1775

Panaji, 14th January, 2021 (Pausa 24, 1942)

SERIES I No. 42

Reg. No. RNP/GOA/32/2021-2023

RNI No. GOAENG/2002/6410

PUBLISHED BY AUTHORITY

Suggestions are welcomed on e-mail: dir–[email protected]

NOTES

There is an Extraordinary issue to the Official Gazette, Series I No. 41 dated 7-1-2021, namely:—

(1) Extraordinary dated 11-1-2021 from pages 1773 to 1774, Department of Power, Notification No. CEE/Accts/357/

OTS/2020-21/69/3315 dated 8-1-2021 regarding extension of validity of OTS Scheme, 2020.

INDEX

Department

Order/Notification/Add.

Subject

Pages

1. Environment & Climate

Corri.- 5/20/87-STE/DIR/

—

1775

Change

/Part VII/1138

Dir. & ex officio Jt. Secy.

2. GAD

Not.- 23/1/87-GA&C

The Business of the Government of Goa (Allocation)

1778

Under Secretary

(Vol.IV)/2593

(Thirty-eighth Amendment) Rules, 2020.

3. River Navigation

Not.- RND/Accts/Toll Fee/

Fixation of rates of special trips for Ferry boats.

1778

Captain & ex off. Jt. Secy.

2020-2021/1641

4. Science & Technology &

Add.- 227-10-2016/STE-

—

1779

Waste Management

DIR/965

Dir. & ex officio Jt. Secy.

5. Transport

Not.- D.Tpt/Accts/TRANS/ The Goa State Interim Compensation to road

1780

Dir. & ex officio Addl. Secy.

/2021/54

Accident Victims, 2020 Scheme.

GOVERNMENT OF GOA

Department of Environment &

Climate Change

Corrigendum

5/20/87-STE/DIR/Part VII/1138

Read:(1) Notification No. 5/20/87-STE/DIR/

Part VII/591 dated 09th September,

2020 published in Official Gazette,

Series I No. 25 dated 17-09-2020.

(2) Notification No. 5/20/87-STE/DIR/

Part VII/1030 dated 11th December,

2020 published in Official Gazette,

Series I No. 40 dated 31-12-2020.

In exercise of the powers conferred by sub-

-section 3(A) of section 12 of the Water

(Prevention and Control of Pollution) Act, 1974

(Central Act 6 of 1974); and in supersession

of notification No. 5/20/87-STE/DIR/Part VII/

1030 dated 11-12-2020 read at 2 above, the

Goa State Pollution Control Board (GSPCB),

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1776

with the approval of the Government of Goa;

hereby makes the following amendment rules

so as to regulate the recruitment to various

technical and non technical posts in the Goa

State Pollution Control Board, namely:—

1. Short title, application and commence-

ment.— (i) These rules may be called the Goa

State Pollution Control Board, Group ‘A’, ‘B’,

‘C’ and ‘D’ posts, Recruitment (Amendment)

Rules, 2020 (hereinafter referred to as ‘these

rules’).

(iii) they shall come into force from the date

of their publication in the Official Gazette.

2. Amendment to Schedule to the Goa State

Pollution Control Board, Group ‘A’, ‘B’, ‘C’ and

‘D’ posts, Recruitment Rules, 2020.— (1) In

Serial No. 2 in column No. 12, the existing

expression

“Promotion

Assistant

Environmental Engineer for the Board with

atleast 5 years service in the grade/holding

analogous position for at least 5 years in the

grade”, shall be substituted by new

expression

“Promotion

Assistant

Environmental Engineer of the Board with

atleast 5 years service in the grade/holding

analogous position/for at least 5 years in the

grade. OR Masters Degree in Environmental

Engineering/Public Health Engineering from

a recognized University/Institution having

experience of atleast 3 years in pollution

control or in related subject”.

(2) In Serial No. 3 in column No. 8, the

existing expression “Degree in Civil

Engineering/Mechanical

Engineering/

Environmental Engineering or equivalent from

a recognised University/Institution and

experience in pollution control or related

subjects. (2) Atleast 7 years experience in

pollution control or related subject.

Knowledge of Konkani. Desirable: (1) M. Tech

in Environmental Engineering (2) Knowledge

of Marathi” shall be substituted with new

expression “N. A.”

(3) In Serial No. 4 in column No. 8, the

existing expression “Essential: (1) Degree in

Engineering (Civil)/Mechanical/Environment

from a recognised University/Institution.

(2) At least four years working expenrience

in industrial pollution control measures and

knowledge of Environmental Rules and Acts

in a Government undertaking, registered

societies/or in any other reputed organisation.

(3) Knowledge of Konkani (4) M. Tech in

Environmental Engineering, Desirable: (1)

Knowledge of Marathi.” shall be substituted

with new expression “Essential: (1) Degree

in Engineering (Chemical/Civil)/Mechanical/

Environment from a recognised University/

Institution. (2) At least Four years working

experience in industrial pollution control

measures and knowledge of Environmental

Rules and Acts in a Government undertaking,

registered societies/or in any other reputed

organisation. (3) Knowledge of Konkani

Desirable.: (1) Knowledge of Marathi (2)

M. Tech in Environmental Engineering.”

(4)

In Serial No. 5 in column 3 the

expression “(04) four” shall be substituted

with new expression “(03) Three”.

