Download Application Form to Avail the Scheme to Promote Voluntary Action for Persons with Disabilities

v{ke O;fDr;ksa ds fy, oksysUVjh ,sD'ku dks c<+kok nsus dh ;kstuk (Scheme to Promote Voluntary Action for Persons with Disablities) Annexure-II MINISTRY OF SOCIAL JUSTICE & EMPOWERMENT Name of the Scheme: I. APPLICATION FORM NEW PROPOSAL (To be submitted in Duplicate) 1 ORGANISATION Name Address (Office/Project) Phone/Fax/Telex (Office): (Project): 2 (i) Name of the Act under which registered : (ii) Registration No. and date of Registration : (Please attach a Photocopy) Any other Organisation/Institute/Body, if applicable,give details (Please see note (ii) below) 3. Registration under foreign contribution Act: 4. Memorandum of Association and Bye-Laws: (Please attach a photocopy) 5. Name, address, occupation & other particulars of the Members of the Board of Management/Governing body. : 6. Details of the project for which the Grant-in-aid: is being applied (here please mention the summary of the project alongwith financial details) 7. Grant-in-aid applied for the current year: Non-recurring Recurring 8. List of the documents to be attached:- a) A copy of the annual report for the Previous year, b) Audited Statement of accounts duly certified by CA for the two years (i) Receipt & payment A/C (by CA) for last two years, (ii) Income & Expenditure/C(by CA) for last two years, (iii) Utilisation certificate for the last two years (by CA) (iv) Balance Sheet for the last two years (by CA0 c) Details of Staff Employed (Appendix-II) d) Details for beneficiaries to be covered (Appendix-II) e) If hostel is maintained, then number of hostellers, Number of Non-hostellers f) Other items, if any, g) Whether located on its own/rented building (Necessary evidence to be attached) 9. If the application is for construction of building, the following additional documents are to be submitted; i) Blue print (Site Plan) of the proposed building, ii) Detailed structural estimates of the construction, iii) Certificate to the effect that proposed cost of construction is not more than the prevailing PWD rates. iv) Proof for permission of land(in name of the organisation). v) Permission for construction of building from local authorities. 10. If the proposal is for establishment of special school, concerned NI's recommendation is also required to be obtained. 11 Whether the organisation is receiving or expecting to receive any grant from some other source for the project for which application is being made? If yes, give details. 12 I , hereby certify that I have read the rules and regulations of the scheme and I undertake to abide by them. On behalf of the Management, I further agree to the following conditions:- a) All assets acquired wholly or substantially out of the central grant shall not be encumbered or disposed of or utilised for purposes other then those for which the grant is given. Should the organisation cease to exist at any time such properties shall revert to the Government of India. b) The accounts of the project shall be properly and separately maintained. They shall always be open to check by an officer deputed by the Government of India or the State Government. They shall also be open to a test check by the Comptroller and Auditor General of India at his discretion. c) If the State or the Central Government have reasons to believe that the grant is not being utilised for approved purposes; the Government of India may stop payment of further installments and recover earlier grant is such manner as they may decide. d) The institution shall exercise reasonable economy in its working especially in respect of expenditure on building. e) In the case of grant for buildings, the construction will be completed within a period of two years from the date of receipt of the first installment of grant unless further extension is granted by the Government of India. f) No change in the Plan of building will be made without the prior approval of the Government of India. g) Progress reports on the project will be furnished at regular intervals as may be specified by the Government. h) The organisation will bear the balance of the estimated expenditure on the project or the organisation will bear ten percent of the expenditure or the organisation will not bear any expenditure and the entire balance will be borne by the State Government; and i) The organisation agrees to make reservation for the Scheduled Caste/Scheduled Tribe candidate/Disabled persons for appointment against the posts required for the working of the organisation in accordance with instruction issued by the Government of India from time to time. Yours faithfully Signature of the Authorised Signatory Name: Designation: Address: Date: Office Stamp: i) No column to