Installment Request Checklist IFD Approved

FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER
DDU-GKY / ROSHNI
All information below has been provided on and is upto date until __________________ (DD/MM/YYYY)
Sl. No.
Particulars
Details / Observations
Means of
Verification/Source of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Project Information / Details
1
1.1
Sanction Order Reference No.
1.2
Name of Implementation Agency
Yes/No
Yes/No
From Sanction Order
1.3
Project sanction date
1.4
Project Duration
1.5
Project Start Date
__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>
Yes/No
________________ years
Yes/No
__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>
1.6
Project Start Date/ Project

Commencement Date
__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>
1.7
Project End Date
__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>
1.8
State in which project is to be

implemented
1.9.i
Central Share
Yes/No
Project Commencement
Certificate from TSA
Yes/No
Yes/No
From Sanction Order
________________________________________________<in Rs.>
Yes/No
Yes/No
From Sanction Order

State Share
________________________________________________<in Rs.>
1.9.iii
PIA Contribution
________________________________________________<in Rs.>
For contribution in kind,

attach CA certificate. For
Cash, audited account
statement
Yes/No
1.9.iv
Total Cost of the Project
________________________________________________<in Rs.>
From Sanction Order
Yes/No
1.9.v
Revision if any to cost of project
________________________________________________<in Rs.>
From Revision order
Yes/No/NA
1.9.ii
Yes/No
1.10
In case of Revised Project Cost
1.10.i
Central Share (Revised)
________________________________________________<in Rs.>
1.10.ii
State Share (Revised)
________________________________________________<in Rs.>
1.10.iii
PIA Contribution (Revised)
________________________________________________<in Rs.>
For contribution in kind,

attach CA certificate. For
Cash, audited account
statement
Yes/No/NA
1.10.iv
Total Revised Cost of the Project
________________________________________________<in Rs.>
From Revision order
Yes/No/NA
Yes/No/NA
From Revision order
Yes/No/NA
FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER DDU-GKY / ROSHNI (Version 1.0) dated 21st, December, 2015
Sl. No.
Particulars
To be trained
1.11
Total number of beneficiaries
1.12
Unit Cost per beneficiary
To be placed
________________________________________________<in Rs.>
Trade
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Quote the original as

well as the revised
numbers as per MoU
and project target. In
case of revisions, attach
duly signed copies of
approval
Yes/No
Calculate on basis on
number of candidates to
be trained (1.10) and
total cost of project (1.9)
Yes/No
Duration of Training (in months)

Yes/No
Yes/No
1.13
Agenda & Minutes of

PAC
Add additional rows if
more than 10 trades
were approved.
Trades approved for training in the

sanction.
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
1.14
Provide a list of assets created, if any
Attach CA certification
1.15
Were the above assets approved in the

project proposal?
Yes/No
1.16
Whether outsourcing has been proposed

and approved?
Yes/No
Yes/No
Yes/No/NA
Sanction Order
Yes/No
Sl. No.
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Outsourced Activity
Agency
Cost of Outsourcing (Per annum)

Yes/No/NA
1.17
List the areas where outsourcing has

been done, and to which agency and
cost of outsourcing (per annum)
Sanction Order and

contracts with
outsourcing agencies
Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA
Project Extension
2.1
Has the project period expired?
Yes/No
Sanction Order
Yes/No
2.2
If project is ongoing, has the project been

duly approved for extension?
Yes/No
Attach Approval letter
Yes/No
2.3
Is there a requirement for project

extension?
Yes/No
If No, Skip to next

section
Yes/No/NA
2.4
Required Extension Period
Enclose detailed action

plan on how this is to be
achieved
Yes/No/NA
2.5
Provide Reason for requiring extension
TSA recommendation
Yes/No/NA
2.6
Has a detailed action plan been prepared

to explain how this will be achieved?
Yes/No/NA

plan
Yes/No/NA
2.7
Has a detailed action plan been certified

by TSA?
Yes/No/NA

plan
Yes/No/NA
______ in months
Terms & Conditions
3.1
Whether signed MoU has been

