GTJIDELINES

FOR
TITAVELGRAN'TSCHEME FOII COL,LE(;E
TEACHERS/COL I-,F]
GEI-,IBII.A
R I AN S/VIC!]
C HANCELLOITS/(]OMMISSIONMEMBERS
AND TJGCOI.-FICERS
xII P'LAN (2012_2017)

U N I V E R S I T YG R A N T SC O M M I S S I O N
B A H A D U RS H A H Z A F A RM A R G
N E W D E L H I. 1 1 0 O O 2
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l L ri

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XII PLANGUIDELINES

Travel Grant Scheme for College Teachers/College Librarians/Vice

Chancellors/Commission Members and UGC Officers
l.

lntrod uction

This scheme is for providing financial assistanceto permanent teachers and

librariansof colleges and v ice-cha
ncellors of state universities,deemed to be
universitiesand central universities,recognisedunder section 2(f) and 12 (B) of
the UGC Act, to present reseerrch
papersat internationalconferencesabroad. In
addition, this facility is avail.rbleto the permanent teachers of Institutions of
NationalImportancer/ith a cap of 1Oyoof the total approvedcasesin a year. The
Commissionmembersand UGC Officersat thr: lsy.1 of EOIUSand above are also
e l i g i b l et o a p p l yu n d e rt h i s s c h e m e .
2. Objectives
To enable the
perntanent College Teachers/College Librarians/Vice_
chancellorslcomm issionMembers/UGC
officerrsat the level of EolUS and aboveto
present their researchpaper(:;)in internationalconferences.The maximum age
limit for college Teachers/co
llege Librarians./uGC
officers is up to the age of
superannuation
and for Vice-Chancellors
and commissionF,lembers
they should be
in position,
3. Nature of Assistance Available under the Scheme
The financialassistancefor permanent teachers of colleges,college Librarians
e n l i s t e di n 2 ( f ) a n d 1 2 B o f t h e U G CA c t w i l l b e p a i d o n 1 0 0 o / o n c e i n t h r e ey e a r s
for the total admissibleexpendituresuch a:; travel, registrationfee, per diem
allowanceand visa fee. Vice-cha
ncellors, of State Universities,deemed to be
universitiesand central unlver:iitiesrecognizedunder section2(f) and 12(B) of the
UGC Act, UGC Members, UGC Officers and SC/ST/OBC (non creamy
l a y e r ) / P h y s i c aH
l l ya n d i c a p p el e
d a c h e r sw i l l b e p r o v i d e df i n a n c i aal s s i s t a n coen c el n
two years on 1007o basis.The necessarydocument/certificate must be enclosed
w i t h t h e a p D l i c a t i of no r r e l a x a t i o n .