be left blank, wherever necessary, please write NA (not applicable) ii) The term 'new' means NGOs who are functioning for at least 2 years from the date of registration. However, it will be open to the Central Government to entertain the application, in relaxation of the condition. iii) The term 'audit' means a/cs duly audited by the C.A. along with its audit report and not mere compilation/preparation of reports on the basis of the books produced. Annexure-III MINISTRY OF SOCIAL JUSTICE & EMPOWERMENT Name of the Scheme : I APPLICATION FORM FOR Ist INSTALLMENT (To be submitted in Duplicate) I. ORGANISATION Name: Address (Office/Project) Phone/Fax/Telex (Office): (Project): 2. Audited/unedited accounts for the previous year indicating the expenditure incurred on each sanctioned item vis- -vis the grant sanctioned (Not for a new NGO) (See note below) 3. Budget Estimates for the financial year for which grant-in-aid is required (show recurring and non-recurring items separately) 4. Whether financial asssistance has been availed in previous 3 years a) If yes, amount year wise 5. Name, address & occupation and other particulars of the members of the managing committee. Please state whether there is any change. If yes, specify details. 6 I, hereby certify that I have read the rules and regulations of the scheme and I undertake to abide by them. On behalf of the Management, I further agree to the following conditions:- (a) All assets acquired wholly or substantially out of the central grant shall not be encumbered or disposed of or utilised for purposes other than those for which the grant is given. Should the organisation cease to exist at any time such properties shall revert to the Government of India. b The accounts of the project shall be properly and separately maintained. They shall always be open to check by an officer deputed by the Government of India or the State Government. They shall also be open to a test check by the Comptroller and Auditor general of India at his discretion. c If the State or the Central Government have reasons to believe that the grant is not being utilised for approved purposes; the Government of India may stop payment of further installments and recover earlier grant is such manner as they may decide. d The institution shall exercise reasonable economy in its working especially in respect of expenditure on building. e In the case of grant for buildings, the construction will be completed within a period of two years from the date of receipt of the first installment of grant unless the Government of India grants further extension. f No change in the Plan of building will be made without the prior approval of the Government of India. g Progress reports on the project will be furnished at regular intervals as may be specified by the Government. h The organisation will bear the balance of the estimated expenditure on the project or the organisation will bear ten percent of the expenditure or the organisation will not bear any expenditure and the entire balance will be borne by the State Government; and i The organisation agrees to make reservation for the Scheduled Caste/Scheduled Tribe candidate/Disabled persons for appointment against the posts required for the working of the organisation in accordance with instruction issued by the Government of India from time to time. Yours faithfully Signature of the Authorised Signatory Name: Designation: Address: Date: Office Stamp: Note:- The term audit means a/cs duly audited by the C.A. along with its audit report and NOT mere compilation/preparation of reports on the basis of the books produced. Annexure-V STANDARDISED CALCULATION SHEET FOR NEW PROJECTS AND CONTINUING PROJECTS Ministry of Social Justice & Empowerment (DD-II Section) Name of the Organisation Purpose for which grant requested No. of Beneficiaries Last Year Current year Recurring/Non-recurring S.No. Name & Post/Item Honorarium paid last year Grants Allowable Whether Edu. Qualification as per revised norms met (Yes/No) Hon. Admissible as per norms Grant Proposed / reco. mm.. by State Govt./ NGO panel To be sanctioned during Per Month Per Annum (1) (2) (3) (4) (5) (6) (7) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 i) Separate Sheet may be used for Total Recurring & Non-recurring Grants 90 Percent ii) Separate Sheets may be used Ist Installment--------------- for separate projects Unspent Balance------------ 2nd & Final Installment------------- Signature of the Authorised Signatory Name: Designation: Address: Date: Office Stamp: APPENDIX I MINISTRY OF SOCIAL JUSTICE & EMPOWERMENT Name of the Scheme: DETAILS OF THE STAFF EMPLOYED Part I (Previous year) (i) Name of the Organization (ii) Name and address of the project (iii) Year Sr.No. Name and address Educational