Ministry of Home Affairs

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2 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 Form FC-4 [See rule 17(1)] Subject: Account of Foreign Contribution for the year ending on the 31st March, Association FCRA registration number and name (i). Number : (ii). Name : ACCESS Development Services 2. Details of receipt and utilisation of foreign contribution : i. Foreign Contribution received in cash/kind(value): 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.) *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 ii (a). Donor wise detail of foreign contribution received in excess of rupees 20,000: Sl.No Name of donors /Individu al Detail of the donor: official Address; address; website address: 1 HSBC 52/60, Mahatma Gandhi Road, Fort Mumbai , manekakumar@hsbc.c o.in, Website Purposes for which received Ministry of Home Affairs 2 LIC Housing Finance 131 Maker Tower F Premises 13th Floor Cuffe Parade Mumbai , India, Id:, Website 3 HDFC LIMITED Raman House HT Parekh Marg, 169 Backbay Reclamation church Gate Mumbai , deposits@hdfc.com, Website 4 Department for International Development 5 Bill and Gates Melinda DFID India,British High Commission,Shantpath, Chankayapuri,New Delhi , India, P.O. Box 23350, Seattle, WA98102, USA,, United States of America, Id: Bakhshi@gatesfoundat ion.org, Website Amount (Rs.) Social Social Social Social Social FCRA Annual Returns for the financial year has been Submitted on 26/12/2018 Page 1 of 4

3 Sl.No Name of donors /Individu al Detail of the donor: official Address; address; website address: 6 Give to Asia 600 California Stree,11th Floor San Francisco,CA 94108, United States of America, Id:, Website 7 Bill and Melinda Gates P.O. Box 23350, Seattle, WA98102, USA,, United States of America, Id: Bakhshi@gatesfoundat ion.org, Website 8 HSBC 52/60, Mahatma Gandhi Road, Fort Mumbai , manekakumar@hsbc.c o.in, Website 9 Rockfeller Philanthorpy Advisers inc 10 Stichting Rabobank 6, West, 48th Street, 10th Floor, New York , United States of America, Id: kthacker2@pnbmetlife. com, Website UCT 0407,P.O.Box 17100,3500 HG UTRECHT,Netherland s, Netherlands, Id:, Website 11 ACCION International 10 Fawcett street Suite 204 Cambridge MA U.S.A., United States of America, 12 Department for International Development 13 United Way Worldwide Purposes for which received Ministry of Home Affairs Amount (Rs.) Social Social Social Social Social Social DFID India,British High Commission,Shantpath, Chankayapuri,New Delhi , India, Social North Fairfax Street Alexandria,Virginia , United States of America, 14 VSO India Trust 4th Floor, Sri SIM Trust Complex, Plot No. 7, Area, Vasant Kunj, New Delhi , India, 15 Stitching Oikocredit International Support Berkenweg 7,3818 LA Amersfoort,The Netherlands, Netherlands, Id:, Website 16 GIZ A-2/18,Safdarjung Enclave,New Delhi , India, Id:, Website 17 Axis Bank Ltd K-12, Green Park Main New Delhi , Greenpark.Operationsh ead@axisbank.com, Website 18 HSBC 52/60, Mahatma Gandhi Road, Fort Mumbai , manekakumar@hsbc.c o.in, Website 19 ACCION International 10 Fawcett street Suite 204 Cambridge MA U.S.A., United States of America, Social Social Social Social Social Social Social FCRA Annual Returns for the financial year has been Submitted on 26/12/2018 Page 2 of 4

4 Sl.No Name of donors /Individu al 20 Michael and Susan Dell (b). Cumulative purpose-wise amount of all foreign contribution donation received : (iii). Details of Utilization of foreign contribution: Detail of the donor: official Address; address; website address: P O Box Austin, Texas USA, United States of America, Id: Varun.Saini@msdf.org, Website 21 Give to Asia 600 California Stree,11th Floor San Francisco,CA 94108, United States of America, Id:, Website 22 VSO India Trust 4th Floor, Sri SIM Trust Complex, Plot No. 7, Area, Vasant Kunj, New Delhi , India, 23 US EMBASSY United State Department of State, Wasington DC, , United States of America, Id: desaike@state.gov, Website 24 Padma Behera Maharana Colony, G. Udayagiri, Kandhamal Orissa , India, 25 GIZ A-2/18,Safdarjung Enclave,New Delhi , India, Id:, Website 26 Axis Bank Ltd K-12, Green Park Main New Delhi , Greenpark.Operationsh ead@axisbank.com, Website 27 Stitching Oikocredit International Support Berkenweg 7,3818 LA Amersfoort,The Netherlands, Netherlands, Id:, Website Sl.No Purpose Amount Purposes for which received 1 Social a. Total Utilization* for projects as per aims and objectives of the association (Rs.) Ministry of Home Affairs b. Total Administrative Exprenses as provided in Rule 5, FCRA 2011 (Rs.) c. Total invested in term deposits(rs.) d.total Purchase of fresh assets(rs.) Total utilzation in the year(rs.) (a+b+d) Amount (Rs.) Social Social Social Social Social Social Social Social * 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 FCRA Annual Returns for the financial year has been Submitted on 26/12/2018 Page 3 of 4

5 (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. : (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 Branch Address( With pincode) 1 AXIS BANK K 12 GREEN PARK MAIN, New Delhi, Delhi, Delhi 3. (b) Details of all utilization bank accounts for utilization of Foregin Contribution (As on 31st March of the year ending) Sl.No Name of Bank Branch Address( With pincode) 1 AXIS BANK Green Park Main,, New Delhi, Delhi, Delhi 2 AXIS BANK Green Park Main,, New Delhi, Delhi, Delhi 3 AXIS BANK Green Park Main,, New Delhi, Delhi, Delhi Declaration I hereby declare that the above particulars furnished by me are true and correct 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. IFSC Code UTIB IFSC Code UTIB UTIB UTIB Ministry of Home Affairs Account No XXXXXXXXXXX9575 Account No XXXXXXXXXXX3131 XXXXXXXXXXX5945 XXXXXXXXXXX2125 Signature of the Cheif Functionary FCRA Annual Returns for the financial year has been Submitted on 26/12/2018 Page 4 of 4

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