Rajasthan Panchayati Raj Rules 1996 (Forms)

 Rajasthan Panchayati Raj Rules 1996

(Forms)

Form I

[See Rule 21 (1)]

Form of the Written Notice of Intention to Make a Motion Expressing Want of Confidence

In the Sarpanch/Up-Sarpanch of ........ a Panchayat

In the Pradhan/Up-Pradhan of ........ a Panchayati Samiti

In the Pramukh/Up--Pramukh of ........ a Zila Parishad.#

To,

The Chief Executive Officer/Development Commissioner, Zila Parishad Rajasthan, Jaipur#

Notice

Sir,

We, the undersigned elected members of the ......... Panchayat/Panchayat Samiti/Zila Parishad# hereby give this notice to you of our intention to make a motion of no-confidence in Shri ........the Sarpanch/Up-Sarpanch/Pradhan/Up Pradhan/Pramukh/Up-Pramukh# of our Panchayat/Panchayat Samiti/Zila Parishad# and also annex hereto a copy of the proposed motion of no-confidence.

Yours Faithfully,

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

Date ............

# Deleted whichever is not applicable.

Form II

[See Rule 21(2)]

Form of the Notice of a Meeting of the Panchayat/Panchayat Samiti/Zila Parishad to be held for consideration of the No-confidence Motion Against the Sarpanch/Up-Sarpanch/Pradhan/Up-Pradhan/Up-Pramukh

To,

Shri ...............

Member,

Panchayat/Panchayat Samiti/Zila Parishad .........

Notice

Dear Sir.

This notice is hereby given to you of ......the meeting of Panchayat/Panchayat Samiti/Zila Parishad which shall be held at the office of the said Panchayat/Panchayat Samiti/Zila Parishad on ......... (date) at ........ (time) for consideration of the motion of no-confidence which has been made against Shri ........... the Sarpanch/Up Sarpanch/Pradhan/Up-Pradhan/Pramukh/ Up Pramukh of the said Panchayat Panchayat Samiti/Zila Parishad

A copy of the motion is annexed hereto.

Chief Executive Officer/Development Commissioner

Place .........

Date ..........

Form III

[See Rule 31]

Panchayat/Panchayat Samiti/Zila Parishad ........

TADA Bill of Shri ........ Designation ...........

Particulars of journeys and halt

Kind of Journey by Rail, Road, or other

Railways/Motor Lorry/Steamer/Airplane fare

Departure

Arrival

Class

Amount of fare

Station

Date

Hour

Station

Date

Hour

mode

Rs.

Ps.

1

2

3

4

5

6

7

8

9

Total

Incidental Charges

Daily Allowance

Local Transport Actual Expenses

Purposes of Journey

Remarks

Km.

Rate

Amount

No. of days

Rate

Amount

Particulars

Amount

Rs.

Ps.

Rs.

Ps.

Rs.

Ps.

10

11

12

13

14

15

16

18

19

Amount (in words)

Certificate

1. Certified that I was not provided with any free locomotion at the expense of a Government Local Fund or a Local Body.

2. Certified that the payment of this bill has not been received before.

3. Certified that I have actually traveled in the same class of accommodation for which TA. has been claimed.

4. Certified that on Sunday or another holiday for which daily allowance has been claimed by me, I was actually in camp.

Station: ...........

Date: ..............

.........................
Signature

Countersignature Counter signed for Rupees (in words)

Abbreviated classification

Controlling Officer
Date:...........
For Treasury Use

Treasury/Bank

Pay Rs ........ Rupees (in words)

Examined and entered

Panchayat Samiti/Zila Parishad Accountant Payee's discharge	Date	Vikas Adhikari/Chief Executive Officer
Received payment	Paid Rs........on ......	Vide Cash Book Item No ............
Signature	Cashier Vikas	Adhikari/Chief Executive Officer

Form IV

[See Rule 63]

Assessment of Demand of Taxes for the period ending.........

Name of Panchayat .............. Panchayat Samiti ............. District ....... Name of Tax ........... Rate of Tax ..............

Name of  Village	Name of Assessee and father's Name, occupation, and address	Areas	Current Demand	Total	Remarks
1	2	3	4	5	6

Date: ...........

Signature of Patwari

Form V

[See Rules 64 and 105]

Demand Slip

Book No ….............	S. No. …..........
Village ….............	Panchayat …......
District …..........	Panchayat Samiti ….......
	For the Year …........

(Counter Foil)

Date	Name of Assessee and father's name, occupation, and address	Name of Tax	Demand			Remarks
			Area	Current	Total
1	2	3	4	5	6	7

Form VI

[See. Rule 67]

Demand and Collection Register

Panchayat Samiti ...................

Panchayat .............

For the year ............

S No.	Name of Village	Name, Father's Name, Occupation, and Addresses of the assessee	Name of Tax	Areas	Current demand	Total	Ref. to demand slip		Amount paid		Total	Ref. of receipt		Ref. to recovery statement		Remarks
							No.	Date	Arrear	Current demand		No.	Date	No.	Date
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17

Form VII

[See Rule 69(6)]

Cattle Entry Pass (in Red Colour)

Book No ..............

S.No .................

Date .................

1 Outpost No .....................

2. Name of breeder bringing the cattle .............. S/o ............Caste ............. R/o ...................

3. Place from where cattle brought ........... Tehsil ................... District ................. State ..............

S. No.	Kind of Animal	Number	Date of Return	Remarks
1	2	3	4	5

Special instructions: -

1 . Every trader/owner of cattle must obtain an entry pass failing which he shall be liable to a penalty at the time of departure.

2. The fact of the sale must be got entered in Mela Office immediately after the sale.

3. The fact of entry or exit of cattle for grazing of the incident of death of animal must be got entered on entry pass failing which tax will be charged for the such animal also.

Form VIII

[See Rule 69(4)]

Rawana (White Colour)

Book No ..............

Serial No ...........

Date ....................

Cattle fair tax recovered from........... (name of purchaser of cattle) S/o ........ R/O ......... as under :

Description of Cattle	Number	Price			Mela Tax	Remarks
		Total	Maximum	Minimum
1	2	3	4	5	6	7

Form IX

[See Rule 69(7)]

Registration of Sales

S. No.	Date	Name of purchaser with address	Description of cattle Purchased	Number	Price			Mela tax	Name & address of seller
					Total	Max	Min
1	2	3	4	5	6	7	8	9	10

Form X

[See Rule 82(4)]

Receipt of Taxes/Octroi Duty

Receipt Book No ............	S. No ..........................
Village .................	Panchayat ...................
Panchayat Samiti ...................	District .......................

 

Name of Depositor (With father's name: occupation and address)
Date	Amount received with details		Reference to demand slip
	Name of Tax	Amount	No.	Date
1	2	3	4	5

 

Signature/T.I. of Tax payer		In case of Octroi duty :		Signature of Patwari
Date	Value of goods	Description of goods	Rate of octroi	Amount of octroi
1	2	3	4	5

Date : .........

Signature of Octroi Collector

Form XI

[See Rule 85 (1)]

Receipt for Transit Goods

Panchayat ….....................	Panchayat Smity..........	District.................
Book No.............................		S.No.....................
		Date......................
	Name of octroi out-post........	Date......................
Name of importer.............	S/o................	R/o.....................

 

Description of goods	Value	Rate	Amount Rs.	Remarks
1	2	3	4	5

 

Railway/Goods Receipts No..........	Date..................
Place of dispatch....................
Pass No........................	Date.................
Signature of the Importer	Signature of In-charge Octroi Outpost

Form XII

[See Rule 91]

Form of License of Vehicle

Shri.........S/o.........resident of.........has paid the vehicle tax for the year and is permitted to keep a vehicle described below within the Panchayat circle for the aforesaid period.

Description

Sarpanch..................

Panchayat..............

Form XIII

[See Rule 106]

Form of Demand Notice

Panchayat...............Panchayat Samiti.............. Zila Parishad...........Case No.............Year....................

To,

................
................

Particulars
.........................

In the above case, a sum of Rs...........is due from you and in spite of demand slip dated you did not deposit the outstanding dues, hence you are hereby ordered to deposit the above amount within fifteen days failing which your movable property will be taken under custody and action for the realization of dues will be taken.

Given under may hand seal this day the........................

Signature of Sarpanch

Form XIV

[See Rule 107]

Warrant of Attachment and Sale

Panchay at..................Panchayat Samiti...............Zila Parishad...........Case No.................Year.............

Description
...........................

To,

.................

In the above case a sum of Rs................is due from Shri.......S/o.....R/O and the same has not been paid inspite of notice of demand and demand slip and the time limit of 15 days has also expired. In pursuance of Rule 107 under Sub-Section (2) of Section 65 of the Rajasthan Panchayati Raj Act, 1994, you are hereby authorised to take under attachment the movable property of...................excluding the articles exempted by law and produce the same before the Panchayat, attach and sell the said movable property according to law and deposit the sale proceeds in the Panchayat.

