Bhopal Ki Nari Hain, Phool Nahi
Hain
acknowledgment thank you for joining the chingari trust family Donations to Chingari Trust are exempt from 50% tax under section 80G of the Income Tax Act.
Title
First Name
Donation Amount
Last Name Donation Frequency
THANK YOU We acknowledge the receipt of your donation form. Your donation will help the children born in families affected by Bhopal Gas Tragedy and the subsequent water contamination in the area.Our PAN for tax exemption purposes is : AAATC7309L. Your first donation will be debited within the next 30 days. We will send you a consolidated receipt and tax exemption certificate once every year. Please note : Chingari Trust does not ask for/ accept cash donations If you have any questions, please feel free to get in touch with us using any of the channels below: CHINGARI TRUST Satguru Complex, Near DIG Bunglow Square, Berasia Road,Bhopal - 462001 | Website : www.chingaritrustbhopal.com E-Mail : chingaritrust@gmail.com | Tel : +91 755 2747500, 2730600
thank you for joining the chingari trust family donation form
Donations to Chingari Trust are exempt from 50% tax under section 80G of the Income Tax Act.
Title
First Name
Last Name
Communication address Pincode Telephone Number
Mobile Number
Date of Birth
E-mail Name on receipt
PAN No.
I would like to support children affected by Bhopal Gas Tragedy.
Signature
D D M M Y Y
Debit Mandate Form NACH / ECS / DIRECT DEBIT UMRN Tick (ü)
Date
SBIN0001308
Sponsor Bank Code
CREATE MODIFY CANCEL
Utility Code
I/We hereby authorize CHINGARI TRUST
NACH00000000022869 To debit (Tickü) SB /CA /CC /SB-NRE /SB-NRO /Other
Bank a/c number
IFSC
with Bank
or MICR
an amount of Rupees FREQUENCY
Mthly
Qtly
H-Yrly
Yrly
As & when presented
Reference 1
Fixed Amount
Maximum Amount
Phone No.
Reference 2 PERIOD
DEBIT TYPE
Email ID I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.
From To Or
ü Until Cancelled
Signature Primary Account holder
Signature of Account holder
Name as in bank records
Name as in bank records
1.
2.
Signature of Account holder
3.
Name as in bank records
This is to conrm that the declaration has been carefully read, understood & made by me/us. I am authorizing the User entity/corporate to debit my account. Based on the instruction as agreed and signed by me. I have understood that I am authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the user entity/corporate or the bank where I have authorized the debit.
Form ID
Fundraiser Signature
Fundraiser Name
Fundraiser ID
Debit Mandate Form NACH / ECS / DIRECT DEBIT UMRN Tick (ü)
Date
SBIN0001308
Sponsor Bank Code
CREATE MODIFY CANCEL
Utility Code
I/We hereby authorize CHINGARI TRUST
NACH00000000022869 To debit (Tickü) SB /CA /CC /SB-NRE /SB-NRO /Other
Bank a/c number
IFSC
with Bank
or MICR
an amount of Rupees FREQUENCY
Mthly
Qtly
H-Yrly
Yrly
As & when presented
Reference 1
Fixed Amount
Maximum Amount
Phone No.
Reference 2 PERIOD
DEBIT TYPE
Email ID I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank.
From To Or
ü Until Cancelled
Signature Primary Account holder
Signature of Account holder
Name as in bank records
Name as in bank records
1.
2.
Signature of Account holder
3.
Name as in bank records
This is to conrm that the declaration has been carefully read, understood & made by me/us. I am authorizing the User entity/corporate to debit my account. Based on the instruction as agreed and signed by me. I have understood that I am authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the user entity/corporate or the bank where I have authorized the debit.
Form ID
Fundraiser Signature
Fundraiser Name
Fundraiser ID