MINISTRY OF SOCIAL JUSTICE & EMPOWERMENT Name of the Scheme: 1. APPLICATION FORM FOR THE IIND INSTALLMENT 1. Organization : Name : Address (Office ) : (Project) Phone (Office) : (Project) : Fax (Office) : (Project) : Telex (Office) : (Project) : E-mail (Office) : (Project) : Grams (Office) : (Project ) : 2. Grant-in-aid (in Rs.) Total A. Applied in the current year : B. Received as Ist Installment : C. Applied for IInd Instalment : 3. The applicant organisation should enclose following papers: i) Annual Report of the previous year. ii) Audited statement of accounts of previous year (Receipts and Payments statement, Income & Expenditure Statement) and Balance sheet. iii) Audited utilization certificate with itemwise expenditure as per the sanctioned items of grant. iv) Details of staff available. v) Details of beneficiaries as per Annexure IV vi) Assets acquired wholly or substantially out of government grants under GFR 19. vii) Any other information considered necessary by the organisation or as asked for: Signature.......... Name .......... Address.......... .............. Date............ (Seal)