The State Government and Union territory shall submit utilisation certificate in prescribed proforma to the Central Government, as provided under General Financial Rules, 2005.
[No. 15-34/2014-NFSA] NILAMBUJ SHARAN, Economic Adviser 12 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)] Schedule-I PROFORMA (See sub-rule (6) of rule 10 and rule 11) Name of the State/UT Department of Claim for release of second/final instalment of Central assistance on intra-State movement and handling of foodgrains Bill No.
Date Statement showing distribution of foodgrains through Targeted Public Distribution System under National Food Security Act, 2013 and expenditure incurred on intra-State movement and handling of foodgrains during the year __ ^ • 1 Foodgrains 1 Wheat Rice Coarsegrains Total Quantity of Foodgrains (in quintals) Allocated by Department of Food and Public DistHbution 2 Actual quantity distributed by the State or Union territory under National Food Security Act, 2013 3 Actual expenditure on intra state movement and handling of foodgrains by State or Union territory Rates (^ per quintal) 4 Total expenditure incurred (in ^in lakhs) 5 Expenditure on intra-State movement and handling of foodgrains as per approved norms* (in ^ in lakhs) 6 Central assistance Percen tage* 7 Less: Advance Central assistance received during the year (in ^ in lakhs) Net amount to be received from Government of India (in f̂ in lakhs) Total due (% in col. 7 to be applied to lower of col.5 or 6) (in f̂ in lakhs) 8 It is certified that:--
1. The above information is correct.
2. The claim has been prepared only for foodgrains actually distributed through Targeted Public Distribution System under National Food Security Act, 2013 out of the allocation made by Department of Food and Public Distribution.
3. The claim is based on the actual expenditure incurred on intra-State movement and handling of foodgrains.
4. The claim has not been preferred earlier.
5. The amount being claimed through above proforma have not been claimed/ shall not be claimed from the Government of India/Food Corporation of India as part of procurement incidental/economic V' 1 [qPT 11-3^5 3(1)] qR3 ^T TFTO : 3|̂ jl|KU| t3 cost, in the finalisation of procurement incidentals cost sheet by the Government of India for the relevant marketing season for respective commodity under consideration.
Financial Head Authorised signatory (Signature with name, date and official seal) (Signature with name, date and official seal) Principal Secretary/Secretary Food and Civil Supplies (Signature with name, date and official seal) Note : The certificate may be signed by the Financial Head and the authorized signatory of the department concerned with distribution of foodgrains under National Food Security Act, 2013 or the nominated agency duly authorized by that department to do so.
*Approved norms and percentage of Central assistance as prescribed in sub-rule (1) of rule 7. < Schedule-11 PROFORMA (See sub-rule (6) of rule 1U and rule 11) Name oi'liic Staie/UT Department of Claim for release of second/final instalment of Central assistance for expenditure incurred on margins to fair price shop dealers Bill No.
Date (A) Statement showing distribution of foodgrains through Targeted Public Distribution System under National Food Security Act, 2013 and expenditure incurred on margins to fair price shop dealers during the year Foodgrains 1 Wheat Rice Coarsegrains Total Foodgrains (in quintals) Allocated by Department of Food and Public Distribution 2 Actually distributed by the State or Union Territory under National Food Security Act, 2013 3 Actual expenditure on payment of margins to fair price shop dealers by State or Union territory Rates (^ per quintal) 4 Total expenditure incurred (in ^ in lakhs) 5 Expenditure on margins to fair price shop dealers as per approved norms* (in ^ in lakhs) 6 Central assistance Percen tage* 7 Less: Advance Central assistance received during the year (in ^ in lakhs) Net amount to be received from Government of India (in ^ in lakhs) Total due (% in col.7 to be applied to lower of col.5 or 6) (in ^ in lakhs) 8 14 THE GAZETTE OF INDIA : EXTRAORDINARY [PART H—SEC. 3(i)] (B) Table showing additional margin payable to fair price shop dealers for sale of foodgrains under National Food Security Act, 2013 through point of sale device during the year ___ S.No.
1 2 3 4 5 6 7 S Item Total number of fair price shops in the State/UT.
Number of fair price shops where point of sale device has been installed.
Number of fair price shops where point of sale device was functioning during the year.
Quantity of foodgrains distributed through point of sale device during the year.
Amount of additional margin payable to fair price shop dealers @ ^17 per quintal for distribution of foodgrains through fair price shops using point of sale device (for quantity mentioned at S.No.4). (in ^ in lakhs) Share of additional margin payable by Central Government* (out of 5 above) Advance Central assistance received during the year (in ^ in lakhs) Net amount to be received from Government of India (in ^ in lakhs) (6-7) No7A mount V (C) It is certified that:-
1. The^above information is correct.
2. The claim has been prepared only for foodgrains actually distributed through Targeted Public Distribution' System under National Food Security Act, 2013 out of the allocation made by Department of Food and Public Distribution.
3. The claim is based on the actual expenditure incurred on margins paid to fair price shop dealers.
4. The claim has not been preferred earlier.
Financial Head Authorised signatory (Signature with name, date and official seal) (Signature with name, date and official seal) Principal Secretary/Secretary Food and Civil Supplies (Signature with name, date and official seal) Note: The certificate may be signed by the Financial Head and the authorised signatory of the department concerned with distribution of foodgrains under National Food Security Act, 2013 or the nominated agency duly authorised by that department to do so.
* Approved norms and percentage of Central Assistance as prescribed in sub-rule (1) of rule 7.
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