Given under any hand and seal this day the.....................

Signature of Sarpanch

Form XV

[See Rules 115 and 118]

Cattle Pound Register (Kine-House)

S. No.	Date and time of the animal	No. of receipt granted on the entry of the animal		Description of animal	Identification mark of the animal and appearance	Name of the person bringing the animal and place of residence	Name of owner of the animal and place of residence if known	Date, time manner of disposal of the animal i.e., sold, released, or released or treated as unclaimed property
								Date	Time	Manner
1	2	3		4	5	6	7	8	9	10
Receipt and No. of the disposal of the animal sold released treated as or unclaimed property	No. of days for which the animal remained in kine house	Fine and feeding charges realised		Amount deposited in Panchayat fund or paid to the owner of the animal		Total deposited in Panchayat fund or paid to the owner of the animal	Name and addressed of individual obtaining the animal	Signatures or Thumb impression of individual obtaining the animal	Signature or incharges of cattle pound (Kind House)	Remarks
		Find	Feeding Charges	Panchayat fund	Owner of animal
11	12	13	14	15	16	17	18	19	20	21

Form XVI

[See Rules 115 and 119]

Receipt for the Entry of Animal (In Two Foils)

Book No...........	Date...........................
Serial No.................	Panchayat …....................
Name of Kine-House......................	Panchayat Samity.......
	District........................

 

Date and entry of animal	Name and place of residence of the individual bringing the animal	No. of animals admitted and description etc	Name and place of the residence of the owner if it is known	Kine-House Register Number	Remarks
1	2	3	4	5	6

Signature of Kine-House Incharge

Form XVII

[See Rule 115 and 126]

Pass for the Release of Animal From Kine-House

Book No...........	Date...........................
Serial No.................	Panchayat …....................
Name of Kine-House......................	Panchayat Samity.......
	District........................

 

Date and time of entry of the animal	Date and time of release of the animal	No. of animals and description	Name and place of residence of individual taking the animal	Fine realised	Grazing fee realised	Any other recovery	Remarks
1	2	3	4	5	6	7	8

Signature of Kine-House Incharge

Form XVIII

[See Rules 115 and 126]

Pass for the Release of Animal

(To be Kept in The Panchayat)

Book No...........	Date............................
Serial No.................	Panchayat ….................
Name of Kine-House..................	Panchayat Samiti...............

 

Serial Number of the Kine House Register	Date and time of release of the animal	Amount of fine	Grazing Fee	Any other recovery	Remarks
1	2	3	4	5	6

Total Including previous total

Signature of Kine-House Incharge

Form XIX

[See Rules 115 and 127]

Receipt to be given to the purchaser of animal	Receipt to be given to the purchaser of animal
Book No...............	Book No......................
Serial No..........Dated the.....19....	Serial No.... Dated the..... 19.... Name of Name of
Kine House...............	Kine House...........
Panchayat..........	Panchayat..........
Panchayat Samiti...............	Panchayat Samiti..............

 

Kine-House Register Number	Description o f animal and class	Identification mark or appearance	Name of purchaser of animal and place of residence	Cost at which animals were sold by auction	Particulars of entry in Cash book	Remarks
1	2	3	4	5	6	7

Signature of purchaser of animals

Signature of Sarpanch

Form XX

[See Rules 137]

Register of Buildings and other Immovable Property............

Panchayat.....................

Panchayat Samiti.................

District...........Year...........19............

Serial No.	Date of receipt of property	Particulars of property	Value	Purpose of which used	Annual income if any	Remarks
1	2	3	4	5	6	7

Form XXI

[See Rule 146]

Panchayat.................

Panchayat Samiti................

District...........Year...........19............

Serial No.	Date of receipt of property	Particulars of property	Value	Purpose of which used	Annual income if any	Remarks
1	2	3	4	5	6	7

Form XXII

[See Rule 148]

Notice Inviting Objections Regarding Proposed Sale of Abadi Land.

Panchayat...............

Panchayat Samiti..........

Zila parishad...........

Notice

No..............

Date...............

Notice is hereby given that Shri......S/o.........residence of.....has applied to this panchayat the land described below:-

(Description of Land)

If any one has any objection to the sale of the above mentioned land, he should file his objections within one month of the thereof.

[[During the Rajasv abhiyan or Prashasan Gaon ke sang abhiyan or any other abhiyan organised by order of the State Government for sale of land and Patta Vitran], period of filing objections will be seven days in place of one month]

Signature of Panchayat

Signature of Sarpanch

Form XXIII

[See Rule 167(1)]

Sale Deed of Abadi Land

This Deed of Sale is made on the.............day of..........between Panchayat established under the Rajasthan Panchayati Raj Act, 1994 (Rajasthan Act No. 13 of 1994), being a body corporate by virtue of the provisions of Section 9 of that Act, (hereinafter called "the Vendor", of the one part and........S/o.......resident of........(hereinafter called the "Purchaser"), of the other part.

Whereas

1. The land described in the Schedule hereto and more particularly described in the plan annexed hereto which shows it as bounded in red, vests in the Vendor for the purpose of the Vendor.

2. The said land was put up to auction for sale on behalf of the Vendor on day of..........(pursuant to the application of Shri........for purchase of the land) and the Purchaser's bid of Rupees.........being the highest was accepted.

Or

This said land has been sold by negotiation at market rate of Rs.........(applicable for sale by negotiation) and has been auctioned by Resolution No..........dated..........of Vendor Panchayat and confirmed by Panchayat Samiti/Zila Parishad/State Government vide order No........dated........

3. The said auction was held in accordance with Rules 150 to 152 of the Rajasthan Panchayati Raj Rules, 1996; as amended upto date and

4. The Purchaser has deposited the said sum of Rupees to the credit of the Vendor.

Now this Deed Witnesses as follows: -

I . In pursuance of the said auction/sale and in consideration of the sum of Rupees........paid by the purchaser as aforesaid (the receipt whereof the Vendor hereby acknowledges), the Vendor hereby; transfer to the purchaser the land described in the Schedule hereto and more particularly described in the plan annexed hereto which shows it as bounded in red. To hold the same to the Purchaser as absolute owner subject to the payment of such cesses and taxes as may be lawfully assessed or imposed thereon and subject to the restrictions imposed by the Rajasthan Panchayati Raj Act, 1994 and rules and bye-laws made thereunder as for the time being in force.

2. It is hereby agreed that the expression "the Vendor" hereinbefore used includes the successor and assigns of the Vendor, and the expression "the Purchaser" hereinbefore used includes his heirs, representatives, successors and assigns.

(Schedule and Plan to be annexed)

Signed on behalf of..............Panchayati in pursuance of resolution No..........dated.........of that Panchayat.

Signature of Sarpanch/Gram Sevak-cum-Secretary Purchaser's Signature Witness

No. 1...................
Witness No. I..................

Witness No. I..........................

Witness No. II.........................

Form XXIII -A

[See Rule 157 (1)]

Patta of Residential Land

Gram Panchayat..................

Panchayat Samiti.....................

District..........................

This Deed in made on the .... ....... day of between (Name of Panchayat) Panchayat established under the Rajasthan Panchayati Raj Act, 1994 (Rajasthan Act No. 13 of 1994), (hereinafter called "the Allotting Authority") of the one part..............and S/o, W/o, D/o.........resident of...........(hereinafter called "the allottee"), of the other part.

Whereas

The land described in the Scheduled annexed hereto which shows it as bound in red, vests in the Allotting Authority for the purpose of the allotment.

This patta issued in favour of Sh./Smt...........S/o/W/o..........resident of under Rule 157 (1) of the Rajasthan Panchayati Raj Rules, 1996 with following conditions.

1. The aforesaid allottee is in possession of old house more than fifty year/constructed during last fifty years from the date of commencement of the Rajasthan Panchayati Raj Rules, 1996 on Panchayat Abadi Land. The allottee has deposited fce rupees One Hundred/Two Hundred.

2. The area of land is marked in red ink in annexed map plan.

3. The allottee can mortgage the document for taking loan from Government Under taking, Co-operative Bank, Commercial Bank or any other financial institution for reconstruction of the house.

4. The allottee shall be liable to pay all taxes or other charges payable to Government or local authority.

Issued by Gram Panchayat...........on date........in compliance of resolution No..........

Signature Secretary

Signature Sarpanch

Demarcation -

1. North..........................

2. South..........................

3. East...........................

4. West............................

Map:- (Land is shown in map is de-marked in red ink)

Measurement: -

North Direction:...........................

South Direction:...........................

East Direction:............................

West Direction.............................

Total area............................Sq.Yard.

Signature Secretary

Signature Sarpanch

Not for use (in red link)

Form-XXIII-B

[See Rule 157(2)]

Allotment of Abadi Land/Regularisation of families possessing hutment/kucha.

