of an enterprise, the benefit of the Government Schemes will be availed as per
the provisions of Notification No. S.O. 2119(E) dated 26.06.2020 issued by the M/o MSME.
Disclaimer: This is computer generated statement, no signature required. Printed from https://udyamregistration.gov.in & Date of printing:-
30/06/2023

For any assistance, you may contact:

1. District Industries Centre: SANT KABIR NAGAR ( UTTAR PRADESH )

2. MSME-DFO: ALLAHABAD ( UTTAR PRADESH )

https://udyamregistration.gov.in/Udyam_User/Udyam_PrintApplication.aspx 2/2
 EMPLOYEES' PROVIDENT FUND

(A statutory Body under the Ministry of Labour and Employment,

www.epfindia.gov.in

PROVIDENT FUND CODE NUMBER INTIMATION

No : 10001282599GKP Date : 26/07/2023

To
VIJAY KUMAR TRIPATHI
Trustee
DRONACHARYA SEWA TRUST
103 New Jaamdeeh Pandey Colony Near District Hospital
Basti BASTI
UTTAR PRADESH - 272002

Sub: Allotment of Code Number to establishment M/s DRONACHARYA SEWA TRUST under Employees' Provident Fund
and Miscellaneous Provisions Act, 1952-regarding.

Sir/Madam ,

Based on the information submitted online by you, your establishment is registered with Employees' Provident Fund
Organisation with the following code number :

Code Number : UPGKP3014617000

This code number is allotted based on the following declarations by you:

1. Name of Establishment : DRONACHARYA SEWA TRUST

2. PAN of Establishment : AAETD3334J

3. Date on which employment : 12/07/2023

strength crossed 19
4. Section under which : 0000001(4)

5. Primary Activity : COMPANIES/SOCIETIES/ASSC/CLUBS/TROUPES FOR PERFORMANCES

6. Ownership Type : FIRMS RUN BY TRUST

7. The address proof of the : - Any license/certificate/number issued by any Govt.

establishment is

Application Number : 10001282599 Page 1 of 2

Code Number : UPGKP3014617000

8. The proof of date of set up 13/01/2023 is Registration Certificate issued by Registrar of Societies

9. As at the time of application, your establishment is having the following licenses and registrations:

S.No. License Under License Number Date Issued By Place of Issue

12920 GOODS AND SERVICE 09AAETD3334J1ZO 25/05/2023 Gst Basti Basti

42 TAX IDENTIFICATION
NUMBER
10. As on date of your application, your establishment is not registered with ESIC.

11. As on date of your application, your establishment is not having LIN.

SUB REGIONAL OFFICE
GORAKHPUR
103 New Jaamdeeh Pandey Colony Near District Hospital 272002
dstbasti@gmail.com

Please note that this intimation letter is generated with the Owners' Details in Form 5A and the intimated letter will be valid
only if the Form 5A is enclosed.

Important information:

1. By virtue of this registration, you are required to comply with the provision of the EPF & MP Act 1952. The
obligations/duties/responsibilities cast upon you as an employer of this establishment and penalties, on account of non-
compliance with the same, are explained on our website www.epfindia.gov.in. You are required to go through them
carefully.
2. Remittance of dues under the provisions of the Act is to be made only through a Challan generated through the Unified
portal. (The process for registration on the portal, preparation of the ECR txt file and related information is available on the
website and the portal).

3. In case this letter is produced as a proof of the code number of the establishment, before any person including
any Inspector from EPFO, the Form 5A generated through the portal at the time of registration should be a part of
this letter. The remittance details of the establishment will be available on the EPFO website through the link
"Establishment Search" where all payments from December 2016 onwards with the names of employees are
available.

4. Please quote the Code Number UPGKP3014617000 for all the future correspondence with EPFO.

This is a system generated letter and needs no signature.

Employees' Provident Fund Organisation

Dated: 26/07/2023

Application Number : 10001282599 Page 2 of 2

Code Number : UPGKP3014617000

 Government of India
Form GST REG-06
[See Rule 10(1)]

Registration Certificate

x
Registration Number : 09AAETD3334J1ZO

Ta
1. Legal Name DRONACHARYA SEWA TRUST

2. Trade Name, if any DRONACHARYA SEWA TRUST

es
3. Additional trade names, if any

ic
4. Constitution of Business Society/ Club/ Trust/ AOP

5. Address of Principal Place of 3, 101, VIJAY KUMAR TRIPATHI, Kailly Road, District
rv
Business hospital Ruchi Dawakhana, New Jamdeeh Colony, Basti,
Basti, Uttar Pradesh, 272002
Se

6. Date of Liability 11/05/2023

7. Period of Validity From 11/05/2023 To Not Applicable

8. Type of Registration Regular

d
an

9. Particulars of Approving Centre

Signature Signature Not Verified

Digitally signed by DS GOODS AND
SERVICES TAX NETWORK 07
ds

Date: 2023.05.25 12:45:16 IST

Name Virendra Kumar Kureel

oo

Designation Superintendent

Jurisdictional Office Basti Sector-1

G

Date of issue of Certificate 25/05/2023

Note: The registration certificate is required to be prominently displayed at all places of business in the
State.

