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[Cites 0, Cited by 0] [Section 45] [Entire Act]

Union of India - Subsection

Section 45(2) in The Person With Disabilities (Equal Opportunities, Protection Of Rights And Full Participation) Rules, 1996

(2)In particular, the annual report referred to in sub-rule (1), shall contain information in respect of each of the following matters, namely:-
(a)Names of officers, staff of the Board and a chart showing the organizational set-up;
(b)The functions which the Chief Commissioner has been empowered under sections 58 and 59 of the Act and the highlights of the performance in this regard;
(c)The main recommendations made by the Chief Commissioner;
(d)Progress made in the implementation of the Act Statewise;
(e)Any other matter deemed appropriate for inclusion by the Chief Commissioner or specified by the Central Government from time to time.
[Form-I] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Application for Obtaining Disability Certificate by Persons with Disabilities(See rule 3)
1. Name.................. .......... ..........
  (Surname) (First name) (Middle name)
2. Father's name.................... Mother's name....................  
3. Dateof Birth :________/ _______/ _______/(Date)(Month) (Year)
 
4. Age at the time ofapplication : ________ Years
5. Sex : Male/Female  
6. Address :    
(a) Parmanentadress................................................................ (b) CurrentAddress (i.e. forcommunication)................................................................
    (c) Period sincewhen residing at current address-------------------------------------
7. Education Status(Pl. tick as applicable)  
  (I) Post Graducate    
  (II) Graduate    
  (III) Diploma    
  (IV) HigherSecondary    
  (V) High School    
  (VI) Middle    
  (VII) Primary    
  (VIII) Illterate    
8. Occupation-------------------------------------------------
9. Identificationmarks (i) ........... (ii).............
10. Nature ofdisability : locomotor/hearing/visua/mental/others
11. Period since whendisabled : From Birth/Since Year ----------
12. (i) Did you everapply for issue of a disability certificate in the past ------YES/NO
  (ii) If yes,detaisl :    
  (a) Authority towhom and district in which applied ------------------
  (b) Result ofapplication ---------------------------
13 Have you ever beenissued a disability certificate in the past? If yes, pleaseenclose a ture copy.
Declaration: I hereby declare that all particulars stated above are ture tothe best of my knowledge and belief, and no material informationhas been concealed or misstated. I further, state that if anyinaccuracy is detected in the application, I shall be liable toforfeiture of any benefits derived and other action as per law.
    ---------------------------(Signatureor left thumb impression of person with disability, or of his/herlegal guardian in case of persons with mental retardation autism,cerebral palsy and multiple disabilities)
Date :    
Palce :    
Encl :    
1. Proof of residence(Please tick as applicable)    
  (a) ration card.    
  (b) voter identitycard,    
  (c) drivinglicense,    
  (d) bank passbook    
  (e) PAN Card,    
  (f) Passpost,    
  (g)telephone, electricity, water and any other utility billindicating the address of the applicant,    
  (h)a certificate of residence issued by a Panchyat, municipality,cantonment board, any gazzetted officer, or the concerned Patwarior Head Master of a Govt. School,    
  (i)in case of an inmate of a residential institution for personswith disabilities, destitute, mentally ill, etc., a certificateof residence from the head of such institution.    
2.Two recent Passport size photographs-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(Foroffice use)
Date :    
Palce : Signature ofissuing authority stamp
[Form-II] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Disability Certificate(In cases of amputation or complete permanent paralysis of limbs and in cases of blindness)(See rule 4)(Name and Address of the Medical Authority Issuing the Certificate)
RecentPP size Attested Photograph (Showing face only of the person withdisability
     
     
     
     
Certificate No.   Date :
This is to certifythat I have carefully examined
Shri/Smt/Kum.__________________________________ son/wife/daughter of shri_______________________________________
Date of Birth ______ ___ Age ______ years, male, female ______________
(D/MM/YYY)
RegistrationNo._______________ Parmanent resident of House No.________________ Ward/Village/ Steet____________PostOffice______________________District ______________ State_______________.
Whose photographis affixed above, and am satisfied that :
(A) he/she is caseof :  
locomotor disability  
Blindness(Pleasetick as applicable)  
(B) the diagnosis inhis/her case is ............
(A) He/She/has...............%(in figure).....................Percent
  (in words)permanent physical impairment/blindness in relation to his/her-----------(Part of body) as per guidelines (to bespecified).
  2. The applicanthas submitted the following document as proof of residence :-
Nature of Document Date of Issue Details ofauthority issuing certificate
     
(Signatureand Seal of Authorised Signatory of notified medical Authority)
Signature/Thumbimpression of the person in whose favour disability certificateis issued
[Form-III] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Disability Certificate(In case of multiple disabilities)(Name And Address Of The Medical Authority Issuing The Certificate)(See rule 4)
RecentPP size Attested Photograph (Showing face only of the person withdisability
     
     
     
     
Certificate No.   Date :
This is to certifythat We have carefully examined
Shri/Smt/Kum.__________________________________ son/wife/daughter of shri_______________________________________
Date of Birth ______ ___ Age ______ years, male, female ______________
(D/MM/YYY)
RegistrationNo._______________ Parmanent resident of House No.________________ Ward/Village/ Steet____________PostOffice______________________District ______________ State_______________.
Whose photographis affixed above, and are satisfied that :(A) He/She is a Case ofMultiple Disability.His/her extent of permanent physical impairment/disability has been evaluated as per guidelines (to be specified) for the disabilities ticked belwo, ans shown aginst the relevant disability in the table below :
S.No. Disability Affected Partof BodyE Diagnosis PermanentPhysical impairment/mental disability (in %)
1 Locomotordisability @    
2. Low vision #    
3 Blindness Both Eyes    
4 Hearing impairment £    
5 Mental retardation X    
6 Metal-Illness X    
(B) In the lightof the above, his/her over all permanent physical impairment asper guidelines (to be specified), is as follows :-
In figures :-___________________________percent
In words :-__________________________________________________percet
2.This conditionis progressive/non-progressive/likely to improve/not likely toimprove
3. Reassessment ofdisability is :
(i) not necessary,
or
(ii)is recommended/after _________years_________months, and thereforethiscertificate shall be valid till _________ _________________(DD)(MM) (YYYY)
@ e.g.Left/Right/both arms/legs
# e.g. Singleeye/both eyes
£ e.g.Left/Right/both ears
4. The applicanthas submitted the following document as proof of residence :-
Nature of Document Date of Issue Details ofauthority issuing certificate
     
5. Signature andseal of the Medical Authority.
     
Name and seal ofMember Name and Seal ofMember Name and seal ofthe Chairperson
Signature/Thumbimpression of the person in whose favour disability certificateis issued
[Form-IV] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Disability Certificate(In cases other than those mentioned in Forms II and III)(Name and Address of The Medical Authority Issuing The Certificate)(See rule 4)
RecentPP size Attested Photograph (Showing face only of the person withdisability
     
     
     
     
Certificate No.   Date :
This is to certifythat I have carefully examined
Shri/Smt/Kum.__________________________________ son/wife/daughter of shri_______________________________________
Date of Birth ______ ___ Age ______ years, male, female ______________
(D/MM/YYY)
RegistrationNo._______________ Parmanent resident of House No.________________ Ward/Village/ Steet____________PostOffice______________________District ______________ State_______________.
Whose photographis affixed above, and am satisfied that he/she is a case of ______________disability. His/her extent of percentage physical impriment/disability has been evaluated as per guidlines (to be specified) and is shown agaisnt the relevant disability in the table below :-
S.No. Disability Affected Partof Body Diagnosis PermanentPhysical impairment/mental disability (in %)
1 Locomotordisability @    
2. Low vision #    
3 Blindness Both Eyes    
4 Hearing impairment £    
5 Mental retardation X    
6 Metal-Illness X    
(Please strike out the disabilities which are not applicable.)
2. The above condition is grogressive/non-progressive/likely to imporve/not likely to improve.
 
 
3. Reassessment ofdisability is :
(i) not necessary,
or
(ii)is recommended/after _________years_________months, and thereforethiscertificate shall be valid till _________ _________________(DD)(MM) (YYYY)
@ e.g.Left/Right/both arms/legs
# e.g. Singleeye/both eyes
£ e.g.Left/Right/both ears
4. The applicanthas submitted the following document as proof of residence :-
Nature of Document Date of Issue Details ofauthority issuing certificate
     
(AuthorisesSignatory of notified Medical Authority)(Name and Seal)Countersigned
{Countersignatureand seal of the Government Hospital, in case the certificate isissued by a medical authority who is not a government servant(with seal)
Signature/Thumbimpression of the person in whose favour disability certificateis issued
Note : In casethis certificate is issued by a medical authority who is not agovernment servant, it shall be valid only if countersigned bythe Chief Medical Officer of the District."
Note : Theprincipal rules were published in the Gazettee of India videnotification number S.O. 908(E), dated the 31st December, 1996.
[Form-V] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Intimation of Rejection of Application for Disability Certificate(See rule 4)
No._____________________ Date :
To,  
(Nameand address of applicant for Disability Certificate)
Sub : Rejection ofApplication for Disability Certificate
Sir/Madam,
Pleaserefer to your application dated __________ for issue of aDisability Certificate for the following disability :_______________________________________
2. Pursuant to theabove application, you have been examined by theundersigned/Medical Board on ___________, and I regret to informthat, for the reasons mentioned below, it is not possible toissue a disability certificate in your favour :
(i)  
(ii)  
(iii)  
3. In case you areaggrieved by the rejection of your application, you may representto _______________________________________________, requestingfor review of this decision.
Yoursfaithfully,(AuthorisedSignatory of the notified Medical Authority(Name and Seal)
[Form-V] [Inserted by Notification No. G.S.R. 2 (E) dated 30.12.2009 (w.e.f. 31.12.1996)]Intimation of Rejection of Application for Disability Certificate(See rule 4)
No._____________________ Date :
To,  
(Nameand address of applicant for Disability Certificate)
Sub : Rejection ofApplication for Disability Certificate
Sir/Madam,
Pleaserefer to your application dated __________ for issue of aDisability Certificate for the following disability :_______________________________________
2. Pursuant to theabove application, you have been examined by theundersigned/Medical Board on ___________, and I regret to informthat, for the reasons mentioned below, it is not possible toissue a disability certificate in your favour :
(i)  
(ii)  
(iii)  
3. In case you areaggrieved by the rejection of your application, you may representto _______________________________________________, requestingfor review of this decision.
Yoursfaithfully,(AuthorisedSignatory of the notified Medical Authority(Name and Seal)
FORM DPER-I(Disabled Persons Employed Return)(See rule 40)Quarterly return to be submitted to the Special Employment Exchange for the Quarter ended ........................
Name and Address of the Employer :________________________________________________________________
Whether-Head Office :________________________________________________________________
Branch Office :________________________________________________________________
Nature of business/principal activity :________________________________________________________________