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                                                                                 Sansthan PAN No. AAHTS3108C

Income Tax Exemption : The Sansathan is Registred under the Section-12A of Income tax, Visakhapatnam. All donations are exempted from Income Tax, under the section 80G of Income tax Act 1961 as per the proceedings of the Commissioner of Income Tax.
 
 

Members Application Form

Request
Name                            : _____________________

DOB                              : _____________________

Name of Father            : _____________________

Name of the Spouse    : _____________________

DOB of Spouse             : _____________________

Marriage Date              : _____________________

Occupaiton                   : _____________________

Permanent Address     : _____________________

                                      _____________________
                                     
Phone No.                    : _____________________

Mobile No.                    : _____________________


Membership Fee
LIFE MEMBER     Rs. 2,100/-
PATRON             Rs. 11,000/-
CHIEF PATRON   Rs. 21,000/-

Please sponsor a Child : You can also sponsor a child's education, food, Medicals treatment and clothing by adopting a child. This sponsorship is for the purpose of care talking and for meeting the monetary expenses only.
You can renew your commitment annually.

Sponsorship Costs :
a) Child's education Rs. 6000/- annually per child.
b) Child's education and food Rs. 12,000/- annually per child.
c) Child's medical needs inclusive of items (a) and (b) Rs. 18,000/-     annually per child. 
d) Child's clothing Rs. 3000/- annually per child.

Yes, I would like to spnsor the following :
1. Rs. 6000/-   2. Rs. 12,000/-   3. Rs. 18000/-

Please find enclosed herewith our cheque / DD NO. _____________ Dt_________ in favour of Sri Balaji Seva Sansthan, Visakhaptnam.
or Sansthan A/C No. 0787351000001906, The Laxmi Vilas Bank Ltd. Visakhapatnam.

Donor's Name and Address _____________________

Mobile No. ____________    Email ID _____________



 
     
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