4 . P r o c e d u r et o A p p l y f o r A s s i s t a n c e
T h e a p p l i c a t i o ns h o u l d b e s i , : n tt o t h e J o i n t S e c r e t a r y( T r a v e lG r a n t ) , L r i v e r s i t y G r a n t s
c o m m i s s r o nB, a h a d u rs h a h z a f a r N 1 a r gN, e w D e l h i -1 1 0 0 0 2r n t h e p r e s c r i b eadp p l i c a t i o n
f o r m a l o n g w i t h a l l n e c e s s a r ye n c : l o s u r ewsi t h a c o p y o f t h e p a p e r ,a c c e p t a n c el e t t e r f r o m
t h e o r g a n i z e r so f c o n f e r e n c ea n d t h e f u l l t e x t o f t h e p a p e r p r o p o s e dt o b e p r e s e n t e di n t h e
c o n f e r e n c et w o m o n t h s p r o r t o t h e c o m m e n c e m e n to f t h e c o n f e r e n c e .I n c o m p l e t e
a p p l i c a t i o n sw i l l n o t b e c o n s i d e r e da n d n o c o r r 3 s p o n d e n c w
e i l b e e n t . c r t a i n e di n t h i s
r e g a r d r h e s u b m i s s i o no f a p r o p o s adl o e s n o t a u t l m a t r c a l l ym e a n t h a t r t r , l s t h e a p p r o v a l
o f t h e U G C . I f t h e p a p e r i s c o a u t h o r e d , t h e n a n o o b j e c t i o n c e r t i f i c a : e ( s )f r o m t h e
a u t h o r ( s )m a y b e a t t a c h e dv ii t h t h e a p p l i c a t i o nI.n c a s eo f t w o o r m o r e a p l l i c a t i o n sf o r t h e
s a m e p a p e r ( s )o n l y o n c a p p i c a t i c nV v r lbi e c o n s i d e r e da n d p r i o r i t yw i l l b e q i v e n t o t h e f i r s t
a u t h o r .T h e U G C O f f i c e r sa p p l y i n gu n d e r t h e s c h e m e ,n e e d n o t o b t a i n f ) r i o r a p p r o v a lo f
c h a i r m a nb e f o r es e n d i n gt h e p a p r r n t h e c o n f e r e n c eH. o w e v e r o
, n c et h e p a p e ri s a c c e p t e d
t h e y m a y a p p l yf o r f i n a n c i a,l t s s i s t a n cfeo r t h e i r p a | t i c t p a t i o Inn t h e c o n f e r e r . l c e .
5. Submissionof the Clainl
I n o r d e r t o e n s u r e p r o m p t a c t i o n i n r e e a s i n gt h c g r a n t , t h e a p p l i c a n t: i h aI s u b m i t t h e
f o l l o w i n gd o c u m e n t sw i t h i n o n e m o n t h a f t e r t h e c o n f e r e n c ei s o v e r :
L

T e r m s& c o n d i t i o n sf o r t h e g r a n tf o r v i s i t o f t . h ec o l l e g et e a c h e r sf o r p r e s e n t i n gp a p e r
a t i n t e r n a t i o n aclo n f e r e n c em a y b e s e e ni n l p p e n d i x - l
i i . A s t a t e m e n to f a c c o u n tg i \ , l n gf u l l d e t a t l so f e x p e n d t t u r en c u T T e o
dn v a n o u s r t e m s
v r z . /t r a v e i / a r r p o r t t a x , r e g i s t r a t i o nf e e , v i s a f e e a n d d a i l y a l l o w a n c em a y b e f t l l e d
i n A p p e n idx -I I
i i i . A u t i l i z a t i o n c e r t l f i c a t e i n t h e p r e s c r i b , e df o r m a t ( A p p e n d i xI I I ) f r o m t h e
c o l l e g e / u n i v e r s i tayu d i t o r / c h a r t e r eadc c o u n t a nfto r t h e t o t a l e x p e n d t t u r ei n c u r r e do n
the visit.
i \ . T h e d e t a is o f a s s i s t a n c eT e c e v e do r f a c l i t e s p r o v i d e d b y t h e o r q a n s e r s o f t h e
c o n f c r e n c eo r a n y o t h e r s i n i l a r I n d a n / f o r e l g na g e n c y .
r.
T h e a r n o u n tm a d c a v . rl a b l e rb y t h e C o l l e g e / U n i v e r s i t y / S t aGt eo v e r r n r e n ta n d o t h e r
s o ur c e s .
ri.
T h e a m o u n tp a y a b l ef o r e a c f ri t e m b y t h e U G Ca s p e r t h e t e r m sa n d c J n d r t i o n s .
r i i . A b r i e f n o t e o n t h e p a r t i c i p a : i o inn t h e c o n f e r e n c e .
riii. Certificate
o f p a r t i c i p a I i o nn t h e c o n f e r e n c e .
ir.
C o n v c r s i o nr a t e o f t h 3 U S d o l l a r l n t o I n d a n c u r r e n c y ,( F r o m a n y b a n k o r o t h e r
f i n a n c i ai n
l s t iut t i o n)
\.
N o o v e r w r i t i n g / c o r r e c t i ornn a y b e m a d e i n t h e c l a i m b i l l & u t i l i z a t i o nc e r t i f i c a t e .
x i . O r i g i n a cl a s h m e m o / R e c e i pm
t a y b e e n c l o s e dw i t h t h e c l a i m . I f t h c t , h o t o c o p i easr e
t o t h e s u b m i t t e dt h e n t h r s s , h o u l db e s i g n e dr y t h e a p p l i c a n t .
\ i i . P a g i n gm a y b e d o n ei n a l l t h e e n c l o s u r cast t a c h e dw i t h t h e c l a i mb i l l .
\ i i i . D e t a i l so f B a n k A c c o u n to f P r i n c i p a l / D e a n / D i r e m
c taoyr b e s e n t w t h t h e c l a i mo n
t h e m an d a t ef o r m ( A p p e n d i x - t V ) .

