FORM GFR 19-A

(See Government of India's Decision (1) below Rule 150)

FORM OF UTILISATION CERTIFICATE

Certified that out of Rs……………… grants-in-aid sanctioned during the year 2013-2014

under…………………………………………………

…………….…………………………………………

under this Letter No. given in the margin, a sum of Rs…………………… only has been utilised for which it was sanctioned and that the balance of Rs………………… remaining unutilized as on

31st July 2013

02. Certified that I have satisfied myself that the conditions on which the grants-in-aid was sanctioned have been duly / are being fulfilled and that I have exercised the following check to see that the money was actually utilised for the purpose for which it was sanctioned.

Kinds of Checks exercised.

01.

02.

03.

04.

05.

Signature :

Designation :

Date :