qualification Date of appointment Whether SC/ST/ OBC/ Disabled Period for which employed during the year Salary per month Total Salary paid during the year Remarks 1 2 3 4 5 6 7 8 9 Part II(Current year) (i) Only notify change from the previous year (ii) In case there is no change in Part I from the previous year, please certify as follows: "No change in Staff particulars from the previous year". APPENDIX II MINISTRY OF SOCIAL JUSTICE & EMLOYMENT Name of the Scheme DETAILS OF THE BENEFICIARIES Part I (Previous Year) (i) Name of the Organization (ii) Name and address of the project (iii) Year No.of Beneficiaries (Give name, Address of the beneficiaries separately) Male Below 18 years Female Below 18 years Age 18 years and above Type of Disability (1) (2) (3) ( 4) (5) (6) APPENDIX III Form GFR 19 (See Government of India's Decision (7) (b) under Rule 149(3)) Assets acquired wholly or substantially out of Government grants Register maintained by grantee institution ---------------------------------------------- Block Account maintained by Sanctioning Authorities Name of the Sanctioning Authority Sr. Name of the Grantee Institu-tion No. and date of sanction Amount of the sanct-ioned grant Brief purp-ose of the grant Whether any condition regarding the right of ownership of Govt. in the property or other assets acquired out of the grant was incorporated in the grant-in-aid sanction. Particu-lars of assets acutally credit-ed or acqui-red Value of the assets as on Purp-ose for which utili-sed at pres-ent Encu-mbered or not Reasons if encu- mbered Dispos- ed of or not Reas-on and autho-rity , if any, for disp-osal Amo-unt reali-sed on dispo-sal Rem-arks 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Place: Signature Date: Signature of Secretary / President: Seal of the Organisation Note: In case there is no change from the previous year a photocopy of the statement of the previous year be furnished with the following statement "No change from the year ---------------------------------". Annexure-VI MINISTRY OF SOCIAL JUSTICE & EMPOWERMENT DD-II Section File No. New Project Financial Year CHECKLIST FOR PROCESSING GRANT-IN-AID PROPOSAL FROM THE VOLUNTARY ORGANISATION FOR NEW PROJECTS (To be filled in by the NGOs) 1. Particulars of the Organisation j) Name of the Organisation iii) Registration No. & Date. iv) Whether Registration Certificate is valid. v) Whether has completed two-year of existence.(w.e.f. the date of registration) vi) Whether Memorandum of Association and Byelaws furnished. vii) Whether composition of the Managing Committee furnished as per col. Whether audited accounts for the last two years furnished. viii) (a) Receipt & Payment A/C (by CA) for last two years, (b) Income & Expenditure A/C (by CA) for last two years, (c) Utilisation Certificate for last two years (by CA) (d) Balance Sheet for last two years (by CA) (e) Whether located on its own/rented building (necessary evidence may be verified). II Details of the New Project (s) i) Specific purpose for which project proposed to be started ii) Date from which to be started iii) Whether similar project already exists in the area iv) Extent and nature of problem (i.e.for which project proposed to be started) in the area v) Details of Expenditure of Organisation/Member of Managing Committee to run the project vi) Amount of the Grant required recurring Non- recurring vii) Whether organisation fulfills eligibility condition for grant viii) No. of beneficiaries proposed to covered; Hostellers Non-hostellers ix) Whether the organisation is receiving or expecting to receive any grant from some. Other source for the project applied for? If yes, give details. III Details of Projects of the Organisation already being assisted under the scheme. a) Name of the Project Amount of grant given last year Whether the performance of project is satisfactory IV. For construction of building the following details are to be verified; (b) Whether blue print submitted, (c) Detailed structural estimates submitted (d) Whether certificate to the effect that proposed cost of construction is not more than the prevailing PWD rates, (e) Proof of possession of land (in the name of the Organisation) (f) Permission from local authorities obtained or not (Verify necessary evidence and attach copy) Signature of the authorised Signatory Name: Designation Address Date Office Stamp (To be filled by the Govt./competent Authority) I have verified the above noted facts furnished by the organisation. (i) Whether any complaint received against the organisation. (ii) If so, whether any enquiry conducted and if so, the result thereof? (iii)Whether any audit objection/Audit para pending? (iv) If so, settled or not? (ii) Whether recommendation of the State Govt./ any other agency