Ministry of Social Justice and Empowerment
Government of India
PROFORMA FOR INSPECTION OF PROPOSALS FROM ELIGIBLE ORGANIZATION
FOR GARIMA GREH
A. Details of Inspecting Team
Sr No Particulars Details
1 Name, Designation, Address, Telephone No. and
email address of the inspecting officer
2 Name and Designation of accompanying officials
if any
3 Date and Day of the inspection
4 Time of
(a) reaching for inspection
(b) completion of the inspection
5 Nearest landmark and Google coordinates
B. Information related to organization
6 Name of the Organization
7 District for which Garima Greh application has
been filed for
8 Address of the head office
9 Telephone Number
10 Email Address
11 Year of Establishment
12 Registration No. (attach copy of certificate)
13 Name of Head of the organization with phone
number
14 Composition of managing body and details (to be
annexed) Kindly cross verify if the organization is
headed by a transgender person or being run by
the transgender persons community*
Ministry of Social Justice and Empowerment
Government of India
15 Date of last election of managing body and
validity till
16 Aims & Objectives of the organization as
mentioned in the Memorandum of Association,
Trust Deed or any other relevant government
certificate (Trust, Company, Start-up, CBO,
NGO)
The original aims & objectives duly signed during
registration has to be checked or any amendments
if done and attached with the IR*
17 Details of turnover in the last 2 financial years
The inspecting officer shall check the funds
utilised over the past 2 years by the organization,
if it has been used anywhere for Transgender
welfare thoroughly. The major heads of
expenditure and area of work conducted in the
past two years.*
18 Activity Report/ Annual Report of the
Organization for the last year
The activities pertaining to transgender welfare
has to be cross-verified with the organization,
evidence of work shall be sought.*
19 Projects undertaken by the organization for the
welfare of Transgender persons (Evidence to be
provided)
20 How many beneficiaries (Only Transgender
persons) benefitted in the past 2 years.
List of beneficiaries may be provided with name,
contact number, address, Aadhar number
21 Any awards received by the organization for
transgender welfare (Evidence to be provided)
22 Number of transgender persons rehabilitated by
means of self- employment, job employment, so
far (of the total estimated number of transgender
communities in the district)
Ministry of Social Justice and Empowerment
Government of India
23 Annex the list of workers present in the
organization who are directly working on projects
related to transgender persons
24 Income Tax Registration & Exemption
Certificates, if any
25 Does the organization have any linkages with
government schemes, programmes or other
organizations to provide:
a. Skill development
b. Employment
c. Health requirements
d. Counselling services
e. Recreation
f. Any other
C. Infrastructural Requirements
26 Location of the building for setting up of Garima
Greh (Proposed) Rent agreement if any
27 Google Coordinates to be provided
28 Is the project location accessible? Yes/ No
In case of No, Justify
29 Number of rooms in the building with its usage
30 The suggested dormitories have sufficient space Yes/ No
for 25 residents?
In case of No, Justify
Ministry of Social Justice and Empowerment
Government of India
31 Comment on the building’s hygiene level,
ventilation, connection to transportation, nearby
shops and availability of resources such as food,
water etc.
D. Any other comments by the inspecting officer on the functioning and capacity of the
organization to run Garima Greh under the Ministry of Social Justice & Empowerment.
E. Certification-I
This is to certify that the information provided to the Inspection Officer, deputed by
competent authority of Ministry of Social Justice and Empowerment, Govt of India, is best of
knowledge of undersigned and undersigned is completely responsible for inputs provided.
Any decision taken by competent authority of Ministry of Social Justice and Empowerment,
Govt of India on the basis of this report will be acceptable to undersigned as head of applicant
organization.
Sr No Particulars Details
1 Name of the Organization head
2 Designation
3 Date of visit
4 Signature
Ministry of Social Justice and Empowerment
Government of India
F. Certificate-II
This is to certify that the undersigned has been deputed by competent authority of Ministry of
Social Justice and Empowerment, Govt of India for the inspection of the organization
namely………………(name of organization). Undersigned has prepared this inspection report
on the basis of inputs given by head of applicant organization and the prevailing conditions
(visual and documented) noted on-spot during designated period of inspection. This
inspection report has been prepared without any external/ internal pressure/influence/biasness.
Sr No Particulars Details
1 Name of the inspection officer
2 Deputed for inspection by the authority of
3 Designation
4 Date of visit
4 Time of visit
6 Signature
Certificate for infrastructure requirement for Garima Greh
To whomsoever it may concern
This is to certify that undersigned is competent signatory on the behalf of
……………………………………………(name of organization) who have
applied for Garima Greh at ………………………………………(address of
proposed Garima Greh).
Undersigned further certify that the proposed Garima Greh at given address have
total built-up/non built-up area of (approx) …………………..sq ft, and has been
built as per the given standards in advertised Expression of Interest of Garima
Greh.
Signature of authorized signatory:
Name of authorized signatory:
Mobile Number of authorized signatory:
Date:
Stamp of organization:
