Government of India
North Eastern Council
Annexure – I
Proforma for Application
ORGANIZATION PROFILE
1. Name of the Organization
2. Name of the Website/ Social Medial link
3. Address, Street, District State Pin Code, Phone & Fax No, (with STD
Code) E-mail
4. Name, Designation, Aadhar Number & address of Chief functionary
5. Name of other key Functionaries & their Aadhar Number, Contact No. &
Address
6. Registration details Act Under which registered Date of registration
7. FCRA NO. (if available)
8. PFMS Registration No. with NEC
9. Unique identifier of NGO Darpan, NITI Aayog Portal
10. Activities in brief
11. Thrust Area
12. Experience in the area in which funding is sought
13. Source of funds (last three years)
National/ Name of the Amount Year
International Project received
14. Banking details (Account No. Name & Address of the bank)
15. Has the work of your organization been evaluated by any independent
agency, if yes, Please attach the evaluation report
PROJECT PROFILE
1. Title of the Project
2. Aims & Objectives
3. Duration
4. The project description needs to include following details
i. Project goal
1
ii. Project area
iii. Target Group
iv. Problems to be addressed
5. Details of any ‘need assessment’ done in the area before deciding on
the project
6. Beneficiary oriented? (Yes/ No)
7. Strategy / Action Plan
8. Voluntary contribution from the community
9. Monitoring & Evaluation indicators
10. Project sustainability (How will the activities be sustained after project
support is completed)
11. Proposed Budget for the project
ATTACHMENTS TO BE FURNISHED
1. Registration certificate
2. By-laws & Memorandum of Association
3. Annual Report (latest one year)
4. Audit statements (for last three years)
5. Latest list of Executive Committee Members (copy of Aadhar Card)
6. List of Employee
All attached photocopies of documents should be attested by Gazetted
officer/ Notary
Annexure – II
Self –Certificate regarding financial assistance
received/ applied for from other Ministries/ Department of
GoI/ State Government
(on official letter head)
This is to certify that the (name of VO/NGO/Agency) has received/
applied for Rs. which is % of the total budget of the event from
(name of Ministry/ Department of GoI/ State Govt.)
Signature with stamp
2
Annexure – III
Certificate for Financial Contribution Statement
(on official letter head)
This is to certify that the (name of VO/NGO/Agency) is contributing
Rs. which is % of the total budget of the event.
Signature with stamp
Annexure – IV
Acknowledgement for receipt of Sanction
(on official letter head)
This is to acknowledge that the sanction of Rs. (in words) to
(name of VO/NGO/Agency) has been received on
(date) for organizing (name of the project).