Annexure-III Department of Empowerment of Persons with Disabilities Ministry of Social Justice and Empowerment Name of the Scheme: APPLICATION FORM FOR THE 2ND/3rd INSTALLMENT Organization Name : Address (Office) : (Project) (Office) : (Project) Fax (Office) : (Project) E-mail (Office) : (Project) Grant-in-aid (in Rs.) Total: Applied in current year : Received as 1st Installment : Applied for 2nd Installment : (i) The applicant organization should enclose the Utilization Certificate of the 1st/2nd Installment. Audited statement of account along with item-wise expenditure. Income from the event, if any, to be reflected in the audited accounts. (iii) Any other information considered necessary by the organization or as asked for. Signature…………………………… Name………………………………… Address……………………………..………………………………………….. Date…………………………………… (Seal)………………………………….
Annexure-III Department of Empowerment of Persons with Disabilities Ministry of Social Justice and Empowerment Name of the Scheme: APPLICATION FORM FOR THE 2ND/3rd INSTALLMENT Organization Name : Address (Office) : (Project) (Office) : (Project) Fax (Office) : (Project) E-mail (Office) : (Project) Grant-in-aid (in Rs.) Total: Applied in current year : Received as 1st Installment : Applied for 2nd Installment : (i) The applicant organization should enclose the Utilization Certificate of the 1st/2nd Installment. Audited statement of account along with item-wise expenditure. Income from the event, if any, to be reflected in the audited accounts. (iii) Any other information considered necessary by the organization or as asked for. Signature…………………………… Name………………………………… Address……………………………..………………………………………….. Date…………………………………… (Seal)………………………………….