FORM GFR 19 A (See Government of India's Decision (1) below Rule 150) Form of Utilisation Certificate S.No. Letter No. & Date Amount Total . Certified that out of Rs........ of grants-in-aid sanctioned during the year .... under this Ministry/Department Letter No. given in the margin and Rs....... on account of unspent balance of the previous year, a sum of Rs...... has been utilised for the purpose of ........................................................... for which it was sanctioned and that the balance of Rs..................... remaining unutilised at the end of the year has been surrendered to Government (vide No.......................... dated) / will be adjusted during towards the grants-in-aid payable during the next year. 2. Certified that I have satisfied myself that the conditions on which the grants-in-aid was sanctioned have been duly fulfilled/are being fulfilled and that I have exercised the following checks to see that the money was actually utilised for the purpose for which it was sanctioned. Kinds of checks exercised : 1) 2) 3) 4) 5) Signature Designation Date SPACE BELOW FOR USE IN THE MNES Countersigned by the Division concerned. SSO / PSO / DIRECTOR HEAD OF THE DIVISION