Gram Panchayat .............................
Panchayat Samiti .............................
District ...........................(Rajasthan)

This Deed of allotment is made on the .........day of........between (Name of Gram Panchayat) Panchayat established under the Rajasthan Panchayati Raj Act, 1994 (Rajasthan Act, No. 13 of 1994), being a body corporate by virtue of the provisions of Section 9 of the that Act, (hereinafter called "the Allotting Authority"), on the one part and Smt. ............ W/o ............ resident of (hereinafter called "the allottee"), of the other part.

Whereas

The land described in the Scheduled annexed here to which shows it as bound in red, vests in the Allotting Authority.

Whereas as family of allottee does not have any house or housing site any where and in possession of abadi land by way of construction a hutment/kutcha house upto year 2003 on the aforesaid land.

Whereas the Gram Panchayat has allotted and handed over possession of the land to the allottee under Rule 157 (2) of the Rajasthan Panchayati Raj Rules, 1996.

Whereas panchayat has agreed to allot above land measuring ....... Sq. yard (maximum 300 yards) on the terms and conditions hereinafter mentioned.

And Whereas the Panchayat had handed over possession of the demised land to allottee on .......................

Now this Deed Witnesses as Follows:

1. This allotment is being made after following the procedure laid down in the rules.

2. Such land has been allotted free of cost to Smt for residential purpose with reference to his application to the allotting authority.

3. Allottee and his heirs have no right to transfer land to anybody and shall be in possession of allottee himself except provided in condition No.4.

4. To construct the house on this land the allottee will have right to mortgage the document for taking the loan from Government Undertaking. Co-operative Bank or from any other financial institution.

5. This plot can be utilized as residential purpose.

6. The allotting authority reserves the right to cancel the allotment of land if any false information is given by the allottee or if he transfers the plot to any person.

7. The allottee shall be bound to comply with the plans approved by Gram Panchayat for systematic development of village.

8. Allotting authority reserves the right to cancel the allotment, if the applicant violates any condition or provisions of rules. Before cancellation of allotment the allotting authority shall given the opportunity of hearing to the allottee.

9. The allottee shall be liable to pay all taxes or charges payable to Government and other local authority.

Issued by Gram Panchayat ........... is on date ......... is compliance of resolution No. .....................

Signature Secretary

Signature Sarpanch

Demarcation -

1. North .............................

2. South .............................

3. East .............................

4. West. .............................

Map :- (Land is shown in map is demarked in red ink) Measurement :-

North Direction .............................

South Direction .............................

East Direction .............................

West Direction .............................

Total Direction : ............................. Sq Yard

Signature Secretary

Signature Sarpanch

Form XXIII-C

[See Rule 158]

Allotment of Abadi Land at concessional rate/free of cost

Gram Panchayat .............................
Panchayat Samiti .............................
District ......................... (Rajasthan)

This Deed of allotment is made on the ............ day of ........ between (Name of Panchayat) Panchayat established under the Rajasthan Panchayati Raj Act, 1994 (Rajasthan Act, No. 13 of 1994). Being a body corporate by virtue of the Provisions of Section 9 of the that Act. (hereinafter called "the Allotting Authority") of the one part and ............ S/o ........... resident of .............. (hereinafter called "the allottee "), of the other part.

Whereas

Whereas the allottee requested for allotment of land for construction of house at concession rate/free of cost and the Panchayat agree to allottee the same.

Whereas the Gram Panchayat has allotted and handed over possession of the land to allottee under Rule 158 of the Rajasthan Panchayati Raj Rules, 1996.

Whereas the Gram Panchayat has allotted and handed over possession of land to allottee under Rule 158 of the Rajasthan Panchayati Raj. Rules, 1996.

And Whereas Panchayat has agreed to allot land measuring .... Sq. yards (upto 150 yards) on the terms and conditions hereinafter mention for the residential purpose -

And Whereas the Panchayat had handed over possession of the demised land to allottee.

Now this Deed Witnesses as Follows :

1 . The allottee is eligible for allotment at Concessional rate/free of cost.

2. Land which is indicated in the annexed map allotment in red ink is transferred to allottee for residential purpose.

3. Allottee and his heirs have no right to transfer land to anybody and shall be in possession of allottee himself except provided in condition No. 4.

4. To construct the house on this land, the allottee shall have right to mortgage the document by taking the loan from Government Undertaking, Co-operative Bank or from any other financial institution.

5. Such land has been allotted at the rate of ........../- or free of cost to allottee for residential purpose with reference to his application, as per the provisions of the Rajasthan Panchayati Raj Rules, 1996.

6. This plot can be utilized as residential purpose.

7. The allotting authority reserves the right to cancel the allotment of land if any false information is given by the applicant or if he transfers the plot to anybody else.

8. The allottee will be bound to comply with the plans approved by Gram Panchayat with a view to systematic development of village.

9. Allotting authority reserves the right to cancel the plot if the applicant violates any condition or provisions of the rules. Before cancellation of such plot the allotting authority shall give the opportunity of hearing to the allottee.

10. The allottee shall be liable to pay all taxes or charges payable to Government and other local authority.

Issued by Gram Panchayat .......... is on date ........ is compliance of resolution No .............................

Signature Secretary

Signature Sarpanch

Demarkation:

1. North: .............................

2. South: .............................

3. East: .............................

4. West: .............................

Map: - (Land is shown in map is demarked in red ink) Measurement: -

1. North Direction: .............................

2. South Direction: .............................

3. East Direction: .............................

4. West Direction: .............................

Total Area.............................Sq. Yard.

Signature Secretary

Signature Sarpanch"

Form XXIV

[See Rule 168 (1)]

Patta Bahi (Register of Sale Deeds) of Abadi Land

Panchayat ................ Panchayat Samiti .............. District ............

S.No.	File No.	No. and date of order of Panchayat and date of confirmation by higher by authority, if any	Plot No. & Size	Total Cost of	Name of person obtaining Sale Deed	Signature of Recipient of Patta	Signature of Secretary/Sarpacnch	Date of sending of monthly statement to Panchayat Samiti from No...;to....
1	2	3	4	5	6	7	8	9

Form XXV

[See Rule 180]

Register of Works

Name of Panchayat ….......................

Panchayat Smiti …................................

Particulars of work .................

S.No.	Date of Commencement of work	Amount sanctioned for the work	Amount spent		Name of person obtaining Sale Deed	Signature of Recipient of Patta	Remarks (Date of payment for wages/material be indicated)
			Material	Wages
1	2	3	4	5	6	7	8

Form XXVI

[See Rule 191]

Form of Agreement

An agreement made this ........... day of .......... between .......... (herienafter called the approved supplier which expression shall where the context so admits, be deemed to include his heirs, successors, executors and administrators) of the one part and Panchayat/Panchayat Samiti/Zila Parishad, which expression shall, where the context so admits be deemed to include its successors in office and assigns of the other part.

2. Whereas the approved supplier has agreed with the ....... Panchayat/Panchayat Samit/Zila Parishad to supply .......... all these articles set forth in the Schedule appended hereto in the manner set forth in the conditions of the tender and contract appended herewith and at the rates set forth in column ......... of the Schedule.

3. And whereas the approved supplier has deposited a sum of Rs ........... in:

(I) Cash/Bank Draft/Banker Cheque No ........ dated .......

(II) Post office/Saving Bank Pass Book duly hypothecated to the Panchayat/Panchayat Samiti/Zila Parishad

(III) National Saving Certificates/Defence Saving Certificates/Kisan Vikas Patra or any other instrument under National Savings Scheme. (The Certificates being accepted at their surrender value).

4. Now these present witness -

(1) In consideration of the payments to be made by the said Panchayat/Panchayat Samiti/Zila Parishad at the rates set forth in the Schedule hereto the approved supplier shall duly supply the said articles set forth in .......... and ........ thereof in the manner set forth in the conditions of the tender and contract.

(2) The conditions of tender and contract for open tender as enclosed to the tender notice No ...... dated ......... and also amended to this agreement will be deemed to be taken as part of this agreement an are binding on the parties executing this agreement.

(3) Letters No ............. received from tenderer and letter Nos. .............. issued by the Panchayat/Panchayat Samiti/Zila Parishad and appended to this agreement shall also form part of this agreement.

(4)(a) The said Panchayat/Panchayat Samiti/Zila Parishad do hereby agree that if the approved supplier shall duly supply the said articles in the manner aforesaid and observe and keep the said terms and conditions, the Panchayat/Panchayat Samiti/Zila Parishad will through ........... pay or cause to be paid to the approved supplier at the time and the manner set forth in the said conditions, the amount payable for each and every consignment.

(b) The mode of payment will be as specified below:-

1 : ...........

2 : ...........

3 : ...........

5. The delivery shall be effected and complied within.......... period of......... from the date of this agreement and/or the date or order ..........

S. No.	Item	Quantity	Delivery Period
1.
2.

6. (1) In case of extension in the delivery period with liquidated damages, the recovery shall be made on the basis of following percentage of value of stores which the tenderer has failed to supply

Note - (I) Fraction of a day in reckoning period of delay in supplies shall be eliminated if it is less than half a day.

