dkedkth efgykvksa ds fy;s Nk=kkokl fuekZ.k@foLrkj (Construction/Expansion of Hostel Buildings for Working Women) (TO BE SUBMITTED IN DUPLICATE) Central Scheme of Assistance for Construction/Expansion of Hostel Building for Working Women with a Day -Care-Centre SUPPLEMENT TO THE APPLICATION FORM PART-I (Note Application received in an incomplete form or after the prescribed date will not be entertained) (To be completed by the applicant) 1. Name of Organisation/Institution----------------------------------- 2. Brief history of organisation/institution and description of its objects and activities--------------------------------------. 3. Whether recognised by the State Government--------------------------------. 4. Whether the organisation/institution is registered under Indian Societies Registration Act, 1860(Act XXI of 1860) or corresponding State Acts, or it is managed by a Trust or Body of Trustees, (Details of registration with the Name of theAct) ------------- 5. Whether the organisation/institution is managed by Central Government/State Government or Local Body---------------------------. 6. Whether the organisation/institution is of All-India character. If so, give the nature of its All-India activities----------------------------------. 7. Whether organization/institution has already a hostel if so, whether its own or in a rented building stating number of inmates---------------------. 8. Number of working women for whom hostel is intended to be constructed and also the number of the pre-school children for whom the day care centre is proposed. ----------------------------------------------------------------------------------- 9. Likely date of commencement and completion of hostel building --------------------------------------------------------------------------. 10. Whether the project is likely to be assisted by some other official or non-official agency. If so, their name and the extent of assistance proposed to be provided by each may be indicated.------------------------------------------------------------------. 11. Justification of the project indicating the outstanding features, which entitle it Central Assistance. ------------------------------------------------------------------------------------- 12. Details of the project: a. Total estimated expenditure on the Project b. Amount of grant required from Government of India. c. Source(s) from which the balance expenditure is proposed to be met. ---------------------------------------------------------------------------------. 13. Whether necessary land for the proposed building is available if so, give details in India (Location and area) with evidence for ownership ------------------------------------------------------------------------------------- 14. Details of plinth area to be constructed in relation to the number of working women for whom construction to be undertaken including number of rooms with capacity number of floor, toilets and common facilities ----------------------------------------------------------------------------------. a. Whether plinth area is according to the standard laid down by the State Government / Local Administration for similar projects ----------------------------------------------------------------------------------. b. Whether trained staff and other suitable facilities for undertaking construction are available, If so, give details --------------------------------------------------------------------------------- 15. Whether the institution/organisation is in a position to meet the balance expenditure, if so, indicate the source(s) ------------------------------------------------------------------------------. 16. List of papers/statements to be attached a. Prospectus of the voluntary organisation/institution of a brief description of its objectives and activities b. Constitution of the Organisation/Institution; c. Constitution of the Board of management and the particulars of each member d. Copy of the latest available Annual Report; e. Detailed structural financial estimates of the hostel building, giving item-wise details of recurring and non-recurring expenditure and the sources from which the remaining funds will be obtained. f. Information relating to the grants received, from, promised by or the requests made to other bodies, e.g. State Governments, Local Bodies etc. for the construction of the proposed hostel building. The decisions of these bodies on such requests would be communicated to them; g. A statement of the full receipts and expenditure of the voluntary organisation/ institution for the last two years and a copy of the balance sheet for the previous year certified by authorised auditors/ Chartered Accountant; h. A copy of site-plan of the proposed hostel building with a certificate from the local municipal authorities that the construction of the building has been permitted; i. A certificate to the effect that the rates of construction to be adopted are not in excess of the schedule of rates of the PWD of the State concerned duly counter-signed by the Head of the State PWD concerned or its nominee; j. Documentary proof of ownership of; lot on which the hostel is proposed to be constructed. 17. List of additional papers, if any 18. Additional Information, if any Date------------------ Signature Name in block letters Designation Office Stamp PART-II Recommendation of the State Government/Union Territory Administration . The application from ----------------------------------------is forwarded duly recommended to the Department of Women & Child Development, Government of India with the following comments a. that a senior officer of the ---------------------Department has visited the institution/organisation with a copy of this report. b. that the institution/organisation is recognised and/or registered under the Indian Societies Registration Act, 1860 or correspoinding State Act/Public Trust (give numbers); c. that the application has been examined and that it is found to be covered under the scheme; d. that the hostel building for which the application is being recommended is absolutely essential in the area for the following reasons---------------------. e. that there is a minimum of 25 working women in the area; f. that its work in the field of welfare of women/social welfare/women's education has been reported as satisfactory during the last three years; g. that the organisation/institution is not run for profit to any individual or a body of individuals. h. that the organisation/institution does not charge capitation or other similar fees from inmates of other states; i. that the land for the construction of hostel building is available. The locality is good and respectable. j. that the accommodation proposed to be constructed and rates of the proposed construction to conform to the standards laid down by the State Government. k. that assistance has/has not been given by the State Govt. In the former case, details of the assistance sanctioned during the last five years for the purpose may be given------------------------ l. that the organisation/institution is on a sound financial position; and m. the organisation/institution has facilities, resources, personnel and experience to initiate construction of the hostel building and the balance expenditure will be met by the organisation/institution or by the State Government. 2. The State Government/Union Territory Administration recommend that the grant for Rs.-------------- may be sanctioned to the organisation/institution by the Ministry of Human Resource Development, Department of Women & Child Development for the construction of the hostel building. Date-------------------------- Signature Name in block letters Designation Office Stamp