This is a system generated digitally signed Registration Certificate issued based on the approval of application granted
on 25/05/2023 by the jurisdictional authority.
 Annexure A

Goods and Services Tax Identification Number: 09AAETD3334J1ZO

Details of Additional Place of Business(s)

Legal Name DRONACHARYA SEWA TRUST

x
Trade Name, if any DRONACHARYA SEWA TRUST

Ta
Total Number of Additional Places of Business in the State 0

es
ic
rv
Se
d
an
ds
oo
G
 Annexure B

Goods and Services Tax Identification Number: 09AAETD3334J1ZO

Legal Name DRONACHARYA SEWA TRUST

Trade Name, if any DRONACHARYA SEWA TRUST

x
Ta
Details of Members of Managing Committee

1 Name VIJAY KUMAR TRIPATHI

Designation/Status DIRECTOR

es
Resident of State Uttar Pradesh

2 Name GEETA TRIPATHI

ic
Designation/Status Director
rv
Resident of State Uttar Pradesh
Se
d
an
ds
oo
G
 MoU Number: 23/HEALTH/0000024762

MEMORANDUM OF UNDERSTANDING

This Memorandum of Understanding (MoU) is entered on 17th Day of August, 2023 at Lucknow

between

M/s DRONA CHARYA SEWA TRUST, a Company incorporated under the Companies Act 2013, having its Corporate Office at
GOITHAHA BAZAR SANTHA BAZAR through Shri/ Smt. VIJAY KUMAR TRIPATHI,DIRECTOR,DRONA CHARYA SEWA
TRUST (herein after referred to as "Company" which expression shall unless repugnant to the context thereof include its
successor) of the one Part

and

The Governor of Uttar Pradesh through Shri Prathamesh Kumar, Government of Uttar Pradesh (herein after referred to as
"GoUP" which expression shall unless repugnant to the context thereof include his successor in office) of the other Part.

Now, therefore, this MoU witnesses as follows:

Company wishes to establish the following Project in Uttar Pradesh :-

Project Name Project Details Location Investment Employme Proposed Year

Proposed (In nt (Nos) of
Crore INR) Commencement

DRONA CHARYA DRONA CHARYA HOSPITAL Sant Kabir 2 11 April, 2024

HOSPITAL Nagar

1. For establishment of aforesaid Project, GoUP would facilitate Company to obtain necessary permission / registrations /
approvals / clearances etc. as per the existing facilities / rules and regulations of the State GoUP and would also help to
avail incentives under various schemes announced by State / Central Government, wherever applicable.
2. GoUP will facilitate Company to establish the aforesaid Project in the State of Uttar Pradesh in a time bound manner.
3. Parties to this MoU agrees as below :
This MoU is not intended to provide any basis for any investment decision to be made by any interested parties
and each prospective interested party must make their own independent assessment of the Project;
None of the provisions of this MoU shall be deemed to constitute a Partnership between parties hereto, and no
party shall have any authority to bind or shall be deemed to be agent of the other in any manner whatsoever;
In due course of time, if the GoUP undertakes a transparent competitive bidding process based on the feasibility
reports to award the Projects, then the interested parties including Company may consider their participation as
per their discretion.

IN WITNESS WHEREOF the Parties hereto have set and subscribed their respective hands on the day and the year first herein

Page 1 of 2 Print as on: 18-08-2023

 MoU Number: 23/HEALTH/0000024762

before written.

For and on behalf of For and on behalf of

Government of Uttar Pradesh M/s. DRONA CHARYA SEWA TRUST

(AUTHORISED SIGNATORY) (AUTHORISED SIGNATORY)

Name:Shri Prathamesh Kumar Name: VIJAY KUMAR TRIPATHI
Designation: Additional Chief Executive Officer, Invest UP Designation:DIRECTOR
Contact No.: 0522-2720236, 2720238 Contact No.:+918707220114
Email: aceoinvestup@udyogbandhu.com Email: dssbasti@gmail.com
Contact Address::4th Floor Block A PICUP Bhawan, Contact Address: GOITHAHA BAZAR
Lucknow, Uttar Pradesh 226010 SANTHA BAZAR

