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FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER

DDU-GKY / ROSHNI
All information below has been provided on and is upto date until __________________ (DD/MM/YYYY)
Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Project Information / Details

1
1.1

Sanction Order Reference No.

1.2

Name of Implementation Agency

Yes/No

Yes/No
From Sanction Order

1.3

Project sanction date

1.4

Project Duration

1.5

Project Start Date

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

Yes/No

________________ years

Yes/No

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

1.6

Project Start Date/ Project


Commencement Date

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

1.7

Project End Date

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

1.8

State in which project is to be


implemented

1.9.i

Central Share

Yes/No
Project Commencement
Certificate from TSA

Yes/No
Yes/No

From Sanction Order

________________________________________________<in Rs.>

Yes/No
Yes/No

From Sanction Order


State Share

________________________________________________<in Rs.>

1.9.iii

PIA Contribution

________________________________________________<in Rs.>

For contribution in kind,


attach CA certificate. For
Cash, audited account
statement

Yes/No

1.9.iv

Total Cost of the Project

________________________________________________<in Rs.>

From Sanction Order

Yes/No

1.9.v

Revision if any to cost of project

________________________________________________<in Rs.>

From Revision order

Yes/No/NA

1.9.ii

Yes/No

1.10

In case of Revised Project Cost

1.10.i

Central Share (Revised)

________________________________________________<in Rs.>

1.10.ii

State Share (Revised)

________________________________________________<in Rs.>

1.10.iii

PIA Contribution (Revised)

________________________________________________<in Rs.>

For contribution in kind,


attach CA certificate. For
Cash, audited account
statement

Yes/No/NA

1.10.iv

Total Revised Cost of the Project

________________________________________________<in Rs.>

From Revision order

Yes/No/NA

Yes/No/NA
From Revision order
Yes/No/NA

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

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Details / Observations

Particulars

To be trained
1.11

Total number of beneficiaries

1.12

Unit Cost per beneficiary

To be placed

________________________________________________<in Rs.>

Trade

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Quote the original as


well as the revised
numbers as per MoU
and project target. In
case of revisions, attach
duly signed copies of
approval

Yes/No

Calculate on basis on
number of candidates to
be trained (1.10) and
total cost of project (1.9)

Yes/No

Duration of Training (in months)


Yes/No
Yes/No

1.13

Agenda & Minutes of


PAC
Add additional rows if
more than 10 trades
were approved.

Trades approved for training in the


sanction.

Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No

1.14

Provide a list of assets created, if any

Attach CA certification

1.15

Were the above assets approved in the


project proposal?

Yes/No

1.16

Whether outsourcing has been proposed


and approved?

Yes/No

Yes/No

Yes/No/NA

Sanction Order

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Outsourced Activity

Agency

Cost of Outsourcing (Per annum)


Yes/No/NA

1.17

List the areas where outsourcing has


been done, and to which agency and
cost of outsourcing (per annum)

Sanction Order and


contracts with
outsourcing agencies

Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA

Project Extension

2.1

Has the project period expired?

Yes/No

Sanction Order

Yes/No

2.2

If project is ongoing, has the project been


duly approved for extension?

Yes/No

Attach Approval letter

Yes/No

2.3

Is there a requirement for project


extension?

Yes/No

If No, Skip to next


section

Yes/No/NA

2.4

Required Extension Period

Enclose detailed action


plan on how this is to be
achieved

Yes/No/NA

2.5

Provide Reason for requiring extension

TSA recommendation

Yes/No/NA

2.6

Has a detailed action plan been prepared


to explain how this will be achieved?

Yes/No/NA

Enclose detailed action


plan

Yes/No/NA

2.7

Has a detailed action plan been certified


by TSA?

Yes/No/NA

Enclose detailed action


plan

Yes/No/NA

______ in months

Terms & Conditions

3.1

Whether signed MoU has been


attached?

3.2

Has the project been implemented as


per conditions of PAC /EC /Sanction
Order (as applicable)?

Yes/No

Yes/No

Yes/No
Stamped
affadavit/certificate
required by CEO of PIA,
or designated authority
approved by Board of
Directors

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

3.3

Whether the PIA has complied with the


provisions of standard Terms &
Conditions

3.4

Whether the PIA has complied with


special Terms & Conditions

Conditions listed in
Sanction.
Provide Stamped
affadavit/certificate

Yes/No

Yes/No

Conditions listed in
Sanction.
Provide Stamped
affadavit/certificate

Yes/No

1) Total should match


with numbers provided
in project details in
Section 1.
2) Information should be
sourced from the MoU.