(II) The maximum amount of agreed liquidated damages shall be 10%

(III) If the supplier requires an extension of time in completion of contractual supply on account of occurrence of any hindrances, he shall apply in writing to the authority which had placed the supply order, for the same immediately on occurrence of the hindrance but not after the stipulated date of completion of supply.

(2) Delivery period may be extended with or without liquidated damages of the delay in supply of goods is oh account of hindrances beyond the control of the tenderer.

7. All disputes arising out of this agreement and all questions relating to the interpretation of this agreement shall be decided by the Government and the decision of the Government shall be final.

In witness whereof the parties hereto have set their hands on the ........day .....

Signature of the Approval Supplier

Signature for and on behalf of the Panchayat/Panchayat Samiti/Zila Parishad

Date ...........

Witness No. I .......

Witness No. II .......

Date ................

Witness No. I .......

Witness No. II .......

From XXVII

[See Rule 194(4)]

Budget Estimate of a Panchayat

Panchayat Samiti..................

For the year 20........20.........

Panchayat...............

Zila Parishad....................

Estimated Income					Estimated Expenditure
S. No.	Head wise sanctioned budget of previous year	Actual Income of previous year	Estimated Income of the year 20........20......	S. No.	Head of expenditure	Sanctioned budget of previous year	Actual expenditure of previous year	Estimate expenditure of the year 20........20.......	Remarks
1	2	3	4	5	6	7	8	9	10
1. 2.	Opening Balance Own income from taxes (i) Tax on buildings (ii) Octro including on country liquor (iii) Pilgrims tax (iv) Vehicle tax (v) Water Tax (vi) Tax on commercial crops (vii) Any other tax			1	General Administration (I) Pay of establishment (II) Traveling allowanace (A) of establishment (B) of Panch and Sarpanch (III) Honorium of Sarpanch/Meeting/Allowance/Refreshment in meeting (IV) Contingencies(Office expenses, stationery, postage, etc.) (V) Payment of Collection charge to Patwari.
				2	Construction of public streets, draines, latrines, soak pits
3.	Own income from non-tax revenues (I) Fees (II) Penalties and fmes (III) Abadi and (A) Sale of land (B) Temporary use of land (IV) Water Reservoirs (A) fisheries (B) Contract for Singhada etc (C) Tank bed cultivation (D) Irrigation charges (E) Natural produce of trees on Tank Bank (V) Grazing charges (A) Grazing chages (B) Sale of natural produce. (C) Penalties from Trespassers (VI) Agricultural Farms/Orchards (VII) Local Fairs (VIII) Sale of hides and skins of dead animals (IX) Cattle Pound receipts (X) Sale of Ration Cards (XI) Sale of unserviceable articles (A) Shops and sites (B) Licenese fees (C) Patta fees (D) Others			3.	Construction of buildings (Schools, Dispensary, Anganwadi etc.)
				4. (A) (B)	Drinking water supply Original works Repairs to (I) Hand pumps (II) Wells (III) Maintenance and construction of river ghats or ghats on tanks or ponds.
				5.	Sanitation and construction of drains etc.
				6.	Lighting: (A) Establishment (B) Maintenance (C) Other Requisites
				7.	Burning and Burial grounds (A) Construction (B) Maintenance
				8.	Cattle Pounds (A) Establishment and maintenance (B) Contingencies (C) Remuneration to Pound Keeper/Contractor
				9.	Medical relief (Vaccination, family welfare camps)
4.	Grant-in-aid from the Government (I) General grant-in-aid @ Rs. 11/- per capita. In Lieu of share of land revenue. (II) Maintenance grant for repair of school building etc. (III) General purpose grant for sanitation, electricity, repair of rural roads etc. (IV) Grant-in-aid to new Panchayats (V) Incentive grant. (VI) development grant/Matching share.			10.	Maternity and Child Welfare (Anganvadi Centers)
				11.	Public Health (Prevention of diseases)
				12.	Maintenance of public building vested in the Panchayat including school. buildings
				13.	Primary Education (I) Construction of schools (II) Construction of quarters for teachers Slaughter houses (I) construction (II) Repairs
				14.	Slaughter houses (I) Construction (II) Repairs
5.	Grant-in-aid from Central Government through the D.R.D.A for (I) jawahar Rozgar Yojana (II) Apna Gaon Apna Kaam (III) Other Schemes.			15.	Village defense
				16.	Development of Agricultural and Forestry (I) Agriculture farms/Orchards (II) Development of grazing grounds. (III) Social forestry. (IV) Plantation on road sides. Waste land development.
6.	Grant-in-aid through Panchayat Samit/Zila Parishad for: (I) Maintenance of hand pumps and other water Supply Scheme (II) Maintenance of stud bulls. (III) other grants for development/maintenance functions.			17.	Census
				18.	Family Planning
				19.	Maintenance of stud bulls
				20.	Breeding and protecting cattle
				21.	Village industries
				22.	Assistance for fire.
7.	Sums received by way of donations/contributions for Development.			23.	Welfare of the people (I) Maintenance of Akhadas/Clubs (II) Radio/T.V. (III) Social and cultural activities (IV) Library and reading room
8.	Sums ordered by a Court or a department to be placed to the credit of Panchayat Funds.
9.	Miscellaneous receipts (interest etc.)			24.	Other works of public utility
				25.	Miscellaneous/Audit fees
10.	Loans, deposits advances (I) Loan from State Govt./financial Corporation (II) Deposits (A) Contractors (B) others (III) Advances			26.	Loans, deposits and advances (I) Repayment of loans (II) Repayment of deposits (III) Repayment of advances
				28	Closing balance
11.	Total Receipts			29.	Grand total
12.	Grant Total (including opening balance)
	Total Rs.				Total Rs.

Form XVIII

[See Rule 194(4)]

[Part (A)]

Budget estimate of Panchayat Samity...........Zila Parishad..............

Receipts					Expenditure
S. No.	Head wise sanctioned budget of previous year	Actual Income of previous year	Estimated Income of the year 20........20......	S. No.	Head of expenditure	Sanctioned budget of previous year	Actual expenditure of previous year	Estimate expenditure of the year 20........20.......	Remarks
1	2	3	4	5	6	7	8	9	10
1.	Opening Balance			1.	2515-General administration (I) Pay of establishment including dearness and other allowances. (II) Traveling allowances (A) Of establishment (B) Of Chairperson (III) Honorarium of Chairperson (IV) Contingencies (P.O.L., stationery, postage, telephone, electricity and other expenses)
2.	Own income form taxes (I) Trades, callings, professions and industries (P.S) (II) Education Cess(P.S.) (III) Fairs(P.S./Z.P.) (IV) Entertainment tax(P.S) (V) Water rates(P.S./Z.P) (VI) Surcharges on stamp duty(Z.P.) (VII) Surcharges on sale of Agricultural produce (Z.P.)
3.	Own income from non-Tax revenues (I) Appeals fees(P.S.) (II) Auction of bone contracts (P.S.) (III) Agricultural farms (IV) Tractor/Bull dozer/Truck etc. (P.S.)			2.	2202-Primary Education (I) Pay of establishment including dearness and other Allownaces (II) Traveling allowances (III) Other contingencies (IV) Non-formal education (V) O.B.B. (VI) 2225-Incentive to S.C./S.T. (VII) 2575-B.A.D.P. (VIII) 2705-C.A.D.
4.	Grant-in-aid from the state Government (I) 3604-General grant in aid in lieu of share of land revenue @ Rs. 1.25 per capita (P.S.) (II) 2515-Non-plan) -Establishment grant for Administrative expenses including pay and allowances (P.S./Z.P.) (III) maintenance grant (P.S./Z.P.) (IV) Incentive grant (P.S./Z.P) (V) 2215-water supply and cleaning (P.S./Z.P) (VI)2215 – (plan-Rural) sanitation Programme P.S./Z.P) (VII) 2202-Primary education P.S./Z.P) (VIII) 2202- Non-formal education (P.S.) (IX) 2201-operation Black Board (P.S./Z.P) (X) 2810-Non-conventional sources of energy (improved Chulha)(Z.P) (XI) 2216-Rural housing assistance (P.S./Z.P) (XII) 2211-Family welfare (P.S./Z.P) (XIII) 2225-Incentive to S.C./S.T. (P.S./Z.P) (XIV) 2575-B.A.D.P. (P.S./Z.P) (XV) 2705-C.A..D.(P.S./Z.P) (XVI) Development of wayside facilities on highways			3.	Expenses from own income (I) Siting fees/Refreshment in meetings (II) Audit fees. (III) Conveyance advance (IV) Gratuitous relief (V) School articles/equipments(out of education cess) (VI) construction/Repair of school buildings(do) (VII) Repair of residential quarters, office building and other property. (VIII) Development of agricultural farms/tanks etc. (IX) Collection charges to patwaries. (X) P.OL. In excess of prescribed limit. (XI) Purchase/repair of jeep etc. (XII) Purchase of furniture/other equipments. (XIII) Any scheme to increase revenues (XIV) Others
				4.	2215-water supply and cleaning (I) Salaries (II) maintenance
5.	Grant-in-aid from Central Government through D.R.D.A. For (I) 2505-J.R.Y Establishment (P.S.) (II) Indira Avas(P.S.) (III) Jeevan Dhara(P.S) (IV) Apna Gaon Apna kaam(P.S./Z.P) (V) 30 Zila 30 kaam (P.S./Z.P) (VI) United fund (P.S./Z.P) (VII) Assured employment scheme(P.S.) (VIII) TRYSEM			5.	2215 (Plan) Rural sanitation programe (I) subsidy to B.P.L. For house hold latrines etc. (II) Latrines/Urinals in schools. (III) Soak pits/drain on Hand pumps/storage tanks.
				6.	2810-Non-conventional sources of energy (I) Subsidy for improved Chulla (II) Other expenses
6.	Public contribution/donations			7.	2216-Rural housing assistance
7.	Loans, deposits and advances (I) Loans from State Government/Financial corporation for shops, housing market etc. (P.S./Z.P) (II) Deposits:(P.S./Z.P) (A) Contractors. (B) Others (III) Advances(P.S./Z.P)			8.	2211-Family welfare
				9.	Development of wayside facilities on highways
8.	Miscellaneous(interest etc.)			10.	Expenditure on Scheme of rural employment and poverty alleviation (I) Indira Avas (II) Jeevan Dhara (III) Apna Gaon Apna Kaam (IV) 30 Zila 30 Kaam (V) TRYSEM (VI) United fund (VII) Assured employment scheme (VIII) others
9.	Total receipts
10.	Grand total (including opening balance)
				11.	Loans for (I) Rural housing (II) shops, markets etc.
				12.	Total expenditure
				13.	Closing balance
				14.	Grand total(including closing balance)
	Total Rs,				Total Rs,