6, Conveyance claim
Personsselectedfor participationshould travel by excursioncategory tickets in
s e c t o r sb y t h e c h e a p e s a
t i r t i c k e t b y a n y a i r l i n e s( i n a n y c a s e n o t e x c e e d i n gA i r
India fare). Actual fare not exceedingAC II class train fare will be admissiblefor
travel from the college headquartersto the nearest airport and back. In case of
Vice-Cha
ncellors, Menrbersof ths g.rn..sion and UGC Officersit will be as per
entitlement.
7. Per Diem Payment
F o r t h e p a y m e n t o f d a i l y a l l , f w a n c et h e G o v e r n m e n to f I n d i a ' s r a t e s w i l l b e
followed.D,A. will be paid for the durationof the conferenceplus four days i.e, two
days beforeand two days after the conferencewhich will jncludethe travel period.
8. Procedure for Approval of the Proposal
The proposal(s)receivedduly clmpleted in all respectswill be evaluatedby subject
experts.Basedon their recomntendation, a final decisionwill be taken by the UGC.
The proposalsof Vice-Chancellors,
CommissionMembersand UGC Officerswill be
approvedby the Chairman,UGC directly.After the approval,an approvalletter is
sent to the candidate.
9. Procedure for release of grant
T h e e n t i r ea m o u n t d u e t o t h e c a n d i d a t ei s d i s b u r s e di n o n e i n s t a l m e n at f t e r t h e
conferenceis over and relevantdocumentsare submittedby the applicant.

UNIVERSITY CRANl'S C]O!IMISSION

I ] A H , \ D U R S T I A H 7 , A T ' A RM A R ( ;
\ E W D E L H T-

0 002

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s \p o s i au n d e r t h c
' T r a \ c l ( l r a n t s ' s c h e m e f o r c 0 l l e g ct e a c h e r s / C o l l c g c
L i b r a r i a n s , V i c e - c h a n c c l l o r sC, o m m i s s i o n
Me mbers and l-l(iC Officers.
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ot'ninl trfgi.l
( F o r c o l l c s cl c a c h e r (s' o l l c s c l . i b r a r i a ntsh e
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d a t ce t p a r t i c i p a t i oinn t h c c o | 1 ! r c n c c )
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coniirence is held)
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t8.

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cgistfation
[ i o r r nt o b c c n c l , ] s e d )
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r c q u i r e d( i n d i c r r trch en u r n b e r
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( c ) ( l e t t h c l l l a i n l c n a n carlll o r r a n c e ' . )
(d) SupporlboarilingiLrrdlodging)
( e ) A n ) o t h c r ' . ' ( s p e c )i l !

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l i k c l y t o b e r n a d ca v a i l a b l e
(arlach
docultrentar\et idcnce).
l { a st h c a p p l i c a nat r a i l e dt h c l l n a n c i a l
a s s i s t a n ct cr o m I J C C l b r a t t c n d i l g
s c r n r n acf o' n f e r c l ) c cs l m p o s i u l ne l c . i n
t h e l a s tI j r c a r sp r i o rk r t h e d a t eo l - t h c
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instilutionafier thc cont-erenc
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A n y o t h c r i n t i ) f r n a t i o nt h c a p p l i
w o u l dl i k c t o g i \ c i n s r i p p o rol f t h e c a s e .

lcefiil'\'1hat
(a)

T h c d c t a i l sg i r e n a L r o vac r ec o r . c c t .

