Annexure – III

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APPLICATION FOR ASSISTANCE TOWARDS STORAGE AND DISPLAY OF BOOKS

From :

(To be routed through the State Government/Union Territory)

To

       The Director,

       Raja Ram Mohan Roy Library Foundation,

       Block DD-34, Sector-1, Salt Lake

       Calcutta-700 064

Sub : Assistance towards Storage and Display of Books.

Sir,

       I submit herewith an application (in duplicate) for a grant under the scheme "Matching assistance to public libraries towards Storage and Display of books". I certify that I have read the rules and regulations of the scheme and I undertake to abide by them. On behalf of the management, I further agree to the following conditions

          (a) All the assets acquired wholly or substantially out of the Foundation’s grant shall not be encumbered or disposed of or utilized for purposes other than that for which grant is given. Should the library cease to exist at any time such properties shall revert to the Foundation.

          (b) The accounts of the project shall be properly and specifically reflected in the final accounts of the library. This shall also be open to test check by the Foundation or the State Government.

          (c) The organization undertakes to meet the balance of the estimated expenditure on the scheme.

          (d) The present application form dully filled-in is enclosed together with the required documents.

                                                                            Yours faithfully,

                                                                                                   Signature.

      Designation of the applicant with

              Office Seal

1. Name of the library with full address

    including Pin Code.

 

2. Whether the library is located in its Own

     building/Rented house/Other institution.

 

3. Nature of the library – Government or

    Private.

    Whether it is a registered body? (Please

    quote the Registration No. and Date and

    attach Xerox copy of Society Registration

    Certificate)

 

4. Managing Committee-Name and address

    of the members.

    (Separate sheet be attached )

5. Particulars of staff with designation.

6. Source of Income-Grant from Governments

    (Central and State), donation from public,

    subscription from members etc.

7. Average monthly expenditure.

8. Average no. of readers and borrowers per

    month.

9. Total no. of books and periodicals.

1. Books

2. Periodicals

10.Stock of Almirahs and Racks.

1. No. of Almirahs

2. No. of Racks

11.Whether any grant is received from any other

    source for the same purpose? If so, give particulars.

 

12.Particulars of furniture required.

a.       Type of Almirah/Rack/Cup Board. (Steel/Wooden)

b.      Size of Almirah/Rack/Cup Board. (Length, Breath, Height and no. of Shelves)

c.        Estimated cost.

     (Attach Catalogue/Quotation form from standard

    firm/supplier)

d.      Assistance for

       (Rs. 6000/- per Library) 

e.        Balance amount if any, the source from which balance amount will be incurred to be         specifically stated.

13.Whether any grant is received from foundation (Yes/No)? If yes, give sanction letter         no. and date.

 

 14.Declaration

 

              On behalf of the Institution/Organisation I solemnly declare that the particulars furnished above areJ true. I certify that I have read the rules and regulations of the scheme and I undertake to abide by them. The cheque may be drawn in favour of

 

List of Enclosures :

         

    i)  Constitution/Memorandum of Association/Organisation.

    ii) Copy of the Society Registration Certificate.

    iii) Latest available Annual Report.

    iv) Name and address of the members of Managing Committee.

    v) Quotation for the article to be purchased.

 

 

Place :                                                                               Signature

Date :                                                      Name and designation of the applicant

                                                                                     with office seal

 

15. Recommendation

 

The application has been scrutinized. The library deserves assistance under this scheme an amount of Rs. ______ is recommended for purchasing ________________ Almirah/Racks from matching fund which has been approved by the state library committee in its meeting held on ___________.

 

Place :                                                                              Signature

Date   :                                                  Name and designation of the Convener,

                                                                                 SLC/SLPC office seal

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