Annexure I Application For Central Scheme To Physically Handicapped Persons For Purchasing/Fitting Of Aids/Appliance From Date: To The Secretary to the Government of India Ministry of Welfare, Shastri Bhavan New Delhi Subject: Assistance under the Central Scheme of Assistance to Physically Handicapped Persons for purchase/fitting of aids/appliance. I submit herewith an application for a grant for the year under the scheme of Assistance to Physically Handicapped persons for purchase and fitting of aids/appliances. I 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 be encumbered or disposed of or utilised for the purposes other than those for which the grant is given. Should the organisation cease to exist at any time, such properties shall be reverted 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 any officer deputed by the Government of India or the State Government. They shall also be open to test check by the Controller and Auditor General of India at his discretion. c) If the state of Central Government has reason to believe that the grant is not being utilised for the approved purposes; the government of India may stop payment of further installments and recover grants in such a manner as they may decide. d) The institution shall exercise reasonable economy in the implementation of the scheme e) The organisation will obtain and undertaking from the beneficiaries as required under the scheme before fitting/giving of aids/appliances Yours faithfully (Signature ) (Designation) (Office Stamp) Annexure II APPLICATION FORM (To be completed by the applicant) 1. Name of the organisation: 2. Nature of the organisation/institution 3. Brief history of the Organisation/Institution and its objects and activities 4. Whether recognised by the State Government/state run or state Managed. 5. Whether registered under the Indian Societies Registration Act. 1860 ( ACT XXI of 1860) 6. Present number of beneficiaries from overall activities of the organisation 7. The year for which application is being made 8. Approximate number of beneficiaries category wise to be assisted under the scheme and types of aids to be provided 9. Approximate amount required 10. Details of assistance earlier received under the scheme (i) amount (ii) Sanction No and date 11. Whether the institution has the necessary staff and facilities to undertake the implementation of the scheme (Signature ) (Designation) (Office Stamp)
