Schedule-5
(Related to Sub-rule (1), of Rule-9)
Format of application for the permission to operate Service Centre
Date:
Subject: Requesting for the permission to establish and
operate Service Centre
Ministry of Women, Children and Social Welfare,
Singhadurbar, Kathmandu.
As this Organization is interested to establish and operate the Service
Centre; therefore, this application has been filed pursuant to Domestic Violence
(Offence and Punishment) Act, 2066 (2009), and Domestic Violence (Offence
and Punishment) Rules, 2067 (2010), for the permission.
1. Details of Organization:
(a) Name of the organization:
(b) Address of the organization:
(c) Name and address of the chief official of the organization:
(d) Contact person:
2. Details of proposed Service Centre:
(a) Place, where Service Centre will be established and operated,
(b) Details of the standards of Service Centre,
(c) Human resources of Service Centre,
(d) Financial Source,
Enclosed documents:
1. Copy of the statute of organization,
2. Copy of the Registration certificate of the organization,
Seal of organization: Organization’s authorized person’s
Signature:
Name:
Contact Address: