Application Form For Grant of Financial Assistance under the Scheme of Strengthening of Nodal Agencies 1. Name, complete address : Tel No., Fax No. of the Nodal Agency 2. Date from which designated as: as Nodal Agency 3. Reference No., date and : amount of one time grant (lump sum) last sanctioned 4. Whether U.C. for the above : grant has been furnished and if so, the reference No. and date 5. Reference No., dated and : amount of recurring grant last sanctioned and the year for which granted 6. Whether U.C. for the above: grant has been furnished and if so reference No., and date 7. Amount of grant applied for: (whether one time and/ or recurring 8. Details of one time grant : Item Estimated cost (This is available for installation i) of basic office equipment including ii) computer system, internet etc. iii) iv) 65 66 9. Details of recurring grant: Item Estimated cost (This is available for meeting i) expenditure on engaging ii) personnel for preparation of iii) data base, publication of profiles, iv) office consumables etc. Total Place Name, signature & designation of the authorized signatory Date Tel No. Fax No.