Yes/No

Physical progress in project


Type of course

4.1

Yes/No

Total training target for the project


(in no. of candidates)

Residential
Non-residential

3 months

6 months

9 months

12 months

Total

Yes/No

Total training target required for release


of installment in case of:
2nd installment (10% of total target)

Yes/No

3rd installment (67.5% of total target)

Yes/No

4th installment (100% of total target)

Yes/No

4.2

Attach MIS generated


candidate list, plus field
inspection report by TSA

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

A
Total training target categories

4.3

Total no. of candidates to be


trained for being eligible for
nd rd th
2 /3 /4 Installment

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Total no. of candidates trained Whether the shortfall is within 5% of the


by PIA
target for the sub-category?

Scheduled Caste/ Scheduled Tribe

Yes/No

Yes/No

Minorities

Yes/No

Yes/No

Women

Yes/No

Yes/No

Other

Yes/No

Yes/No

Total

4.4

Has the required training target been


been achieved in terms of:

Yes/No

4.4.i

Targets listed in 4.2

Yes/No

4.4.ii

Targets listed in 4.3

Yes/No

Yes/No
Attach MIS generated
candidate list, plus field
inspection report by TSA

Yes/No

Yes/No

3 months course
Total To Be Trained

Total Trained

Total To Be Trained

Total Trained

Total To Be Trained

Total Trained

Total To Be Trained

Total Trained

Percentage Achieved

Yes/No

Percentage Achieved

Yes/No

Percentage Achieved

Yes/No

Percentage Achieved

Yes/No

6 months course

4.5

For 4th Installment release,


list achievement in each course duration
(in no. of candidates)

9 months course

12 months course

4.6

Total number of BPL candidates trained

4.7

Whether the PIA has given training in the


approved trades?

Yes/No

Yes/No

4.8

Has the required placement target been


achieved?

Yes/No

Yes/No

4.9

Has placement met minimum wage


requirements as per guidelines?

Yes/No

Provide minimum wage


act of concerned state(s)
relevant for each trade

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Total placement target required for


release of installment in case of:
4.10

Placement target should


be at least 75% of
training target

2nd installment (75% of target)


3rd installment (75% of target)
4th installment (75% of target)

4.11

Number of placed candidates continuing


work, as per PIA?

4.12

Physical status of training centres

4.13

Whether the MIS has been updated

Yes/No
Yes/No
Yes/No

_____________________________________

Yes/No

Field inspection report


by TSA.

Relevant screenshots to
be attached.

Yes/No

Yes/No

Yes/No

Performance Monitoring

5.1

Has the CTSA monitoring report with


regard to training and placement under
previous instalment been attached?

Yes/No

5.2

Whether any complaints have been


raised regarding implementation of
project?

Yes/No

Details of Complaint

Compliance by PIA

Yes/No

Documentary proof of
complaint

Yes/No

Proposed Action by CTSA


in case of non-compliance
Yes/No/NA
Yes/No/NA

5.3

Provide details of complaints

TSA observation and


compliance report and
documentary proof of
complaints. Add rows if
required

Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Information specific to final installment & project closure

6
6.1

Total interest earned by PIA

________________________________________________<in Rs.>

Audited account
statement

Yes/No

6.2

Total interest earned by TSA

________________________________________________<in Rs.>

To be filled by TSA

Yes/No

Asset

Original
Value

Acquisition
Date

Depreciation for
this period

Residual Adjusted Value


Yes/No

6.3

Depreciation amount
should be calculated as
per depreciation for item
listed in General
Finance Rules/IT Act.
Add rows if required for
additional assets. CA
certification to be
attached.

List financial value of permanent assets


created under project

Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No

Financial Progress in project

7
Item
7.1.i

1st installment

2nd Instalment

3rd instalment

4th instalment

Total

Central Share released to PIA (in Rs.)

Yes/No
Sanction Order

7.1.ii

State Share released to PIA (in Rs.)

Yes/No

7.1.iii

PIA Contribution (in Rs.)

Audited account
statement

7.1.iv

Total funds available to PIA (in Rs.)

[7.1. (i+ii+iii)]

Yes/No

Interest earned by PIA

Interest earned by PIA


may be adjusted at the
time of release of
instalment as indicated
in Guidelines.

Yes/No

7.2

________________________________________________<in Rs.>

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Yes/No

Particulars

Details / Observations

7.3

Total expenditure by PIA (in Rs)

________________________________________________<in Rs.>

Sanction references, UC
duly signed by CA,
authorized
representative of PIA
and countersigned by
TSA

7.4

Balance Funds available with PIA

________________________________________________<in Rs.>

Should equal
7.1.(iv)+7.2-7.3

Yes/No

7.5

Has To/Fro allowance been duly paid to


students and is this reflected in UC/Audit
Report?

Yes /No

UC/Audit Report

Yes/No

7.6

Regarding Post Placement Support:

7.6.i

What is the total amount that has been


paid to students as Post Placement
Support?

7.6.ii

Is this amount reflected in UC/Audit


Report?

7.6.iii

How many students have been provided


paid post placement support?