Vikas Adhiari/Chief Executive Officer

Form XXVIII

[See Rule 194(4)]

Part - B

Detailed estimate of fixed charges viz. Pay of Officers and establishment of Panchayat

Samity.........

Zila Parishad....................

For the year.......................

 

Account Head	Serial Number	Name or Number	Designation	Minimum of pay scale	Rate of increment	Maximum of pay scale
1	2	3	4	5	6	7
Actual on 1st March	Amount of provision for the period from march to February	Date of increment falling due within the period	Amount of increment	Total of column 9 &11	Revised estimate for the current year	Remarks
8	9	10	11	12	13	14

Part - C

Statement showing the actual expenditure of Panchayat Samity..............
Zila Parishad .......for the year.....

Head	Original budget	Change during the year	Final budget for the year	Actuals	Variations	Remarks
1	2	3	4	5	6	7

Form XXIX

[See Rule 229]

Cash Book

Panchayat.............Samiti..........Zila Parishad....................Year
19.........19........................

S. No.	No. of receipt/Cheque/D.D./Challan and date	From whom received	Particulars	Ledger A/C. No.	Amount		Classification on of Head of Account
					Cash	Post Officer/Bank/Treasury
1	2	3	4	5	6	7	8

Payment

S. No.	Voucher and date	To whom paid	Particulars	Ledger A/C. No.	Amount		Classification on of Head of Account
					Cash	Post Officer/Bank/Treasury
1	2	3	4	5	6	7	8

 

Form XXX	From XXX
[See rule 230]	[See Rule 230]
Counter Foil	Receipt
….....Panchayat/Panchayat Samity Zila Parishad	….....Panchayat/Panchayat Samity Zila Parishad
Book No........ No...........	Book No........ No...........
Received from Shri.....................	Received from Shri..................
Item No. Particulars Period Amount of demand of Payment	…...........................
Register	Rs. (In Words)...........................
…...............................................	On account of ….......................
Total in word Rs.....................................	For the period............................
Head of Office	Head of Office
Cashier	Cashier

Form XXXI

[See Rule 234]

Claim for Payment

Bill No …............. Date ….................. Head of Account …...............................
No. of Voucher Particulars Amount(Rs.) To be entered by Drawing Office received contents Signature and designation of Head of Officer   Total rs. (in words) Appropriation for the current Including this bill Rs............. Balance available Rs............... For Office Use
Pay Rs. …........ Accountant	Head of Office Date ….............. Place …...............
Paid Rs ….............on ….....(date) vide cash book item No …..............	Cashier

Form XXXII

[See Rule 236]

General Ledger

Panchayat.........

Panchayat Samiti..............

Zila Parishad.................

For the year

Date	Particulars	Cash Book Folio No.	Dr. Amount	Cr Amount	Balance Amount
1	2	3	4	5	6

Form XXXIII

[See Rule 237]

Register of Revenue Realised

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

 

S. No.	Name of tax prayer or any other person from whom sums recovered	Monthly rate if any Rs.	Arrears of the last year	Current demand	Total column (4 & 5) Rs.	Receipt No. & date and cash book page No. where amount credited	Amount Rs.	Total collection	Amount written off Rs.	Balance 6-(9+10) Rs.	Initials of the Secretary
1	2	3	4	5	6	7	8	9	10	11	12

Form XXXIV

[See Rule 239]

Stock Register

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

For the year............

Receipt
S. No.	Date of purchase	Full Particulars	Balance in hand	No. or quantity	Total	Cost
1	2	3	4	5	6	7
Issue
Reference voucher No.	To whom issued or for what purpose	No. or quantity issued		Balance	Reference of issuing indent No.
8	9	10		11	12

Form XXXV

[See Rule 239]

Quarterly Statement of Accounts

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

For the year............

Revenue

Account head	Principal head of Revenue	Budget head estimate for the year	Actual revenue during the quarter	Cumulative up to the end of the quarter
1	2	3	4	5
	As per budget head of Expenditure

Payments

Account head	Principal head of Expenditure	Budget head estimate for the year	Actual expenditure during the quarter	Cumulative total up to the end of the quarter
1	2	3	4	5
	As per budget head of Expenditure

Form XXXVI

[See Rule 246(1)]

Abstract of Annual Account for the year...........

Panchayat.........

Panchayat Samiti...............

Zila Parishad.......................

Revenue

Account head No.	Principal head of Revenue	Budget Provision	Actuals	Savings (-) Excess (+)
1	2	3	4	5
	As per budget head of Expenditure

Payments

Account head No.	Principal head of Expenditure	Budget Provision	Actuals	Savings (-) Excess (+)
1	2	3	4	5
	As per budget head of Expenditure

Form XXXVII

[See Rule 246(2)]

Statement in Grant-in-aid Received and spent during the year............

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

 

Sr. No.	Department	Name of the Scheme	Amount received during the year	Amount spent during the year	Particulars about completion certificate etc.
1	2	3	4	5	6

Form XXXVIII

[See Rule 26(3)]

Statement of Loans Received from.....and Payments made
during the year......

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

 

Sr. No.	Name of Department to which the loan relates	Reference No. and date of sanction	Purpose for which loan was granted	Dates on which loan which was received	No. of installments fixed	Amount received	Amount that became due for repayment during the year including arrears, if any	Amount actually repaid	Balance unpaid installment if adjusted out of gran-in-aid.
1	2	3	4	5	6	7	8	9	10

Form XXXIX

[See Rule 246(4)]

List of Works for the Year...........

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

For the year................

S. No.	Name of Village	Particulars of work	Date of commencement	Amount sanctioned	Amount spent	Other particulars whether carried out departmentally or through contract, date of completion etc.
1	2	3	4	5	6	7

Form XL

[See Rule 246(5)]

Statement of Assets and Liabilities

Panchayat.........

Panchayat Samiti....................

Zila Parishad.......................

For the year................

Liabilities		Assets
Head	Amount	Head	Amount

 

1. Deposits-		1. Loans (Recoverable)
(1) Security deposits from Government servant. (2) Deposits from Contractors and firms (3) Other deposits	…....... …....... ….......	(1) Agriculture (2) Taccavi (3) Co-operative (4) Industrial (5) Community development	…........ …........ …........ …........ …........
Total	….......	Total	…........
2. Loans repayable to the State:		2. Advances:
(1) Agriculture (2) Taccavi (3) Co-operative (4) Industrial (5) Community		(1)Miscellaneous Advance (2) Permanent Advance (3) Advance to Government Servants (Festival, food grains, development Conveyance, Housing)	…........ …........ …........
Total	….......	Total	…........
3. Other Loans		3. Investment
4. Bills Payable		4. Gran-in-aid
5. Un—utilised specific		5. Interest accrued on loans
		Cash balance:.............
		(1) In Hand .............
		(2) In P.D. Account .............
Total	…........	Total	…........
Grand Total	….......	Grand Total	…........

