FORM No. 42-I

(See Paragraph 369-H)

FORM OF UTILISATION CERTIFICATE

Serial no. letter no. amount and date

Certified that out of Rs.———of Grants-in-aid sanctioned during the year————in favour of———under this office/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—————

Total

 

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 towards the grant-in-aid payable during the next year—————

2. Certified that I have satisfied myself that the conditions on which the grant-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 check exercised :

1.

2.

3.

4.

5.

Signature—————

Designation—————

Date—————