(b)

l f t h e i n f o r t r a t i o ns u p p r l i cids fcund to be incorfectat a latcf date.I shtrllreinrbulscthc entilc

a n r o u ntto t h e C c l m t n
ission.

(c)

l h e a m o L l nrte c c i v e d* i l l b e u s : d l b r t h c p u r p o s cf o r * h i c h i t i s r e q u c s t e d .

t0)

ln casctlnancialassistance
is receivcdfiorr thc orsanizefsor anv otltcr agenc\ I shall par
back thc amountlranted by lhe Contntrssron.

(e)

l . l r r l l a h i , l ch 1 r l r c , 1 ,i . .i . ' n, , t r l r eC o n r n r . . i , , r .

Placc:
Date:

( S i g r r a t u rocf t h c a p p l i c a n t )
Dcsignarion

C e r t i f i c a t eb r [ l c a d o f t h e l n s t i t u t i o n :
lccnit\ thi :
(i)

T h c d c t a i l sg i v c nb r t h c a p p l i c a nat r ec o r r e c t .

(ii)
(iii)

1 ' h ca p p l i c a nht a sn o r! r \ a i l c dt h e p r o ri s i o ni n r h el a s rI 3 1 c a r s .
1 h c c o l l c g ch ^ s b c e nd e c l a r e dr ' r i o r e c e i \ cr i n a n c i aar s s i s r a n cucn c r c r . s c c l i or 2n( t s )o f i h c
t j ( ; ( l A c l ( t h c l e t l e ro l ' i n c l U s i oonf l l ( l l ) o t U ( j C r n a r b c c n c l o s c d )

(i\ )

T h e a p p l i c a nhl a se n c l o s e a
dl l t h er e l e \ a nd
t ocumcnts.

(\ )

l hc infbrmation
p r . o irc l c di n t h e a p p l i c a t i o ins c o r r c c t .

(vi)

l n c a s er h e i n s t i t u l i o ni s r b u n dn o t i i r u n d c rs c c t i . ' l l ( f 3 ) o f r h e U G C A c r e r c n a f i e . t h c
a p p r o r a ol l ' r h ec a s e t. h e q r r n t u i l l a u t o r n a t i c a lbl )c c o n s i d e r cads c a n c e l l e d .

(vii)

I n t h e c a s eo f s c ' s r o B C ( e \ c l u d i n .cur c a r r l l a r c r ' )I - e a c h c r ist .i s c c r l i f l e dr h a lt h e \ b c l o n g

1 0S C IS ' I O B C ' P h l s i c a l l yI 'l a n d i c a p p c(dc r c l u d i n gc r . c a r nlra r c r )c o r r m u n i t y .

S i g n a arue
Nanrc
l)esignation
Add ress
()ltce scal
I)atc

APPendix-l
'l'erms
a n d c o n d i t i o n sf o r t h e g r a n t a p p r o v c d b v t h c C o m m i s s i o nf o r v i s i t o f t h e c o l l e g c
l e a c h c r sa l n r o s tl b r p r e s n t i n gp a p c r a l l n t c r n a t i o n a lC o n f e r e n c c ,
l.