attached?
3.2
Has the project been implemented as

per conditions of PAC /EC /Sanction
Order (as applicable)?
Yes/No
Yes/No
Yes/No
Stamped
affadavit/certificate
required by CEO of PIA,
or designated authority
approved by Board of
Directors
Yes/No
Sl. No.
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
3.3
Whether the PIA has complied with the

provisions of standard Terms &
Conditions
3.4
Whether the PIA has complied with

special Terms & Conditions
Conditions listed in
Sanction.
Provide Stamped
Yes/No
Yes/No
Conditions listed in
Sanction.
Provide Stamped
Yes/No
1) Total should match

with numbers provided
in project details in
Section 1.
2) Information should be
sourced from the MoU.
Yes/No
Physical progress in project

Type of course
4.1
Yes/No
Total training target for the project

(in no. of candidates)
Residential
Non-residential
3 months
6 months
9 months
12 months
Total
Yes/No
Total training target required for release

of installment in case of:
2nd installment (10% of total target)
Yes/No
3rd installment (67.5% of total target)
Yes/No
4th installment (100% of total target)
Yes/No
4.2
Attach MIS generated

candidate list, plus field
inspection report by TSA
Sl. No.
Particulars
A
Total training target categories
4.3
Total no. of candidates to be

trained for being eligible for
nd rd th
2 /3 /4 Installment
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Total no. of candidates trained Whether the shortfall is within 5% of the

by PIA
target for the sub-category?
Scheduled Caste/ Scheduled Tribe
Yes/No
Yes/No
Minorities
Yes/No
Yes/No
Women
Yes/No
Yes/No
Other
Yes/No
Yes/No
Total
4.4
Has the required training target been

been achieved in terms of:
Yes/No
4.4.i
Targets listed in 4.2
Yes/No
4.4.ii
Targets listed in 4.3
Yes/No
Yes/No
Attach MIS generated
candidate list, plus field
inspection report by TSA
Yes/No
Yes/No
3 months course
Total To Be Trained
Total Trained
Total To Be Trained
Total Trained
Total To Be Trained
Total Trained
Total To Be Trained
Total Trained
Percentage Achieved
Yes/No
Percentage Achieved
Yes/No
Percentage Achieved
Yes/No
Percentage Achieved
Yes/No
6 months course
4.5
For 4th Installment release,

list achievement in each course duration
(in no. of candidates)
9 months course
12 months course
4.6
Total number of BPL candidates trained
4.7
Whether the PIA has given training in the

approved trades?
Yes/No
Yes/No
4.8
Has the required placement target been

achieved?
Yes/No
Yes/No
4.9
Has placement met minimum wage

requirements as per guidelines?
Yes/No
Provide minimum wage

act of concerned state(s)
relevant for each trade
Yes/No
Sl. No.
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Total placement target required for

release of installment in case of:
4.10
Placement target should

be at least 75% of
training target
2nd installment (75% of target)

3rd installment (75% of target)
4th installment (75% of target)
4.11
Number of placed candidates continuing

work, as per PIA?
4.12
Physical status of training centres
4.13
Whether the MIS has been updated
Yes/No
Yes/No
Yes/No
_____________________________________
Yes/No
Field inspection report

by TSA.
Relevant screenshots to
be attached.
Yes/No
Yes/No
Yes/No
Performance Monitoring
5.1
Has the CTSA monitoring report with

regard to training and placement under
previous instalment been attached?
Yes/No
5.2
Whether any complaints have been

raised regarding implementation of
project?
Yes/No
Details of Complaint
Compliance by PIA
Yes/No
Documentary proof of
complaint
Yes/No
Proposed Action by CTSA

in case of non-compliance
Yes/No/NA
Yes/No/NA
5.3
Provide details of complaints
TSA observation and

compliance report and
documentary proof of
complaints. Add rows if
required
Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA
Yes/No/NA
Sl. No.
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Information specific to final installment & project closure
6
6.1
Total interest earned by PIA
________________________________________________<in Rs.>
Audited account
statement
Yes/No
6.2
Total interest earned by TSA
________________________________________________<in Rs.>
To be filled by TSA
Yes/No
Asset
Original
Value
Acquisition
Date
Depreciation for
this period
Residual Adjusted Value