Form XLI

[See Rule 305]

Driver's Log Bock

Panchayat..............

Zila Parishad...............

Vehicle No...........

Date	Time out	In	From	To	Route	K.M. Reading at Commencement of journey	Details of journey KM Reading at the end of journey
1	2	3	4	5	6	7	8
Distance travelled in Kms	Purpose of	Name of persons or particulars of articles carried	Authority for making journey		Petrol/Diesel in litters		Supplies Lubricating oil in litters
9	10	11	12		13		14
Signature of user	Recoveries to the effected if any Rate		Amount		Signature of Controlling Officer		Remarks
16	17		18		19		20

Form XLII

[See Rule 305]

Stock Register

Panchayat..............

Zila Parishad...............

Vehicle No...........

Date	Petrol/Diesel/Power Line	Oil	Spares and replacement	Repair	Miscellaneous	Purchase Price	Remark
1	2	3	4	5	6	7	8

From XLIII

[See Rule 305]

List of Tools and Equipment with the Vehicle

Panchayat..............

Zila Parishad...............

Vehicle No...........

Sr. No.	Name of tool	Quantity received	Date of receipt	Signature of Driver	Date on which checked	Initial of Controlling officer
1	2	3	4	5	6	7

Form XLIV

[See Rule 328]

Register of Applications for Inspection/grant of Copies

S. No.	Name & Address of applicant	Date and application	Whether urgent or ordinary	Particulars of the document of which copies/inspection is sought	Amount to be paid including search fee	Date and time on which inspection made	Date of supply of copy/dispatch by post	Signature of the person inspecting/receiving copy	Remark
1	2	3	4	5	6	7	8	9	10

Form XLV

[See Rule 353]

General Ledger

Annual Adminstration Report ....Panchayat.......Panchayat Samiti
Year of........

1. Name of Village and its population under Panchayat Samiti

(i) Name of Villages	Population
(A)
(B)	Total...........

2. Details of concern Panchas and Sarpanches.

S.C.		ST		Other B/C		Other Classes		Total
Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
1	2	3	4	5	6	7	8	9	10

1. Unanimous Elected

2. Contested Elected

3. Name of the Instituted Panchases

Total.............

4. Writs and Appeals against Panchases & Sarpanch

5. Names of Panches whose offices have been declared to have been vacated under Section 39 of the Rajasthan Panchayati Raj Act, 1994.

6. Names of Sarpanch or Up-Sarpanch whose office has become vacant under Section 41 of the Rajasthan Panchayati Raj Act, 1994.

7. Has any action been taken against the Panchayat under Section 94 of the Rajasthan Panchayati Raj. Act, 1994.

8. Details of meetings :-

(I) Total number of Gram Sabha meetings.

(II) Total number of meetings of the Panchayat for.

(A) Development works

(B) Administrative matters

Total A & B

(III) Meetings postponed due to incomplete quorum.

(IV) Resolutions passed unanimously

(V) Resolutions passed by majority.

9. Details regarding staff:-

(A) Secretary: -

(I) Name.

(II) Age.

(III) Educational qualifications

(IV) Trained or untrained

(V) Regular/on contract.

(VI) Full time or part time.

(VII) Pay per month, if on contract

(VIII) Does he work in any other Panchayat, if yes, then mention the name of such panchayat

(B) Other Staff/Contractors for Kine House/Sanitation etc.

(I) Other Clerks (No.)

(II) Peons (No.) .

(III) Staff for lighting (No.)

(IV) Sanitary (No.)

(V) Watch and ward :

(A) Honorary (No.)

(B) On Contract (No.)

(C) In how many villages such arrangements have made by Panchayat (No.)

10. Has panchayat rendered any assistance in natural calamities like fire, flood etc.

(I) No. of families given protection

(II) Estimated value of property saved.

(III) No. of village in which fire/food occurred

11. Has Panchayat organised voluntary labour force for community works and works for uplift of the people ? If yes, then give:-

(I) Number of people participated

(II) Number of hours devoted.

(III)Name of works executed

12. Fairs and hats.

(I) Fairs and hats organised by panchayat (No.)

13. Amount of Small Savings Certificates sold.

14. Has Panchayat seemed life and General Insurance business ? If yes, then:-

(I) No. of persons insured.

(II) Amount of general insurance business secured.

15. Has Abadi Land been allotted free of cost to the persons belonging to Scheduled Castes and Scheduled Tribes ? If yes, then:-

(I) Number of families to whom allotted.

(II) Sq. Yards of Land allotted.

16. (I) Does Panchayat undertake and render the Postal Services.

(II) No. of villages not having Postal facility.

17. No. of Panchas and Sarpanch who have attended the Training or other Camps also mention the no. of camps).

18. When the accounts of Panchayat were audited (Date).

19. Name of officials who have inspected Panchayat.

Name of the Officer

Date

20. Details regarding bye-laws passed by Panchayat (copy to be enclosed).

Part 'B'

Physical progress of activities of panchayat during the year

(I)	General functions:-	Unit
	(A) Cases in which relief was mobilised in natural calamities	No.
	(B) Cases in which encroachments on public properties were removed.	No.
(II)	In the sphere of administration:-
	(A) For how many villages located in Panchayat circle, development plans were prepared.	No.
	(B) In how many villages the premises were numbered.	No.
(III)	Agriculture including Agriculture extension:-
	(A) Was any waste land developed, how much?	Acres
	(B) In how many villages grazing lands were maintained?	No.
(IV)	Animal husbandry dairying and poultry
	(A) In how many cases medical facilities for cattle provided	No.
	(B) Artificial Insemination service provided.	No.
	© Maintenance of stud bulls.	No.
(V)	Social and farm foresty, minor forest produce, fuel and fodder:-
	(A) for the improvement of agriculture how many model agriculture farms were established.	Acres
	(B) How many trees were planted on the sides of village and district roads and other public lands under its control?	No.
	© Village forests raised.	Acres
(VI)	Khadi, village and cottage industries:-
	(A) Village industries aided.	Names
	(B) How much amount given as aid, loans and advances	Rs.
(VII)	Drinking water:-
	(A) Construction, repairs and maintenance of drinking water wells, tanks & ponds.	No.
	(B) Prevention and control of water pollution.	No.
	© Maintenance of hand pumps and pump and tank schemes.	No.
(VIII)	Roads, buildings culverts, bridges, ferries, water-ways and other means of communication:-
	(A) Construction, maintenance and repairs of public streets.	Km.
	(B)Construction, maintenance and repairs of drains.	Metres
	© Construction, maintenance and repairs of bunds.	No.
	(D) Construction, maintenance and repairs of bridges/culverts.	No.
(IX)	Rural electrification including providing for and maintenance of lighting of public streets and other places:-
	New lamps installed for lighting	No.
(X)	Education (Primary):-
	Position of enrolment and attendance in primary Schools-how many boys and girls out of each one hundred boys and girls of the school going age group were enrolled and how many of such boys and girls were attending the school:-
	(A) Enrolment, as on 15th August:
	(1) Boy	No.
	(2) Girls	No.
	(B) Attendance, as on 1st March:
	(1) Boys	No.
	(2) Girls	No.
(XI)	Cultural activities:-
	(A) Established and maintenance of akharas clubs and other places of recreation and games.	No.
	(B) Established and maintenance of theatres for promotion of art and culture	No.
	© Public television and radio-sets installed.	No.
(XII)	Rural sanitation:-
	(A) Cleaning of public roads, drains, tanks, wells and other public places.	No.
	(B) Maintenance and regulation of burning and burial grounds.	No.
	© Construction and maintenance of rural latrines, facility parks, bathing platforms, soak pits etc.	No.
(XIII)	Public health and family welfare:-
	In how many villages infectious disease spread and out of those in how many villages measures were taken to prevent it.	No.
(XIV)	Construction and maintenance of Cattle sheds, ponds and cart stands.
	(A) Cattle ponds established and maintained.	No.
	(B) For the supply of water to animals for how many ponds arrangements were made for excavation, cleaning and maintenance.	No.
(XV)	Maintenance of Public parks, play grounds etc:-
	(A) Layout and maintenance of play grounds.	No.
	(B) Layout and maintenance of public parks.	No.
(XVI)	Any other activity which is in furtherance of functions enumerated in the First Schedule to the Act.

Part - C

Income and Expenditure Statement

Panchayat.........

Fanchayat Samiti....................

Zila Parishad.......................

For the Year...............

