FORM NO.12

                                                (See Rule 10 )

 

 

Monthly statement of disbursement of unemployment allowance under the EGS for the month of.....................................

 

 

1.Balance amount at the beginning of    :  Rs...............................

   the month out of the amount received

   from the Samiti Officer for

   disbursement of unemployment

   allowance.

 

2.Amount received during the                 : Rs................................

   month.

 

 

3. Total                                                 : Rs................................

 

4. No.of disbursement made during        : Rs................................

    the month.

 

5. Amount disbursed during the             : Rs.................................

    month.

 

6. Balance at the end of the month

    ( 3 minus 5 )

 

 

Place...........................

 

 

Date............................                Signature of Registering Authority.