ANNEXURE – 2

FORMAT FOR APPLICATION OF PROJECT UNDER EMR SCHEME

GOVERNMENT OF INDIA
MINISTRY OF HEALTH and FAMILY WELFARE
(DEPARTMENT OF AYURVEDA, YOGA and NATUROPATHY, UNANI, SIDDHA AND
HOMOEOPATHY [AYUSH])

APPLICATION FOR GRANT-IN-AID OF EXTRA MURAL RESEARCH PROJECTS IN AYUSH

(Please furnish 10 hard copies and one soft copy in CD)

Section A
GENERAL

1. Title of the Research Project:

2. Institution responsible for the research project

Name:
Postal address:
Telephone:
Telegraphic address:
Fax:
E-mail:

[Link] case of Individuals applying for the Research project:

(Name of the collaborating institute may be cited in S. No. 2 above)

Name of the individual:

Postal address:
Telephone:
Telegraphic address:
Fax:
E-mail:

4. Name and Designation of

i) Principal investigator:

ii) Co-Investigator(s):

iii) Consultant (s):

5. Duration of Research Project:

i) Period required for pre-trial preparations:

ii) Period which may be needed for collecting the data:

 iii) Period that may be required for analysing the data:

6. Amount of Grant-in-aid asked for (details are to be furnished in Section B):

Total 1st year 2nd 3rd year Balance10%

year Of the total
Salary

Equipment

Books

Other Non-Recurring Expenditure

Recurring Expenditure

TA/DA

Institutional Support

Appropriate fee of PI and CoI

Miscellaneous expenses

Total

7. Details of research project(s) taken up by the Organization/Institute (completed and

ongoing)
7.1 Under EMR Scheme
[Link]. Name Date of Date of completion Total Grant Names and Status Status
of the inception of the Cost received Designation of the of the
Project of project/expected (till the of the PI Project U.C.
project date of completion date of and the Co-I
of the project applying)

7.2 Under other schemes of the Government / other Institutions/Organizations

[Link]. Name of the Project Date of Date of Total Grant Names and Status Status
And the granting inception completion of Cost received Designation of the of the
Ministry/Organization of the (till the of the PI Project U.C.
project project/expected date of and the
date of applying) Co-I
completion of
the project
 8. DECLARATION AND ATTESTATION
Certified that:
i) I/We have read the provisions, terms and conditions, mentioned in the Extra-mural
Scheme along with its Annexure, Guidelines formulated by the Department of
AYUSH (Ministry of Health and Family Welfare) and I/we shall abide by all the
provisions contained therein.
ii) Necessary Institutional facilities will be provided if the research project is
approved for financial assistance.
iii) All records and reports related to the Project shall be shown and furnished to the
authorized representatives of the concerned Research Council/Dept. of AYUSH
iv) Project shall be open for evaluation of the physical progress and utilization of
funds at the discretion of the concerned Research Council/Dept. of AYUSH.
v) I/We agree to submit within one month from the date of termination of the
project the final report and a list of articles, both expendable and non-
expendable, left on the closure of the project.
vi) I/We agree to submit audited statement of accounts duly audited by the auditors
of the Institute.
vii) All information furnished is true, I/We shall be responsible for the authenticity of
the information and documents furnished in the application, proposal, and all
reports, and documents sent in relation to the study project, thereafter.
viii) The Department of AYUSH, through the concerned Research Council, shall have the
right to recover the grant or take legal action against the Individual/Organization,
for any default or deviation from the provisions/terms and conditions of the EMR
Scheme.
ix) It is certified that the equipment (needed for the project and provisioned for in
the budget) is/are not available in the Institute/Organization or these are
available but cannot be spared for the project. (Note: If any equipment already
exists with the Institute/Organization, the Investigator should justify purchase of
another equipment.)
x) I/we undertake that:
a) In the event, the grantee Institution fails to perform its activities, duties,
obligations, acts and deeds as per the scheme and the Annexures appended
thereto, the terms of this agreement, instructions, orders issued from time to
time, will amount to default and in such circumstances, the Department of
AYUSH through Research Council’s can recall the entire funds provided and
stop further release of installments
b) In such case of default, Grantee Institutions shall refund the amount disbursed
to them within 15 days of receipt of such intimation from the Department of
AYUSH / Research Councils. Interest @ 12% shall be charged if the amount is
not returned within this stipulated time.
c) All the Officers bearers, Principal Investigators, Co-Investigators, President,
Chairperson, Secretary, or any other person or person(s) functioning to the
grant-in-aid Institution shall be generally and severally responsible and liable to
refund the amount with the interest and can also be prosecuted both under the
Civil and Criminal Law for breach or default as stated above.
d) Jurisdiction: All disputes or differences between the Department of AYUSH /
Research Councils and the grantee Institution shall be decided by referring to
arbitration in which Secretary, AYUSH shall be the arbitrator, whose decision
shall be final and binding.
The Courts at Delhi shall have the only and exclusive jurisdiction for all matters connected to such
disputes / differences.

