Form – 3 (Part A)
Statement of Expenditure referred to in para 10 of the Utilization Certificate for the period from ________ to _________
Part A: Receipt details (Rs. in Lakhs)
Item
1
(A) Non-Recurring
Unspent balance carried forward from the
previous period
Amount received from DBT during this period
Total Amount available during this period
Grants-in-aid
Loan
Total
Grants-in-aid
Loan
Total
Grants-in-aid
Loan
Total
2
3
4 (2+3)
5
6
7 (5+6)
8 (2+5)
9 (3+6)
10 (4+7)
(I) Equipments
(2) Accessories
Total A
(B) Recurring
(1) Manpower
(2)Consumables
(3) Travel
(4) Contingency
(5) Overhead
Total B
Total A+B
Interest Earned
Total
Date:
(Project Co-ordinator/
Principal Investigator)
(Finance Officer)
of the Industry
(Head of the organization)
(Chartered Accountant)
Form – 3 (Part B)
Statement of Expenditure referred to in para 10 of the Utilization Certificate for the period from _____to _____
(Rs. in Lakhs)
Part B: Expenditure Details (Rs. In Lakhs)
Actual Expenditure incurred during this period
Committed Expenditure during this period
(Justification with details to be annexed)
Total Expenditure during this period
Item
Grants-in-aid
Loan
Total
Grants-in-aid
Loan
Total
Grants-in-aid
Loan
Total
11
12
13 (11+12)
14
15
16 (14+15)
17 (11+14)
18 (12+15)
19 (13+16)
(A) Non-Recurring
(I) Equipments
(2) Accessories
Total A
(B) Recurring
(1) Manpower
(2) Consumables
(3) Travel
(4) Contingency
(5) Overhead
Total B
Total A+B
Interest Earned
Total
Date:
(Project Co-ordinator/
Principal Investigator
(Finance Officer)
of the Industry
(Head of the organization)
(Chartered Accountant)
Form – 3 (Part C)
Statement of Expenditure referred to in para 10 of the Utilization Certificate
Part C: Balance/ Unspent amount (Rs. in Lakhs)
Amount to be carried forward to the next period
Item
S.
No.
Grants-in-aid
Loan
Total
20 (8-17)
21 (9-18)
22 (10-19)
Assets acquired / Ordered
Item
Price as
Actual
indicated cost (Rs.
in the
in Lakhs)
original
budget
Date of
procurement
(A) Non-Recurring
(I) Equipments
(2) Accessories
Total A
(B) Recurring
(1) Manpower
(2) Consumables
(3) Travel
(4) Contingency
(5) Overhead
Total B
Total A+B
Interest Earned
Total
Deduction – Amount
refunded, if any
Net Total
Date:
(Project Co-ordinator/
Principal Investigator)
(Finance Officer)
of the Industry
(Head of the organization)
(Chartered Accountant)