Authorization Certificate

(To be submitted on Government Letter Head with stamp and signature)

Title of the Nomination

Category of Nomination* Project State Sustenance

Sub Category (For Central Government District Authority/Local

State Government
Projects (Nomination entity Administration/ Panchayat
Entity
By)* Entity

Lead SI/ Implementation

Partner Named for award
Yes / No
jointly for Project
Category, if relevant*

* Pl tick as appropriate

This is to certify that the information provided and submitted in our nomination document
along with enclosures (if any) is correct to the best of my knowledge. We also confirm that we
have read the conditions of participation and decided to participate on our own and submitting
our nomination.

I hereby authorize the submission of the same on behalf of my organization / Institution /

Department / Office for consideration of the Computer Society of India - NihilenteGovernance
(CNeG) Awards 2018.

I also have no objection in sharing the nomination document/s with Computer Society of India
(CSI) / CNeG Awards or their authorized officials for editing / publishing the same in the CSI-
SIG eGov annual compendium and their websites.

In case, the nomination gets shortlisted at any stage and requires interactions, presentations,
field visits, our nominated officials shall participate and enable completion of evaluation process.
In addition, in case our nomination gets shortlisted for the final award, we will depute our Senior
most officer / functionary to represent and receive the award.

Name of the Official:

Designation :

Date : [Signature with seal]