Name and Signature of the:

a) Principal Investigator _________________ __________________

Name Signature

b) Co-Investigator(s) _________________ __________________

Name Signature

_________________ __________________
Name Signature

c) Head of the Department _________________ __________________

Name Signature

Signature of the Head of the Institution

Name in full:
Seal:
Place:
Date:

LIST OF DOCUMENTS ENCLOSED (SEE SECTION 6.7.4):

1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
6. ____________________________________________________________
 Section –B
FORMAT FOR BIO-DATA OF THE INVESTIGATORS (PI, Co-I(s), Consultants)

1. Name (Dr./Mr./Ms.): ____________________________________

First name(s) Surname
2. Designation:

3. Complete Postal Addresses and PIN:

Telephone Number(s), Fax, E-mail

4. Date of birth:

5. Educational Qualification: Degrees obtained (Begin with Bachelor’s Degree)

Degree Institution Field(s) Year

6. Research Experience
Duration (From-To) Institution Particulars of work done

7. Other Experience (Apart from Research)

Duration (From-To) Institution Particulars of work done

8. Research specialization
(Major scientific fields of interest)

9. Financial support received

a) From the Ministry of Health and Family Welfare
Past
Present
Pending

b) From other organizations

Past
Present
Pending

10. Research projects in hand under EMR Scheme of Department of AYUSH

11. Research Projects in hand under any other Grant-in-aid scheme of Government of India

12. Other research projects, if any:

13. Recent publications (last 5 years, with titles and references), also papers in press

14. Other information, if any:

Signature
Date
 Section – C
BRIEF SUMMARY OF THE RESEARCH
[Adequate information must be furnished in a brief but self-contained manner to enable the
Department to assess the project.]

1. Title of the Research Project:

2. Objectives.

3. Summary of the proposed research (up to 150 words) indicating overall aims of the research,
importance of the objectives and their application in the context of the priority areas set out in the
application form.

4. Milestones with deliverables in the research project

5. Relevance and usefulness of the study with particular reference to concerned AYUSH system.

[Link] values

7. Present knowledge and relevant bibliography including full titles of articles relating to the subject.

8. Preliminary work already done by the Investigator on the subject, e.g. selection of subjects,
standardization methods earlier research work done.

9. Links with other project (s) administered by Ministry of Health and Family Welfare i.e Department of
Health, Department of Family Welfare and Research bodies under the Ministry.

10. List of important publications over the last 5 years of the Investigator relevant to the project
(enclose reprints).

11. Ethical and other clearances: (See section 6.7.3 in Scheme)

i. The description of ethical considerations relating to the trial is to mentioned and
Approval of the Institutional Ethical Committee/Institutional Animal Ethics Committee
should be enclosed for research involving human subjects/animal experimentation.
ii. If radio tagged material is proposed to be used in the project either for clinical trials or
experimental purposes, then clearance from Nuclear Medicine Committee, Bhabha
Atomic Research Centre, Mumbai, should be attached.
iii. Projects involving recombinant DNA/Genetic engineering work should be examined and
certificate by the Institutional Bisafety Committee (IBSC) to be enclosed. Guidelines for
constitution of IBSC can be obtained from Secretary, Department of Bioechnology, CGO
Complex, Lodhi Road, New Delhi-110003.

12. Budget requirements (head wise and item wise) with detailed break-up year wise and with full
justification (Refer section 9 of Scheme)
1. Salary (See section 10.1)
2. Equipments (see section 8,9)
3. Books
4. Other Non-Recurring Expenditure (mention details item wise)
5. Recurring Expenditure (mention details item wise)
6. TA/DA
7. Institutional Support (see section 8.3)
8. Appropriate fee of PI and CoI (see section 10.4)
9. Miscellaneous expenses

Total Grant-in aid required for the period of three years: _________
 SECTION-D
Detailed Research Protocol

Give here the design of study as per guidelines for clinical trial protocol including toxicity
investigators, indicating the total number of the cases/samples to be studied, as well as the mode of
selection of subjects specially in experiments involving human subjects, equipment and other materials
to be used, the techniques to be employed for evaluating the results including statistical methods etc.
Also detail the Standard operational procedures (SOPs) for preparation of trial drugs and method of
selection of ingredients should also be specified. Facilities in terms of equipment, etc., available at the
institution for the proposed investigation are to be specified.

(Also, the Investigator is required to go through the Good Clinical Practices (GCP) for Clinical
Research in India provided by Central Drug Standard Control Organization (CDSCO), Directorate
General of Health Services, Ministry of Health and Family Welfare, Govt. of India.)

See Annexure – 3 and 4 for preparation of detailed research protocol.