S. No.	Particulars	Amount assessed during the year	Amount realized		Total	Last year	Balance		Expenditure
			From last years balance	From current			Current year	Total
1	2	3	4	5	6	7	8	9	10
1	Heads of Revenue Own income from taxes (i) Tax on buildings (ii) Octroi including on country liquor (iii) Pilgrims Tax (iv) Vehicle Tax (v) Water Tax (vi) Tax on commercial crops (vii) Any other tax				1	Heads of Expenditure General Administration (I) Pay of establishment (II) Traveling allowance (A) of establishment (B) of Panch and Sarpanch (III) Honorium of Sarpanch/Meeting/Allowances/Refreshment in meeting (IV) Contingencies (office expenses, stationery, postage etc.) (V) Payment of collection charges to Patwari
2.	Own income from non-tax revenues (I) Fees (II) Penalties and fines (III) Abadi and (A) Sale of land (B) Temporary use of land (IV) Water Reservoirs (A) Fisheries (B) Contract for Singhada etc. (C) Tank bed cultivation (D) Irrigation grounds (E) Natural produce of trees on Tank Bank (V) Grazing grounds (A) Grazing charges (B) Sale of natural produce (C) Penalties from Trespassers (VI) Agriculture Farms/Orchards (VII) Local Fairs dead animals (IX) Cattle Pound receipts (X) Sale of Ration Cards (XI) Sale of unserviceable articles (XII) Miscellaneous income (A) Shops and sites (B) License fees (C) Patta fees (D) Others				2.	Construction of public streets, drains, latrines, soak pits
					3.	Construction of buildings (Schools, Dispensary, Anganwadi etc.)
					4.	Drinking water supply (A) Original works (B) Repairs to (I) Hand pumps (II) Wells (III) Maintenance and construction of river ghats or ghats on tanks or ponds
					5.	Sanitation and construction of drains etc. (A) Establishment expenses- (B) contingencies (C) Maintenance of (I) Drains and Soak pits (II) Latrines (III) Manure pits
					6.	Lighting (A) Establishment (B) Maintenance (C) Other requisites
					7.	Burning and Burial grounds (A) Construction (B) Maintenance
					8.	Cattle Pounds (A) Establishment and maintenance (B) Contingencies (C) Remuneration to Pound Keeper/Contractor
3.	Grant-in-aid from the State Government (I) General grant-in-aid @ Rs. 11/- per capita. In lieu of share of land revenue (II) Maintenance grant for repair of school building etc. (III) General purpose grant for sanitation, electricity, repair of rural roads etc. (IV) Grant-in-aid to new Panchayats (V) Incentive grant. (VI) Development grant/matching share				9.	Medical relief (Vaccination, family welfare camps)
					10.	Maternity and Child Welfare (Anganvadi Centres)
					11.	Public Health (Prevention of diseases)
					12.	Maintenance of public buildings vested in the Panchayat including school buildings
					13.	Primary Education (I) Construction of schools (II) Construction of quarters for teachers
					14.	Slaughter houses (I) Construction (II) Repairs
4.	Grant-in-aid from Central Government through the D.R.D.A. For: (I) Jawahar Rozgar Yojana (II) Apna Gaon Apna Kaam (III) Other Schemes				15.	Village defense
					16.	Development of Agriculture and Forestry (I) Agriculture farms/Orchards (II) Development of grazing grounds (III) Social forestry. (IV) Plantation on road sides. Waste land development
5.	Grant-in-aid through Panchayat Samit/Zila Parishad for: (I) Maintenance of hand pumps and other Water supply Schemes (II) Maintenance of stud bulls. (III) Other grants for development/Maintenance functions.				17.	Census
					18.	Family planning
					19.	Maintenance of Stud bulls
					20.	Breeding and protecting cattle
					21.	Village industries
					22.	Assistance for fire
6.	Loans from State Government/Financial Corporations				23.	Welfare of the people (I) Maintenance of Akhadas/Clubs (II) Radio/TV (III) Social and cultural activities (IV) Library and reading room.
7.	Total receipts				24.	Other works of public utility
8.	Grant Total				25.	Miscellaneous/Audit fees
					26.	Loans, deposits and advances (I) Repayment of loans (II) Repayment of deposits (III) Repayment of advances
					27.	Total expenditure
					28.	Grand Total

Form XLVI

[See Rule 354]

Annual Administration Report of Panchayat Samiti Zila Parishad

1. Constitution and Management: -

(1) Was there any change in the jurisdiction of the concerned Panchayati Raj Institution during the year ? Quote the number and date of order.

(2) What is the population of the concerned Panchayati Raj Institution according to the latest census figures available ?

(3) Give the names of the Panchayati Raj Institutions under the jurisdiction of the reporting Panchayati Raj Institutions.

(4) What is the total strength of concerned the Panchayati Raj Institutions ?

For Panchayati Samiti

Directly elected Members.

Members of the State Legislative Assembly representing constituencies wholly or partly comprising the Panchayat Samiti area.

For Panchayat Samiti

Directly elected Members

Members of the Lok Sabha representing constituencies wholly or partly comprise the Zila Parishad area.

Members of the Rajya Sabha registered as electors within the Zila Parishad area.

Members of the State Legislative Assembly representing constituencies wholly or partly comprising the Zila Parishad area.

(5) Was there any election of the Chairperson or Deputy Chairperson during the year and was there any election dispute ?

(6) Whether any Chairperson/Deputy Chairperson or Member resigned from his office. If so, give particulars of the persons who resigned and reasons for such resignation.

(7) If standing committees were constituted, give details thereof.

(8) Whether any additional standing committee were constituted ? If so, give details thereof.

(9) Was the Deputy Chairperson in-charge of Office of the Chairperson ? If so, for what period ?

(10) Was there any motion of non-confidence against the Chairperson or the Deputy Chairperson.

2. Meetings. - How many meetings were held and how many meetings were adjourned for want of quorum ?

3. Management. - (1) Where is the office of the concerned Panchayati Raj Institution located ? If rented, what is the amount of rent paid ? (2) Are the prescribed registers and forms maintained ?

4. Establishment. - (l) State the number of staff employed with their scale of pay.

Cadre	Sanctioned strength	Pay scale	Vacancies	Action taken
1	2	3	4	5

(2) Whether the existing staff is sufficient for the efficient discharge of the duties cast upon the concerned Panchayati Raj Institution ? If not, elucidate the jurisdiction for increased staff (details of staff required to be given)

5. Taxes. - (1) Give the particulars of taxes imposed by the concerned Panchayati Raj Institution.

6. Accounts and Audit. - (1) Are the prescribed accounts kept and the accounts of the receipts and expenditure maintained ?

(2) When was the audit of accounts conducted ?

(3) On what date was the audit report received ?

(4) Has a complete compliance report been sent to the Director, Local Fund Audit Department ?

(5) What are the irregularities which have not been complied with ?

(6) What were the amounts of over payments and losses shown in the Audit report ?

(7) Have the over payments been recovered ?

(8) What action has been taken to make good losses caused to the Panchayati Raj Institution Fund ?

7. General. - (1) Was the Panchayati Raj Institution dissolved ? If so, state the period.

(2) Was there any occasion when the State Government exercised powers under Secs. 92, 93, 97 or 100 ? If so, give details.

8. Other important activities.- Description with necessary details of such of the various important activities of the Panchayati Raj Institution as can give a correct picture of its performance during the year under report with reference to its functions enumerated in the relevant Schedule to the Act.

Form XLVII

[See Rule 358]

Form of Application for Recognition of Service Association of Members of Panchayat Samiti and Zila Association of Members of Panchayat Samiti and Zila Parishad Service

Name of the association ........................

Address .................................

Dated the.........day of..........20.............

1. The application is made by the persons whose names are subscribed hereunder :

2. The name of the service association on behalf of which the application is made :

3. The address of the Head Office of the service association to which all communications and notice may be addressed

4. The........service association came into existence on.........the date of......20.........

5. The service association consists of Panchayat Samiti and...........Zila Parishad servants of the category of............engaged in the various Panchayat Samiti and Zila parishads in the State and has...........members out of.........person employed in the said Panchayat Samitis and Zila Parishads.

6. Three copies of the rules of the service association are enclosed :

Note- Table I hereto contains information about the rules and their contents and Table 11 hereto indicates the changes made in the rules from time to time.

7. A list of office bearers of the service association in Table III is attached hereto.

8. We have been duly authorised by the service association to make this application on its behalf by resolution.

No...............dated.................

Signatures	Occupation	Address
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

The number of the rule making provisions for the several matters detailed in column 1 are given in column 2 below:

Matter	No. of Rule
(1)	(2)
1. Name of the service association.	.........
2. Objects for which the service association has been established.	.........
3. Purpose for which the general of the service association shall be utilised.	.........
4. Maintenance of list of members.	.........
5. Admission or ordinary members.	.........
6. Condition under which members are entitled to benefits under the rules.	.........
7. Admission of honorary members.	.........
8. Manner in which the rules can be amended.	.........
9. Manner in which members of the executive and the other office bearers of the service association shall be appointed or removed.	.........
10. Manner of holding meetings.	.........
11. Safe custody of the funds.	.........
12. Annual Audit of the accounts.	.........
13. Facilities for the inspection of the account books by office bearers and members.	.........
14 Manner in which the service association may be dissolved	.........

