APPLICATION FORMATE FOR FINANCIAL ASSISTANCE
1. FULL NAME OF THE APPLICANT
(In block latter)
2. ADDRESS FOR CORRESPONDENCE:-
(Telephone No. if any )
3. FATHERS / GUARDIAN’S NAME:-
4. DATE OF BIRTH:- DD MM YY
Age ______Years______Months _____ Days ____
(Enclose Age proof Certificate)
5. GENDER:- Male Female
6. MARRITAL STATUS:-
7. NATIONALITY:-
8. PLACE OF BIRTH:-
9. CATEGORY:- ( General / ST / SC / OBC )
10. APPLICANT’S PERMANENT ADDRESS:-
11. TYPE OF DISABILITY:-
(With Degree/ Percentage )
12. WHETHER DISABILITY CERTIFICATE ISSUED BY THE STATE MEDICAL
BOARD HAS BEEN OBTAINED:- YES/NO
IF YES, CERTIFICATE NO.
13. FAMILY INCOME:-
( Income certificate o be enclosed duly signed and attested by DC/ SDO/ SDC )
14. OCCUPATION:-
Whether working in Govt./Pvt. Sector
15. IN WHAT TRADE THE APPLICANT IS APPLIED FOR ……………………………
DECLARATION
I hereby declare that all the statement mentioned above are true, correct, and complete to the best of my knowledge and belief. I understand that in the even of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements my application is liable to be cancelled. I undertake to avid by the terms and conditions given by the Department.
Dated:-
Place:- Signature of Applicant.
GOVERNMENT OF MANIPUR
DEPARTMENT OF SOCIAL WELFARE
SCHEME FOR PROVIDING ECONOMIC ASSISTANCE DIFFERENTLY ABLED PERSONS UNDER SECTION 66 OF PERSONS WITH DISABILITIES ACT.1995.
INTRODUCTION
The enactment of the “Persons with Disabilities ( Equal Opportunities, Protection of Rights and Full Participation ) Act.1995 is a landmark legislation and an expression of commitment to the Social Justice.
Section 66 (i) of the Act states that “ the Appropriate Government and Local Authorities” hall within the limits of their economic capacity development undertakes or cause to be undertaken rehabilitation of all persons with disabilities.
Among other rehabilitation processes implementation of the programme may cause to convert a small portion of the mandatory provision into real implementation. The scheme will be address the unmet need of at least some percentage of persons with disabilities who have not yet access to any gainful services so far.
I. OBJECTIVE
The main objective of the scheme are
i) Visually Impaired
a) Blindness
b) Low Vision
ii) Hearing Impaired
iii) Locomotor Disability
iv) Persons with Mental Retardation
v) Mentally ill
vi) Leprosy Cured.
II. The Scheme will be applicable to all categories of Disabilities namely
i) Visually Impairment
a) Blindness
b) Low Vision
ii) Hearing Impairment
iii) Locomotor Disabilities
iv) Persons with Mental retardation
v) Mentally Ill
vi) Leprosy cured
III. DEFINITION OF THE DISABLED PERSONS:
(a) Persons with Disabilities means a person suffering from not less than 40% of any disability as certified by a Medical Authorities ( Sec 2 [t] of PWD Act. 1995). Medical Authority means, “State Medical Board for Disability Certificate” constitute under Rule 4 of the State PWD Rule 1997.
(b) “Blindness” refer to a condition where a person suffer from any of the following condition, namely
(i) total absence of sight, or
(ii) visual acuity not exceeding 6/60 or 20/200 (Snellen) in the better eye with correcting lenses, or
(iii) limitation of the field of vision subtending an angle of 20 degree or worse.
(c) “Person with low vision” means a person with impairment of visual functioning even after treatment of standard refractive correction but who uses or is potentially capable of using vision for the planning or execution of a task with appropriate assistive device.
(d) “ Hearing Impairment” means loss of the sixty decibels or more in the better ear in the conversational range of frequencies.
(e) “Locomotor Disability” means disability of bones, joints or muscles leading to substantial restriction of the movement of the limbs or any form of cerebral palsy.
(f) “Mental Retardation” means a condition of arrested or incomplete development of mind of a person which in specially charectarised by sub normality of intelligence.
(g) “Mental Illness” means any mental disorder other than mental retardation.
(h) “Leprosy Cured Person” means any person who has been cured of leprosy but is suffering from
(i) Lost of sensation in hands or feet as well as lost of sensation and paresis in the eyes and eyes-lid but with no manifest deformity.