received? (iii) Whether recommendation of NI (for Special School) received (iv) Amount of grant proposed to be sanctioned (i.e.90%) First installment Rs. Second Installment Rs. Total Rs. (v) A detailed inspection report is also enclosed. Signature of the Authorised Signatory Name: Designation Address Date: Office Stamp Annexure-VII CHECK LIST FOR THE IST INSTALLMENT (To be filled in by the NGO) Subject: Grant-in-aid to----------------------- The case relates to the release of First Installment for----------------to the Voluntary Organisation namely-----------------------------in regard to their project------------------it is a continuing project. Last year, an amount of Rs----------------------was sanctioned /released to this organisation for this project. The organisation has submitted the following documents:- 3. Budget Estimate for ----------------------------------- (Indicate the year for which grant is sought) 2. Progress Report/Annual Report for---------------------------- (Indicate the year ending 31st March) 3. Audited/Unaudited Balance Sheet as on 31.03--------------------- 4. Audited/Unaudited Income & Expenditure for 31.03---------------------------------------- 5. Audited/Unaudited Receipt & Payment for 31.03------------------------- 6. Audited/Unaudited Utilisation Certificate alongwith Item / post wise Expenditure Statement according to sanctioned break-up 7. Rent Agreement, if rent claimed 8. List of staff with qualification and date of appointment. 9. There is an amount of Rs----------------no unspent balance lying with the organisation Signature of the Authorised Signatory. Name: Designation Address Date: Office Stamp (To be filled by the Govt./competent Authority) (i) I.F. Division may kindly see for concurrence for Rs.-------------as Ist installment during------------ Signature of the Authorised Signatory Name: Designation: Address: Date: Office Stamp Annexure-VIII CHECK LIST FOR THE ii INSTALLMENT (To be filled by the NGO) File No. Continuing Project Ministry of Social Justice & Empowerment Financial year Checklist for processing Grant-in-aid cases for release of grant for on-going project under the scheme of assistance to Organisation for the Disabled Persons. I. Details of Voluntary Organisation i) Name of the Voluntary Organisation ii) Whether has furnished Registration Certificate ? iii) Whether has furnished composition of the Managing Committee ? II. Details of on-going project being run by the Organisation under the Scheme. S.No. Name of the Project Amount of Grant given last year ...... ................................ .................................................. (III) Documents required for the release of first installment i) Name of the Project ii) Whether audited/Unaudited Accounts for the previous year furnished iii) Performance Report No. of beneficiaries in the last year No. of beneficiaries in the current year Whether Performance satisfactory Non-hostlellers/ Hostllers Hostllers Non -Hostllers iv) Whether budget estimate for the current year furnished IV. Documents filed for release of Second Installment i) Income & Expenditure statement of the Organisation as a whole ii) Receipt and payment statement for the Organisation as a whole iii) Balance Sheet for the Organisation as a whole. iv) Item-wise expenditure w.r.t. the grant sanctioned. v) Utilisation Certificate Note: Documents at Sr. (I) to (v) above should be duly certified by the Chartered Accountant. V. Whether has furnished list of staff employed at the project in proforma ? VI. Whether the State Govt./Competent Authority has recommended request of organisation. VII. Details of last year grant i) Amount Sanctioned ii) Amount released iii) Unspent Balance, if any iv) Recurring grant v) Non-recurring grant VIII. Whether the organisation is receiving or expecting to receive any grant from some other source for the project applied for? If yes, give details. Signature of the Authorised Signatory Name: Desigantion: Address: Date: Office Stamp: (to be filled in by the competent Govt. authority) I have verified the above noted facts furnished by the organisation. I. Grant proposed to be sanctioned during the current financial year (90%) a) Amount of total grant proposed to be sanctioned. b) Less unspent balance, if any out of last years grant c) Amount of Ist installment to be released d) Amount of IInd and final installment proposed to be released II. Detailed Inspection report also enclosed Details of complaint/Audit Para i) Whether any complaint received against the organisation. ii) If so, whether any enquiry conducted. iii) If so, the result thereof iv) Whether any audit objection/ audit para pending v) If so, whether settled or not Signature of the Authorised Signatory Name: Desigantion: Address: Date: Office Stamp: