Centrally Sponsored Scheme of Quality Control of Ayurveda, Siddha ...

ANNEXURE IVFORM GFR 19-A[See Rule 212(1) ]Form of Utilization CertificateSl. No.Letter No.and dateTotalAmountCertified that out of Rs………… ofgrants-in-aid sanctioned duringthe year…….in favour of……….under Department of AYUSHLetter No. given in the margin andRs……….on account of unspentbalance of the previous year, asum of Rs…….has been utilised forthe purpose of………….for which itwas sanctioned and that thebalance of Rs……… remainingunutilised at the end of the yearhas been surrendered toGovernment (vide No………….,dated………..)/will be adjustedtowards the grants-in-aid/equitypayable during the nextyear……………2. Certified that I have satisfied myself that the conditions on which the grantsin-aid/equitywas sanctioned have been duly fulfilled/are being fulfilled and that Ihave exercised the following checks to see that the money was actually utilised forthe purpose for which it was sanctioned.Kinds of checks exercised1.2.3.Date………………………………Signature…………………………Designation………………………