___________________________________________________

7.7

For residential students, has lodging and


boarding been duly paid and is this
reflected in UC/Audit Report?

Yes /No

7.8

Whether the UC has been countersigned


by TSA?

Yes /No

Attach UC

Yes/No

7.9

Whether the PIA has been sanctioned


any other SGSY/Aajeevika Skills project
in the past?

Yes /No

Sanction Orders of other


projects

Yes/No

________________________________________________<in Rs.>

Yes /No

Yes/No

UC/Audit Report

Yes/No

Yes/No

Attach UC/AR

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

7.10

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

If so, have all UCs have been submitted


as prescribed in GFR?

Yes /No

Yes/No

7.11

Whether the Financial/Physical progress


of previously sanctioned projects has
been attached?

Yes /No

For physical progress,


attach relevant
screenshots from
website. For financial
progress, attach
submitted UCs

7.12

Whether the PIA is eligible for fund


release in terms of financial
achievement?

Yes /No

As per Aajeevika Skills


Guidelines

Yes/No

Yes/No

Deviations

8
Details of Deviation from SOP/Guidelines

Was due approval


granted by Project
Director?

Reason

Yes/No

Yes/No

Yes/No

Yes/No
Attach Approval letter
Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Proposal for Approval/ Release

9
9.1

Yes/No

Amount for which PIA is eligible as per


sanction order

________________________________________________<in Rs.>

Sanction Order

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

9.2

9.3

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Amount to be deducted for interest


earned

Amount to be deducted on account of


unpaid PPS:

________________________________________________<in Rs.>

Number of Candidates not paid

Amount to be deducted for


each non-payment

Financial Progress
Section

Yes/No

Total Deduction

Yes/No

9.4

Amount to be deducted on account of


non-payment of Boarding/Lodging for
candidates trained in:

Number of Candidates not paid

Amount to be deducted for


each non-payment

Total Deduction

Yes/No
9.5

Total Amount to be deducted on account


of candidates not trained:

9.5.i

As per category wise targets

________________________________________________<in Rs.>

Shortfall in Target
9.5.i.a

SC

Shortfall in Target
9.5.i.b

ST

Amount to be deducted for


each Candidate not trained

Total Deduction

Amount to be deducted for


each Candidate not trained

Total Deduction

Yes/No

Based on TSA
verification reports, and
shortfalls reported in
physical/financial
progress sections

Yes/No

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Details / Observations

Particulars

A
Shortfall in Target
9.5.i.c

Women

Shortfall in Target
9.5.i.d

Minority

Shortfall in Target
9.5.ii

As per total target

9.6

Amount to be deducted on account of


candidates not placed as per target (only
applicable in case of project closure/ final
installment)

9.7

Any other amount to be adjusted

Based on TSA
verification reports, and
shortfalls reported in
physical/financial
Means
of
progress
sections
Verification/Source of
Information

Shortfall in Target

Amount to be deducted for


each Candidate not trained

Total Deduction

Amount to be deducted for


each Candidate not trained

Total Deduction

Amount to be deducted for


each Candidate not trained

Total Deduction

Amount to be deducted for


each Candidate not placed

Total Deduction

Page
Reference

Claim verified and


certified to be
accurate by CTSA

Yes/No

Yes/No

Yes/No

________________________________________________<in Rs.>

Yes/No

Yes/No

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015

Sl. No.

Particulars

Details / Observations

Means of
Verification/Source of
Information

Page
Reference

Claim verified and


certified to be
accurate by CTSA

9.7.i

Provide reason(s) for adjusting above


stated amount

Yes/No

9.7.ii

Provide calculation(s) used as basis for


above stated amount

Yes/No

9.8

Amount for which PIA is eligible after


adjusting applicable deductions

________________________________________________<in Rs.>

Yes/No

PIA Request for Approval

I, _______________________ (authorized personnel from PIA) hereby certify information provided in this application is accurate and correct as of date _ _ <DD>/ _ _ <MM>/ _ _ _ _ <YYYY>
Approval is requested for
a) Installment No. ______________ for total amount of _____________________________ <In Rs>
b) Extension, if any for a total period of ___________________ up to _ _ <DD>/ _ _ <MM>/ _ _ _ _
c) Relaxations of norms, if any, in respect of the following:
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
Reccomendation of TSA with respect to Project & Fund Releases

I, _______________________ (authorized personnel from concerned TSA) recommend for approval of fund release for the above project amounting to___________________________________<in
Rs>, in respect of installment no. ________
Reccomendation of Project Director with respect to Project & Fund Releases
I, _________________________ (authorized personnel from PD) confirm that all the above information has been verified and found to be correct. A total amount of
__________________________________<in Rs> is proposed for release
Reccomendation of PD with respect to deviations

Category
SC
ST
Others

Certification of availability of funds


Head of Account

Budget Availability

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015