C o n l m i s s i o n ' as s s i s t i l n ctco r i a r d sc r p e n d i t u r eo n v i s i t a b r o a do f a C o l l c g et e a c h c ri b r
p r e s c n t i n gp a p c r a t i l n l n t t : r n a t i . n aC
l o n l e r e ' c c* o u l d b c l i n i t e d t o l 0 0 o / ;o l ' t h c
a d r ni s s i b l ec r p c n di t u r co n t h c l b l l o \ \i n s i t c r r so n p r o du c t i o no 1r' e c ei p t u i t h t h c c l a i r n : -

a)

P c r s o n s c l c c t c dl b r l t a r t i c i p a t i osnh o u l dt r a r . c lb t c r c u r s i o nt i c k c l i n s c c m r sb \
t h e c h e a p c sal i r t i c k c t( i n a n , rc a s en o t c x c c c d i n ga i r I n d i a t ' a r ct . A c t u a l f - a r cn o t
erceeding AC-ll c ass rrain l:rre *ill bc admissiblctiorn thc colleqc
headquarter/rcsidence
to the ncarcstair port and back.Ifthe.journet,pcrlbrrncdbr
t a \ i ( r e c e i p tr n a r b c e n c l o s e d/) o u n c a r ( d i s t a n c en t a \ b e n r e n t i o n e dt)h" c f a r e
s h o u l dt h c r e s t r i c t c L
d l A C - l l c l a s st r a i nl a r ei r o a dn r i l e a g e
a c c o r d i n st o d i s t a n c c .
m a ! b eg r v c n .

b)

Actual lrairr'/busfarc lionr thc Airport abroadto the to\\n rrheretlrc cr:nterenccis
h e l da n db a c k .( l l c c e i : t n t a r b e e n c l o s e d ) .

c)

R c g i s t r n l i olne e .( R c c c i p n
t ral bccnclosed).

d)

A i r p o r tt a \ . ( l i c c e r p rt n a l b c c n c l o s c d ) .

c)

V i s af c c .( R e c c i pr r a r b e e n c l o s c d ) .

f)

I ) a i l r a l l o * a n c e s i l l h c p a i d a s p c r t h c e \ i s t i t . t gr a t c s o l - C o \ 1 . o l ' I n d i a .
( A t t e n d a n cccc r l i l l c a t rr r a v b e c n c l o s c d ) .

( 1 h c a b o v c a r c i n c l u s i v cr a t c sa n d c o v e r a l l c \ p c n s c so n a b r o a d .l o J g i n _ 1i n
. cidcntal
e \ p e n d i t u r ca n d i n t c r n atl r a r r : lu i t h i n t h c c o u n t r rc o n c c r n c d
a n d n o o t h e rp c r d i c n rr a t e s
a r ca l l o ne d)
_s)

F o r t h e p a r m c n l o f d a i l r a l l o u a n c ct h c ( i o \ , e r n n t c not f I n d i . r ' sr a r c s* i l l b e
t o l l o r r c dD . A . u i l l b r :p a i d t i r r t h c d u r a t i o no l r h e c o n l t r c n c ep l u s l b u r d a r s i . e .
t r r o d a l , sb c l b r ea n d t \ \ o d a \ s a f t c r t h c c o n l e r e n c eI .f ' l h c . j o u r n e rp c r i o di s l c s s
t h a n t \ \ o d a r s b e l b r ea n d n r o d a r s a l i c r t h a n a c t u a lI ) A r v i l l b e g i r c n t b r t h c
. j o u r n e rp e r i o d .

APPENDIX-II

UNIVERSI'I'Y
GRANTSCOMMISSION
BAIIhDt, RSHAH 7-AF-AR
l\IARG
l\Ew DItLItI _ I t0 002

P r o t i r r n rfab r c l a i r n i n gr e - i n r b u r s c m c0n1t ' 1 hce\ p e n d i t u r ei n c u r r e du n d e rt f r cT r a , " , cCl r a n t

S c h e r ntco a t t c n dC o n f c r c n c a
eb r o a d .
L

Narnc

t.

\ o . & D a t co f L .C t

's

Approval

Name& Placcof ( onlercnceattcnoeo

.1.

D u r a t i o ror f t h c C o n l c r c n c a
ettcnded

5.

[)urationol thc stal abroad

6.