Witness Signature:
Name:SARVESH DWIVEDI
Contact No.:8707220114

Page 2 of 2 Print as on: 18-08-2023

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 Reg No.IN-UP06278237708497V

DRONACHARYA SEWA TRUST

Reg.Off: Jamdeeh Pandey Colony, Kailly Road- Basti-Uttar Pradesh-272002
Operating Branch: Goithaha, Pasai, Sant Kabir Nagar (U.P)-272175
Email: dstbasti@gmail.com
Tel: +91-6387530602, +91-8707220114,
Ref: DST/GEM/EXP/01 Date: 01-08-2023

Experience Declaration

I “ Vijay Kumar Tripathi “ Director of “Dronacharya Sewa Trust” hereby declare that Our Trust Has

its own hospital and we have collaboration with “Dronacharya Sewa Sansthan” an experienced

Company in the field of Manpower Supply for Providing Consultation and Services for smooth

Running of The Project”

For the Organization,

Name: Dr. Vijay Kumar Tripathi
Designation: Director
(Seal & Signature)
 Reg No.IN-UP06278237708497V

DRONACHARYA SEWA TRUST

Reg.Off: Jamdeeh Pandey Colony, Kailly Road- Basti-Uttar Pradesh-272002
Operating Branch: Goithaha, Pasai, Sant Kabir Nagar (U.P)-272175
Email: dstbasti@gmail.com
Tel: +91-6387530602, +91-8707220114,
Ref: DST/Turnover/01 Date: 01-08-2023

Turnover Exemption Declaration

I “ Vijay Kumar Tripathi” Director “Dronacharya Sewa Trust” hereby Declare that Our Firm is

Registered with MSME, DIC Sant Kabir Nagar and Govt. of UP under Micro Small and Medium

Enterprise hence we are Exempted from Turnover Criteria of Procurement however we have

sufficient cash flow to Manage nay Project up to 1000 Manpower Capacity”

For the Organization,

Name: Dr. Vijay Kumar Tripathi
Designation: Director
(Seal & Signature)
 FORM II

[Under rule 21(1) and rule 29 (2) of the Contract Labour (Regulation and Abolition) Central
Rules, 1971]

APPLICATION FOR LICENCE UNDER THE CONTRACT LABOUR (REGULATION AND

ABOLITION) ACT, 1970 (37 OF 1970)

Acknowledgement Number: 21112303112571 Date of Application: 21-11-2023

Details of Contractor

1. Full Name of Contractor: DRONACHARYA SEWA TRUST through VIJAY KUMAR TRIPATHI

2. Full Address of Contractor : 103 New Jaamdeeh Pandey Colony, KAILLY ROAD BASTI, JAMDEEH

PANDEY, Basti, Uttar Pradesh, - 272001

3. LIN/PAN No. of Contractor: 1-6554-0790-7 / AAETD3334J

4. Email Id of Contractor: dstbasti@gmail.com

5. Mobile No. of Contractor: 8707220114

Particulars of Establishment where workman is to be employed

6. Name of PE's Establishment: DRONACHARYA SEWA TRUST

7. Name of Principal Employer: VIJAY KUMAR TRIPATHI DIRECTOR, DRONACHARYA SEWA TRUST,103

New Jaamdeeh Pandey Colony, KAILLY ROAD BASTI, JAMDEEH PANDEY, Basti, - 272001

8. Number and Date of Certificate of Registration of the Establishment under the Act:

UP06278237708497V Dated 13-01-2023

 Particulars of the Contract Labour

9. Nature of work in which workman is employed or is to be employed in the Establishment:

DRONACHARYA SEWA TRUST

10. Location of Work : ALL INDIA RADIO, KAMARAJAR, SALAI,MYLAPORE,CHENNAI, Chennai, Tamil

Nadu - 600004

11. Duration of proposed Contract Work -

1. Date of Commencement of work: 04-11-2023

2. Date of Completion of work: 04-11-2024

12. Name and Address of the Agent or Manager of Contractor at the work-site: RAJESH, ALL INDIA RADIO,

KAMARAJAR, SALAI,MYLAPORE,CHENNAI, Chennai, Tamil Nadu - 600004

13. Maximum number of workmen proposed to be employed on the Establishment on any date: 20

14. Whether a certificate by the Principal Employer, in Form III enclosed: No

15. Work Order Number: GEMC-511687766171223

16. Amount of Licence Fee : INR 15

17. Amount of Security Deposit : INR 1800

18. Jurisdiction for Licensing Officer : ALC I Chennai ( ALCCHENNAI1 )

Signatur of Contractor
(eSign/DSC)
Note: This is an online application summary applied on Shram Suvidha Portal.