FORM NO. 58A
[See rule 11-O(1)]
Certificate of expenditure by way of payment in respect of eligible projects or schemes notified under section 35AC

1. Certified that…….[name & address of donor] (P.A. No…..) has paid a sum of Rs………….[in figure]…………[in words] on………[date] in cash/by cheque No./Demand Draft No…………..in respect of [name of project or scheme] project or scheme which has been notified under section 35AC vide Notification No. SO………dated………issued from File No…………at an estimated cost of Rs………….for assessment year(s)………….
2. It is further certified that the amount received from the donor is within the amount of the project/scheme approved by the National Committee under section 35AC of the Income-tax Act as may be seen from the following :
Amount in Rs.
Amount received till date as donations from others prior to this donation :
Amount received from donor named in Paragraph 1…………………..      
Total amount received for the project/scheme including the amount covered under this certificate………………                                                                                                           
Total cost of the project/ scheme approved by the National Committee under section 35AC ………………………                                                                                                          
3. An annual statement of donations received and the details of project will be sent to the National Committee and the donor by 30th June following the financial year in which the amounts are received.
Name …………                                                  Signature ………………….
Address ………………                                       Name…………………….
Permanent Account No………….of the                    ……………….
donee organisation.                                            Designation of the person managing the 
                                                                           affairs of the donee organisation
Date……………………………..