D c t a i lo 1 ' a c t u aelx p c n d i t u r icr c u r r c d :a)

A C - l l C l l a sR
s a i l t h r co r a c t u a l

B u sl a r cu i t h i nI n d i a
( l i o m P l a c cr l l ' d u r \ t t )
n e a r c sAt i r p o r ta n d
back)

D i s t an c e
(Approx
K.M)

b)

Air lare (b_rEconorrr class l-otal

O r F - x c u r s i ot n
icket)
1ar.
( P h o t o c o ptro b e a t r a c h e d )

c)

Farcliorr Airpon (abroad)upto

the vcnueot thc confcrcncc& L.rack

D i s c o u ngt i r .e n
bY the tra\ cl agent

\et
P a g eN o .
p a \a or e

D i s t a n c e lleceipt
cnclose

(Appr0r
K. Nt)

Page

No:

(l

Yes/No
d)

I ) a i h a l l o r r a n c c1 b r
- ().
1 i ) D o l l a rr a t c sp a s r n
p c rd a r D A ( d o l l a r ) : R s .

days
(ii) No.o1'days
d o l l i r rr a t c sX
( R e c e i pcr n c l o s c dy e s A l o . )p a q cN o .

R e g i s t r a t i olnc e p a i d .r ' R c c c i pet n c l o s e Y

d cs/No)

t)

p a g cN o .

A i r p o f tt a \ p a i d( P h o t o : o ptro b e a t t a c h e d()R. c c e i pct n c l o s e yde s N o ) p a g cN o

s)

V i s a l r e e .( R e c c i pct n c l o s e d
Yes,/No)

PageNo.

h)

C o n rc r s i o nr a t c s( e n c l o s c yd e s , N o )

['agc No.

r)

B r i e f n o t co f p a r t i c i p a t i o n
( e n c l o s c yd c s r , N o )

['ageNo.

i)

A t t e n d a r r cCcl c r t i l l c a t(ce n c l o s c yc cl s r ' N o )

l ' a g eN r ' .

I OTAI.
A s sr s t a n c rec c e i v c dl i . l r l I N S A i D S T , '
I ( I A R / C S I Ro r a n \ o t h e ra q e n c \

r)

Balanccamountto be rcirnbursedllr [-jCC'

C erlifledthar
I

l - h ed c r a i l sg i v c sa b o ' c a r ec o r r c c a
t n d i f t h e i n l b r r n a r i oins t b u n dt o b c i n c o r r e cot n a
l a t e r d a t ce. n t i r ea r r o u n tp a i d r r t h c t i n i l e r s i t l G r a n t sC o n t n r i s s i o n
r r i l l t r er e l u n t l e d .

l h e c x p e n d i t u rhea sb c e nu t i r i z c df o r t h c p u r p o s c lsb r * h i c h
i t h a sh c e na p p r o r . eicnr
a c c o r d a n c\e\ i t h t h et e r l n sa n dc o n d i t i o r rlsa i dd o r rn b r t h e L I G C .

I n c a s el l n a n c i a,l s s i s l a n c ics r c c c i ' c d f r o n tr l r co r g a n i z c rosr a n \

o t l l c ra q e n c \ .t h e
a m o u n tp a i db r t h c [ , n i r , c r s i t C
r r a n t sC ( r n r r n i s s i o$ni l l b e ,r c l l n d e d .
(SUt!4Utg o1';\ pplicant)

( ' e r t i l i e dt h a td e t a i l sg i r e n a b c y ch a v c
b e e nr c r i t l c da n d l b u n dc o r r e c r .
f h e A p p l i c a n lt l a sn o t a v a i l e cal s s i s t a n ci reo n r[ - n i v e r s i t )C r a n t sC o r n m i s s i o n
lirrvisitinu
a b r n a dd u r i n gp a s t h r e c, / t r r or c a r s .( l n c a s eo l S C iS l / ( J I J Cn r l ne r c a r r t r
l a rr r r P h rr i . a l h I l l r n d i c a p p c J

