NSTFDC Annexure "C" FORMAT FOR THE FUNDS UTILISATION CERTIFICATE IN RESPECT OF WORKING CAPITAL ASSISTANCE 1. Name of the SCA/Agency : 2. Name of the Scheme : 3. NSTFDC's LOI No. & Date: 4. NSTFDC's share released: Date Amount i) ii) 5. Certified that: a) Funds have been utilized for the purpose/activities stated in the letter of sanction(LOI) b) An amount of Rs.________________ lakhs have been utilized within 60 days from he date of release of funds by NSTFDC for the implementation of the above said scheme. c) Total no. of _____________________Scheduled Tribes beneficiaries have been assisted under the scheme. d) All the beneficiaries covered under the scheme were eligible for assistance as per eligibility criteria of NSTFDC. Date: Signature (Authorised signatory of the Agency) Name:______________________ Designation:_________________ (OFFICIAL STAMP)