Table I

Rules of Service Association

Table-II

Changes made in Rules of Service Association
Serial No. of Rules	Changes in Rules	Reasons for changes
(1)	(2)	(3)
.........	.........	.........
Dated............		(Signed)

Table III

List of Office Bearers

Name of Service		….......................................
Name	Age	Address	Occupation
Dated............................		(Signed)

Rural Development and Panchayati Raj Department

Certificate of Recognition

The Government of the State of Rajasthan in pursuance of Rule 363 of the Rajasthan Panchayati Raj Rules, 1996 to hereby recognise..........association/ federation for the purpose of said rules.

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

Date.......................

Director Rural Development and Panchayati Raj

[Form XLVIII]

(See rule 173-A)

Application for Change of use of abadi land

1. Name of applicant..............................................

2. Address of the applicant................................................

3. Description of land of which change of land use is desired

(a) Situated at.....................................

(Attach map of the village to pin point the location in the village also attach the proposed land use plan)

(b) Khasara/Plot number............................................... (Attach khasara/Plot plan as well as site plan containing description all specifications of four sides of the abadi land)

(c) Enclose Patta of the abadi land and mention the name of the authority or body by whom the same was issued.

(d) Is there any dispute or litigation pending in the court or other competent authority with respect to the abadi land in question for which change of use is sought ..........................(If any, give full details)

(e) Is there any stay order of any court or other authority with regard to the land? if any? give full details thereof and also enclose copy of such order..............................................

(f) Present permissible use of abadi land ....................

(g)Desired change of use of abadi land (give complete details)..........

(h) Reasons for seeking change of use of abadi land................

4. If any application for change of use of abadi land, now applied for, was made previously also? If so, give details thereof and also enclose copy of the order passed thereon...........................

5. Give details as to title of the land (such as free hold, lease hold, Pattadhari or otherwise lawful holder) -[enclose true copies of documents].......................................... .'......

6. Application fee- give details of fee having been paid- (enclose photo copy of the receipt by which application fee is paid)

Date ......................................	Signature of the applicant
Place......................................	(Name of the Applicant) Address of the applicant

Receipt

Application of the Applicant Shri.................. of.............for change of land use received on .....................(date).

Signature & Seal of Official
receiving the application in the office
of the officer/ Authority
competent to decide the application

[Form XLIX]

[See rule 173-A (10)(13)]

Permission for change of use of land under section 107-A of the Rajasthan Panchayati Raj Act, 1994.

File No. ......................................

Place..............Dated..............

Whereas applicant Shri............s/o w/o...............address ...........place(village)........panchayat............Tehsil.......... District........has filed application for change of use in respect of, abadi land situated in ward No of village falling in Panchayat circle..........Tehsil...........District........... measuring..................... Sqr. meters binded by limits and area as described in detail in the attached site plan alongwith neighbourhood area as shown in red color, subject to all existing conditions and incumbrances, easements attached to the afore cited land, by claiming right, title and interest in said land and making prayer for allowing change of use of land by invoking provisions contained in section 107-A of the Rajasthan Panchayati Raj Act, 1994 (Act No. 13 of 1994) and rules made thereunder and has submitted necessary documents in support of his prayer for change of use of land.

Therefore I...................as Officer/Authority authorised by the State Government under section 107-A of the Rajasthan Panchayati Raj Act, 1994 have considered his request/prayer made in the Application in Form XLVIII and I am satisfied after perusal and examination of documents submitted by the applicant that his/her request is justified and the desired change of use of the Land may be allowed and the applicant is permitted to make desired change in use of the abadi land provided the Applicant deposits the change of land use charges within thirty days from the date of this order.

Place .................	official	Signature
Date....................	Seal	Name& designation of the Officer/Authority Authorized by the State Government

[Form L]

[See rule 173-A(14)]

Panchayat.......................

Lease Deed

This Indenture is made this day of two thousand ............and................. Between the Governor of Rajasthan (hereinafter referred to as Lessor) of the one part and shri/smt.................................s/o,w/o................................................ aged resident of village.........................Tehsil................. Disttrict................. ( hereinafter called the Lessee) of the second part.

Whereas the Lessee being the existing Lessee of the Lessor has applied to the Lessor for change of use of abadi land under section 107-A of the Rajasthan Panchayati Raj Act, 1994 and the rules made thereunder and has requested for grant of permission for change of use of abadi land.

Now this indenture witness that in supersession of the earlier Lease Deed executed on ..........................(give details) between the Lessor and Lessee and in consideration of the amount of change of use of land charges amounting to Rs. (rupees......................only) paid by the Lessee (which the Lessor acknowledges) and the sum earlier paid at the time of execution of earlier Lease Deed as consideration for the said Lease Deed now sought to be superseded, The Lessee for himself or his heirs, executors and administrators and assigns covenants with the Lessor in the manner following, that is to say:-

(a) The Lessee shall from time to time pay all taxes, charges, cess etc. levied by the Lessor in accordance with law with respect to the land or buildings erected thereon;

(b) The Lessee shall not deviate in any manner from layout plan nor alter size of plot whether by sub-division, amalgamation or otherwise without seeking permission of the Lessor in accordance with law inforce at the relevant time;

(c) Whenever the title of the Lessee in the abadi Land which is subject matter of this indenture, is transferred in any manner whatsoever, the transferee shall be bound by all the covenants and conditions contained herein and be answerable in all respects therefor;

(d) The Lessee shall use the abadi land for ..............purposes and not for other purposes without seeking permission of the Lessor in accordance with law and that too by paying necessary change of land use charges as specified by law;.

(e) All powers exercisable by Lessor may be exercised by the officers/authorities authorised by him in accordance with law;

(f) This Lease is being granted under section 107-A of the Rajasthan Panchayati Raj Act, 1994 and rules made thereunder; and

(g) In this Lease the expression "the Lessor" and the expression "the Lessee" herein before used where the context so admits include in the case of Lessor, the successors, assigns and in the case of Lessee, his heirs, executors, administrators, legal representatives and the person or persons in whom Lease hold interests hereby created, shall for the time being be vested by assignment or otherwise.

In witness whereof Shri...................for an on behalf of, by order or direction and by authority under law of the Lessor has set his hand shri/shrimati the Lessee has set into his/her hand the day and year first above written.

Signed.........................

Lessee

Witness:

1- ..............................

2- ...............................

For and on behalf of the Governor by authority/direction under law made by the Governor (the Lessor)

Signed by ................................

Lessor

Witness:

1- ...............................

2- ...............................

[Form LI]

[See rule 173-B (1)]

Application for permission for sub-division or reconstitution of plots.

To

The (Designation of Officer)/Authority

........................Authority

..................................

Sir,

I/We hereby request permission under rulelt3-B of the Rajasthan Panchayati Raj Rules, 1996 for sub-division or reconstitution of plot of land situated in abadi area of mohalla/ward of village ............................. I/We enclose herewith the following documents:- -

(i) Title deed of ownership/Lessee................................. (Enclose true copies of such documents duly attested by a Gazetted Officer)

(ii) Site plan (4 copies) with information as required under the rule 173-B

(iii) Photo copy of the receipt as proof for depositing the fee and Charges.

Date ......................................	Signature of applicant
Place....................	(Name of the Applicant) Address of the applicant

[Form LII]

[See rule 173-B(10) (12)]

Permission for sub-division/reconstitution of Plot

Whereas applicant Shri/Shrimati ............................... s/o/w/o............address...........place..........village............ panchayat................... Distt.................................................. has filed application for sub - division/reconstitution of plot of abadi land situated in Ward No............of village falling in panchayat circle ............ Tehsil ........... District .... measuring ............. (sqr. metres) [ give complete detail of the plot in case sub -division and give detail of each parcel or plot in case of reconstitution] binded by limits and areas as described in the attached site plan alongwith neighbourhood area as shown in ............ colour, subject to all existing condition and encumbrances, easements attached to the aforecited land and has submitted necessary documents in support of prayer for subdivision/reconstitution of the plot.

Where as I ........................... as officer/Authority authorised by the State Government under section 107-B of the Rajasthan Panchayat Raj Act, 1994(Act No. 13 of 1994) have considered this request in the application filed in Form LI and I am satisfied after perusal and examination of the documents submitted by the applicant that his/her request for sub division/reconstitution of plot is justified and allowed and therefore the applicant is permitted to sub-divide/reconstitute the plot/plots and he/she has deposited the required charges therefor vide Receipt No. ................Dated.........in............ Panchayat as a sum of Rs ......... as per rate specified in rule 173-D of the Rajasthan Panchayati Raj Rule, 1996.The plan of Sub-division/reconstitution is appended herewith duly authenticated.

Place....................	Signature
Date....................	Name & designation of the Officer /Authority Authorised by the State Government

[Form LIII]

(See rule 173-G)

Name of the Panchayat................................Register of Abadi land

Sr. No.	Ward Number	House/Plot No. or location of the plot	Boundary marks (with size in sqr. mtrs.)	Occupied by as lessee or otherwise	Other information