Signatu
re
( N a r n ei n l l l o c k L e l t e r s )

Dated

P r i nc i p a l / D c a n
(Seal)

UNIVE RSIl'Y cRArr*TSCONTN{tSSION

BAHAI)URSIIAHZAFAR MARG
NEW DEt_Ht._I l0 002
APPENDIX-III
T]TII-IZA'TION CERTI I.'ICAT[C c r t i l l c dt h a tt h c e x p c n d i t u roei R s .
O n t h e I i s i to l '
lrorn

In

p r c s e nht i s / h c rp a p e ra l t h e

has becn incurred in lccordancc nith terms & conditionslaid dorrn bv

the Universit\ Grants

( - o r r n t i s s i oinn i t s l e t t c rN o . l : .

datcd

a n da l l t h ec o n d i t i o n o
s l t h c g r a n th a v cb c e ni ' u l f i l l c c _l :

n c c 0 L r n t aA
n tu d i t o r , /hCa r t e r e d
A c c o u rt a n t\ \ i t h R e q i s t r a t i o n
n u l n b c ra n ds c a l
P r i n ci p a l / D c a n

'\ppcndir-lV
MANDATE FORM

A.
D E T A I L O I . 'A C C O I ] N ' I ' H O I , I ) E R : .
NA]VlIOF ACCOUNI' HOLt)I-R
CONIPLhI'[CONl ACT A l)DRliSS

B A N K A C ( ' O U \ T I ) 1 , T ALI S : Ilr\NK NAME

_tr

BIIANCHNAI\.1[WITtI C'O\4PL
I-]TF-\DDRI]SS,I
T t L I ] P H O N t ]N U I V I B I : R
AND E-MI\II-

WHITTHI-.R
THE BIiANCtIlS (tO\4pUl'ERIS[D,]
I I : Y E S T I I A N W I I A I I S T H E B I I A I . , ] C III} - S ( ]
COI)E
I S T T I FB R A N C I I A L S O N I F T E N A . I ] I - F D ' ]
I ' Y P EO I JB A N K A C [ ' O L J N T
(SBTCtIRRI:NTICA
l I : t ) t T)
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COMPI.IT'fE
B A N K A C C O Nl N t J I V l B l - _ R

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I . h c r e b l d c c l a r ct h a t t h c p a r t i c u l a rgsi v e na b o \ e a r c c o r r e c ta n d c o m p l e l e I. f t h e t r a n s a c l i o n
is
d e l a r c do r r r o te t l c c t e da t a l l t b r r c a s o n o
s f i n c o n r p l c loer i n c o r r e ciIn l l r n t a r i o 6I. r i o u ] d n o t h o l d
t h c u s e ri n s t i t u t i t l nr c s p o n s i b l eI . h a v er c a d t l r c o p t i o n i n v i t a t i o nl e t t e ra 1 d a g r e ct o d i s c h a r s e
r e s p o n s i b i l ie
t r\ p c c t e dt o m e a s a p a r t i c i p a nutn d c rt h e s c h c n r e .
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c 1c' u s t o l l e r
Date:
C e f t i f i e dt h a tt h c p a f i i c u l a r lsu r n i s h e da b r : l ca r ec o r r c c a
t sp c r o u r r . e c o r c i s .
( I l a n kS t a n p )

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l'

( . . . . . . . . . . . . . . . . . . . . . . ).
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a f t a c ha p h o t o c o p o
' f c h c q u ea r o n gu r t ht h c .v c r i f i c a r i o o
n b t a i nr i o r nt h c b a n k .
2 . I n c a s e) o u r b a n kb r a n c hi s p r , r s c n t ln\ o t R l ( i S c n a b l c dt.h c nu p o ni t s g r a d a t r o n
up
to
R - l ' ( l St : n a b l e db r a . c h .p l c a s es u b m i t h c i n f o r n r a t i oang a i ni n t h c a b o l . ep r o f b r r r a
to rhc
l)epanmcntat earlicst.