Yes/No
6.3
Depreciation amount
should be calculated as
per depreciation for item
listed in General
Finance Rules/IT Act.
Add rows if required for
additional assets. CA
certification to be
attached.
List financial value of permanent assets

created under project
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Financial Progress in project
7
Item
7.1.i
1st installment
2nd Instalment
3rd instalment
4th instalment
Total
Central Share released to PIA (in Rs.)
Yes/No
Sanction Order
7.1.ii
State Share released to PIA (in Rs.)
Yes/No
7.1.iii
PIA Contribution (in Rs.)
Audited account
statement
7.1.iv
Total funds available to PIA (in Rs.)
[7.1. (i+ii+iii)]
Yes/No
Interest earned by PIA
Interest earned by PIA

may be adjusted at the
time of release of
instalment as indicated
in Guidelines.
Yes/No
7.2
________________________________________________<in Rs.>
Yes/No
Sl. No.
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Yes/No
Particulars
7.3
Total expenditure by PIA (in Rs)
________________________________________________<in Rs.>
Sanction references, UC
duly signed by CA,
authorized
representative of PIA
and countersigned by
TSA
7.4
Balance Funds available with PIA
________________________________________________<in Rs.>
Should equal
7.1.(iv)+7.2-7.3
Yes/No
7.5
Has To/Fro allowance been duly paid to

students and is this reflected in UC/Audit
Report?
Yes /No
UC/Audit Report
Yes/No
7.6
Regarding Post Placement Support:
7.6.i
What is the total amount that has been

paid to students as Post Placement
Support?
7.6.ii
Is this amount reflected in UC/Audit

Report?
7.6.iii
How many students have been provided

paid post placement support?
___________________________________________________
7.7
For residential students, has lodging and

boarding been duly paid and is this
reflected in UC/Audit Report?
Yes /No
7.8
Whether the UC has been countersigned

by TSA?
Yes /No
Attach UC
Yes/No
7.9
Whether the PIA has been sanctioned

any other SGSY/Aajeevika Skills project
in the past?
Yes /No
Sanction Orders of other

projects
Yes/No
________________________________________________<in Rs.>
Yes /No
Yes/No
UC/Audit Report
Yes/No
Yes/No
Attach UC/AR
Yes/No
Sl. No.
7.10
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
If so, have all UCs have been submitted

as prescribed in GFR?
Yes /No
Yes/No
7.11
Whether the Financial/Physical progress

of previously sanctioned projects has
been attached?
Yes /No
For physical progress,

attach relevant
screenshots from
website. For financial
progress, attach
submitted UCs
7.12
Whether the PIA is eligible for fund

release in terms of financial
achievement?
Yes /No
As per Aajeevika Skills

Guidelines
Yes/No
Yes/No
Deviations
8
Details of Deviation from SOP/Guidelines
Was due approval

granted by Project
Director?
Reason
Yes/No
Yes/No
Yes/No
Yes/No
Attach Approval letter
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Proposal for Approval/ Release
9
9.1
Yes/No
Amount for which PIA is eligible as per

sanction order
________________________________________________<in Rs.>
Sanction Order
Yes/No
Sl. No.
9.2
9.3
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Amount to be deducted for interest

earned
Amount to be deducted on account of

unpaid PPS:
________________________________________________<in Rs.>
Number of Candidates not paid
Amount to be deducted for

each non-payment
Financial Progress
Section
Yes/No
Total Deduction
Yes/No
9.4

non-payment of Boarding/Lodging for
candidates trained in:
Number of Candidates not paid

each non-payment
Total Deduction
Yes/No
9.5
Total Amount to be deducted on account

of candidates not trained:
9.5.i
As per category wise targets
________________________________________________<in Rs.>
Shortfall in Target
9.5.i.a
SC
Shortfall in Target
9.5.i.b
ST

each Candidate not trained
Total Deduction

Total Deduction
Yes/No
Based on TSA
verification reports, and
shortfalls reported in
physical/financial
progress sections
Yes/No
Yes/No
Sl. No.
Particulars
A
Shortfall in Target
9.5.i.c
Women
Shortfall in Target
9.5.i.d
Minority
Shortfall in Target
9.5.ii
As per total target
9.6

candidates not placed as per target (only
applicable in case of project closure/ final
installment)
9.7
Any other amount to be adjusted
Based on TSA
verification reports, and
shortfalls reported in
physical/financial
Means
of
progress
sections
Information
Shortfall in Target

