Format for Utilization Certificate

(Form GFR 19-A)

Sl. No. Letter No. Amount

¸ÀPÁðgÀzÀ C
¢üãÀ Certified that out of Rs. 3,60,00,000.00 of grant-in-Aid sanctioned
PÁAiÀÄðzÀ²ð
(¥Àæ) during the year 2021-22 in favour of __Department of Kannada
PÀ£ÀßqÀ and Culture__ under this Ministry/Department Letter No
ªÀÄvÀÄÛ
¸ÀPÁðgÀzÀ C¢üãÀ PÁAiÀÄðzÀ²ð (¥Àæ) PÀ£ÀßqÀ
¸ÀA¸ÀÌøw
E¯ÁSÉ(DqÀ½v ªÀÄvÀÄÛ ¸ÀA¸ÀÌøw E¯ÁSÉ(DqÀ½vÀ PÀ£ÀßqÀ) EªÀgÀ
À PÀ£ÀßqÀ)
¸ÀPÁðgÀ DzÉñÀ ¸ÀASÉå:PÀ¸ÀAzÁ 72 PÉMJ¯ïDgï 2020
1. EªÀgÀ 3,60,00,000.00
¸ÀPÁðgÀ ¨ÉAUÀ¼ÀÆgÀÄ, ¢£ÁAPÀ 14.03.2022 given in the margin and
DzÉñÀ
Rs. ___NILL___ on the account of unspent balance of the previous
¸ÀASÉå:PÀ¸ÀA
zÁ 72 year, a sum of Rs. _NILL_ has been utilized for the purpose of
PÉMJ¯ïDgï _Construction of additional at work of Tulu Bhavana, Mangalore_
2020
¨ÉAUÀ¼ÀÆgÀ for which it was sanctioned and that the balance of Rs. ___NILL___
Ä, ¢£ÁAPÀ remaining unutilized at the end of the year has been Surrendered
14.03.2022
to Government (vide No. ____- ___ dated ____- ___ ) will be adjusted
TOTAL 3,60,00,000.00 towards the grants-in-aid payable year ___NILL____.

2. Certified that I have satisfied myself that the conditions on which the grant in aid was sanctioned have been
duly fulfilled/are being full and fulfilled and that I have exercised the following check to see that the money
was actually utilised for the purpose for which was it was sanctioned.

Kind of Checks Exercised

1.
2.
3.
4.
5.

Date:-
Executive Engineer,
Public Works Department,
Mangaluru Division, Mangaluru
 Format for Utilization Certificate
(Form GFR 19-A)

Sl. No. Letter No. Amount

Certified that out of Rs. __3,00,00,000__ of grant-in-Aid
ªÀiÁ£Àå f¯Áè sanctioned during the year __2021-22__ in favour of
¢üPÁjAiÀĪÀgÀ
__Karnataka Border area department Authority__ under
Ä zÀ.PÀ. f¯Éè
gÀªÀgÀ this Ministry/Department Letter No ªÀiÁ£Àå f¯Áè
£ÀqÀªÀ½ ¥ÀvÀæ ¢üPÁjAiÀĪÀgÀÄ zÀ.PÀ. f¯Éè gÀªÀgÀ £ÀqÀªÀ½
1. 3,00,00,000.00
:ªÀÄÄ£ï(2)UÀr/¹
Dgï/02/2022-23/¹. ¥ÀvÀæ :ªÀÄÄ£ï(2)UÀr/¹Dgï/02/2022-23/¹.£ÀA.-167433 ¢
£ÀA.-167433 ¢ £ÁAPÀ 02/02/2022 given in the margin and Rs. ___
£ÁAPÀ NILL____ on the account of unspent balance of the previous
02/02/2022
year, a sum of Rs. __ NILL___ has been utilized for the

TOTAL 3,00,00,000.00 purpose of __Construction of Karnataka Konkani Sahithya

Academy Building___ for which it was sanctioned and that
the balance of Rs. __NILL___ remaining unutilized at the end
of the year has been Surrendered to Government (vide No.
____-_____ dated ____-_____ ) will be adjusted towards the
grants-in-aid payable year ___ NILL____.

2. Certified that I have satisfied myself that the conditions on which the grant in aid was sanctioned have been
duly fulfilled/are being full and fulfilled and that I have exercised the following check to see that the money
was actually utilised for the purpose for which was it was sanctioned.

Kind of Checks Exercised

1.
2.
3.
4.
5.

Date:-
Executive Engineer,
Public Works Department,
Mangaluru Division, Mangaluru