DETAILS OF RMSA FUND UTILIZATION 2009-10

1. 2. 3. 4. 5. Name of School District Educational District Name of Principal/HM Address, Phone No. & Email ID : : : : :

6. 7. 8. 9.

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Bank Account No. : Name of Bank with Branch : IFSC Code of Bank : Amount received under RMSA (a) Date of receipt : (b) Date of withdrawal : (c) Details utilization : Amount allotted for Minor Repair (` 25,000/-) (a) Amount withdrawn : (b) Amount expended : (c) Balance : (d) If not used, reason : Amount allotted for Lab Equipments (` 25,000/-) (a) Amount withdrawn : (b) Amount expended : (c) Balance : (d) If not used, reason : Amount allotted for Purchase of Books, Periodicals and News Paper 10,000/-) (a) Amount withdrawn : (b) Amount expended : (c) Balance : (d) If not used, reason : Amount allotted for Water and electricity charges (` 5,000/-) (a) Amount withdrawn : (b) Amount expended : (c) Balance : (d) If not used, reason : If the programme is yet to be started the proposed date on which it will be completed

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Certified that the above particulars are true and correct as per the work done and the records. Place: Date:

Principal/HM