(ii) Manifest deformity and paresis but having sufficient mobility in their hands and feet to enable them to engage in normal economic activity.
(iii) Extreme physical deformity as well as advance age which prevents him from undertaking any gainful occupation and expression “Leprosy Cured” shall be constructed accordingly.
IV. ELIGIBILITY CRITERIA
(i) Nationality:- A Disabled Person applying for financial assistance shall be a Manipuri by birth or a person who has settled in the state for at least 10 (Ten) years.
(ii) Financial assistance will be given to those who posses Disability Certificate issued by the State Medical Board constitute under Para 4of the Rule.
(iii) The person in the age group of 18-65 years is eligible to get financial assistance.
(iv) If the no. of applicants exceeds the fix number, preference will be depending upon the degree and below poverty line.
(v) The annual family income of the applicant should not be more than Rs. 60,000/- per annum (Income certificate to this effect will have to be submitted)
(vi) In case of M.R./M.I. or profound category (100%) of any kind of disability referred above, the legal guardian may apply for the assistance.
V. RATE OF ASSISTANCE.
The amount of financial Assistance will be fixed by the selection board which may vary from year to year depending on the availability of the fund. The scheme will be taken up every year. However, it is one time assistance and a person who has already enjoyed once will not be allowed to applied again.
Number of Disabled beneficiaries for financial assistance may be targeted one thousand or may be reduced as per decision of the selection board.
VI. CONSTITUTION OF THE SELECTION BOARD:
1. Commissioner/ Secretary, (SW), Govt. of Manipur Chairman.
2. Jt. Secy./Under Secy.(Labour & Employment)
Govt. of Manipur Member.
3. Jt. Secy./Under Secy.(FX), Govt. of Manipur Member.
4. Jt. Secy./ Under Secy.(Comm. & Industries)
Govt. of Manipur. Member.
5. Director,(SW), Manipur. Member Secy.
VII. DOCUMENTS TO BE ENCLOSED
The following documents (Attested copies) shall be accompanied while submitting the application in the prescribed form:-
(i) Disability Certificate (Issued by the State Medical Board for Disability Certificate)
(ii) Photographs (3 Copies )
(iii) Income Certificate (Issued by DC/SDC/SDO)
(iv) Brief Life History
(v) Educational/Vocational qualification, if any
(vi) Age proof certificate.
(vii) Estimate of the project in any trade upto the amount of Rs. 5,000/- only.
VIII. ECONOMIC ASSISTANCE WILL NOT BE AWARDED
i) In case the disabled person is employed in any Government/Private Sector.
ii) A person who is already enjoying other benefits will not be eligible for financial assistance.
IX. PROCEDURE OF MAKING THE ASSISTANCE
The application in the prescribed forms (appended at ANNEXURE) will be invited by the Department of Social Welfare (Disability Cell) from eligible candidates from time to time through advertisement in the local Dailies and other Medias. The eligible applications will be short-listed by the Department of Social Welfare, Govt. of Manipur on the basis of fulfillment the eligibility conditions. Complicated cases whenever come across shall be resolved in consultation with expert of the Labour and Employment Department.
X. POWER TO SANCTION AND PAYMENT
The administrative Department of Social Welfare, Government of Manipur shall be the sanctioning authority. The payment will be made through District Social Welfare Officer concerned.
POINTS TO BE NOTED BY THE APPLICANTS
1. The application form must be filled in accurately & eligibly. The application form can be collected from the District Social Welfare Officer concerned.
2. The completed application form should be submitted in the office of the District Social Welfare Officer concerned.
3. Applicants are warned that if an application is wrongly or incompletely filled in and is not accompanied with any of the documents mention above without a reasonable explanation the application is liable to be rejected and no appeal against its rejection shall be entertained.
4. The name of the selected applicants will be displayed in the notice board of Directorate, Social Welfare. Notification for payment will be published in Local News Papers and will also announce in the AIR/TV network etc.
NB: “WHOEVER, FRAUDULENTLY AVAILS, ANY BENEFIT MEANT FOR PERSONS WITH DISABILITIES, SHALL BE PUNISHABLE WITH IMPRISONMENT FOR A TERM WHICH MAY EXTEND TO TWO YEARS OR WITH FINE WHICH MAY EXTENDED TO TWENTY THOUSAND RUPEES OR WITH BOTH”. (Sec. 69 of PWD Act.1995).