Total Deduction

Total Deduction

Total Deduction

each Candidate not placed
Total Deduction
Page
Reference
Claim verified and

certified to be
accurate by CTSA
Yes/No
Yes/No
Yes/No
________________________________________________<in Rs.>
Yes/No
Yes/No
Sl. No.
Particulars
Means of
Information
Page
Reference
Claim verified and

certified to be
accurate by CTSA
9.7.i
Provide reason(s) for adjusting above

stated amount
Yes/No
9.7.ii
Provide calculation(s) used as basis for

above stated amount
Yes/No
9.8
Amount for which PIA is eligible after

adjusting applicable deductions
________________________________________________<in Rs.>
Yes/No
PIA Request for Approval
I, _______________________ (authorized personnel from PIA) hereby certify information provided in this application is accurate and correct as of date _ _ <DD>/ _ _ <MM>/ _ _ _ _ <YYYY>
Approval is requested for
a) Installment No. ______________ for total amount of _____________________________ <In Rs>
b) Extension, if any for a total period of ___________________ up to _ _ <DD>/ _ _ <MM>/ _ _ _ _
c) Relaxations of norms, if any, in respect of the following:
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________
Reccomendation of TSA with respect to Project & Fund Releases
I, _______________________ (authorized personnel from concerned TSA) recommend for approval of fund release for the above project amounting to___________________________________<in
Rs>, in respect of installment no. ________
Reccomendation of Project Director with respect to Project & Fund Releases
I, _________________________ (authorized personnel from PD) confirm that all the above information has been verified and found to be correct. A total amount of
__________________________________<in Rs> is proposed for release
Reccomendation of PD with respect to deviations
Category
SC
ST
Others
Certification of availability of funds

Head of Account
Budget Availability

Installment Request Checklist IFD Approved

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FORMAT FOR REQUEST FOR FUND RELEASE OF 2ND /3RD /4TH INSTALLMENT OF CENTRAL SHARE OF PROJECTS SANCTIONED UNDER

Claim verified and

Project Information / Details

Sanction Order Reference No.

Name of Implementation Agency

Project sanction date

Project Start Date

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

Project Start Date/ Project

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

Project End Date

__ __ <DD>/ __ __ <MM>/ __ __ __ __ <YYYY>

State in which project is to be

From Sanction Order

From Sanction Order

For contribution in kind,

Total Cost of the Project

From Sanction Order

Revision if any to cost of project

From Revision order

In case of Revised Project Cost

Central Share (Revised)

State Share (Revised)

PIA Contribution (Revised)

For contribution in kind,

Total Revised Cost of the Project

From Revision order

Total number of beneficiaries

Unit Cost per beneficiary

Claim verified and

Quote the original as

Duration of Training (in months)

Agenda & Minutes of

Trades approved for training in the

Provide a list of assets created, if any

Were the above assets approved in the

Whether outsourcing has been proposed

Claim verified and

Cost of Outsourcing (Per annum)

List the areas where outsourcing has

Sanction Order and

Has the project period expired?

If project is ongoing, has the project been

Attach Approval letter

Is there a requirement for project

If No, Skip to next

Required Extension Period

Enclose detailed action

Provide Reason for requiring extension

Has a detailed action plan been prepared

Enclose detailed action

Has a detailed action plan been certified

Enclose detailed action

Terms & Conditions

Whether signed MoU has been

Has the project been implemented as

Claim verified and

Whether the PIA has complied with the

Whether the PIA has complied with

1) Total should match

Physical progress in project

Total training target for the project

Total training target required for release

<DD>/ <MM>/ <YYYY>

<DD>/ <MM>/ <YYYY>

<DD>/ <MM>/ <YYYY>

<DD>/ <MM>/ <YYYY>