(5) In Serial No. 7 in column 7 and 8, the

existing expression “Not exceeding 40 years

(relaxable for Government servants/working

in Government institutions/recognised

Government undertaking/Registered Societies

upto 5 years)” and “Essential: (1) Masters

Degree

Chemistry/any

branch

Environmental Science from a recognised

University/Institution with at least 12 years

experience in pollution control or related field

in Government organisation or in other

reputed

Organisation/Institution

Doctorate in any of the above subjects and

possessing at least 12 years experience in

pollution control or related field in a

Government or in any other reputed

organisation. (2) Knowledge of Konkani

Desirable: Knowledge of Marathi” shall be

substituted with the expression “N.A.”.

(6) In Serial No. 8. for column 11, for the

expression “By promotion” shall be

substituted with the expression “Promotion

of Scientist ‘B’ with atleast 5 years

experience.”.

(7) In Serial No. 11 in column 11, for the

expression “By promotion failing which by

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1777

direct recruitment” shall be substituted with

the expression “70% by promotion failing

which by direct recruitment and 30% by

direct recruitment failing which by transfer

on deputation”.

(8) In Serial No. 15 in column 3, the

expression “6 (Six)” shall be substituted with

expression “7 (Seven)”.

(9) In Serial No. 16 in column 4, the

expression “Group ‘D’” shall be substituted

with expression “Group ‘C’”.

(10) In Serial No. 16 in column 5, the

existing expression “Rs. 5200-20200+1400”

shall be substituted with the expression “Rs.

5200-20200+1800”.

(11) In Serial No. 16 in column 8, the

existing expression “Essential: (1) VIIIth std.

Pass (2) Knowledge of Konkani, Desirable: (1)

Knowledge of Marathi” shall be substituted

with the expression “Essential: (1) Passed

Secondary School Certificate/Examination

from a recognised Board/Institution. (2)

Knowledge of Konkani. Desirable: (1)

Knowledge of Marathi (2) Basic Knowledge

handling

chemicals/glassware

(3)

Multitasking skills such as knowledge of

operating

office

machines

including

computers”.

(12) In Serial No. 17 in column 8, the

expression “Essential: (1) Bachelors Degree

in Law from a recognised University (2) At

least 10 years working experience in Legal

Department of Govt./Govt. undertaking/

/Institution/Autonomous Body dealing with

Environment Acts (3) Knowledge of Konkani

Desirable: (1) Knowledge of Marathi” shall

be substituted with the expression “Essential:

(1) Bachelors Degree in Law from a recognised

University (2) At least 8 years working

experience in Legal Department of Govt./Govt.

undertaking/Institution/Autonomous Body

dealing

with

Environment

Acts

(3)

Knowledge of Konkani, Desirable: (1)

Knowledge of Marathi”.

(13) In Serial No. 18 in column 8, the

expression “Essential: 1) Bachelors Degree in

Law from a recognised University 2) at least

5 years working experience in Legal

Department of Govt. undertaking/Institution

/Autonomous Body dealing with Environment

Acts. (3) Knowledge of Konkani” shall be

substituted with the expression “Essential:

(1) Bachelors Degree in Law from a

recognised University (2) At least 8 years

working experience in Legal Department of

Govt./Govt.

undertaking/Institution/

Autonomous Body dealing with Environment

Acts. (3) Knowledge of Konkani”.

(14) In Serial No. 20 in column 9, the

expression “N.A.” shall be substituted with

the expression “Age No. Qualifications: To the

extent indicated in column No. 12.

(15) In Serial No. 21 in column 12, the

expression “By promotion of Network

Assistant of the Board with 5 years of service

in the grade and possessing the qualifications

as at column No. 8” shall be substituted with

the expression “By promotion of Network

Assistant of the Board with 5 years of service

in the grade”.

(16) In Serial No. 22 in column 5, the

expression “Rs. 5200-20200+1900” shall be

substituted with the expression “Rs. 5200-

20200-2400”.

(17) In Serial No. 22 in column 9, the

expression “N.A.” shall be substituted with

the expression “Age No. Qualifications: To the

extent indicated in column No. 12”.

(18) In Serial No. 24 in column 9 the

expression “Age: No. Qualification: To the

extent indicated in column No. 12” shall be

substituted with the expression “N.A.”.

(19) In Serial No. 34 in column 8 the

expression “Essential: (1) Middle School or

equivalent qualifications” shall be substituted

with the expression “Essential: (1) Passed

Secondary School Certificate/Examination

from a recognised Board/Institution.”

(20) In Serial No. 35 in column 3, the

expression “7 (Seven)” shall be substituted

with the expression “8 (Eight)”.

(21) In Serial No. 35 in column 4, the

expression “Group ‘D’ shall be substituted

with the expression “Group ‘C’”.

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1778

(22) In Serial No. 35 in column 5, the

expression “Rs. 5200-20200+1300” shall be

substituted with the expression “Rs. 5200-

-20200-1800”.

(23) In Serial No. 35 in column 11, the

expression “The department shall identify the

work/duties to be performed by the male and

female employees under the Multitasking

system before appointing the candidates”

shall be substituted with the expression “By

direct recruitment: Note- The department

shall identify the work duties to be performed

by the male and female employees under the

Multi-tasking system”.

By order and in the name of the

Governor of Goa.

Dasharath Redkar, Director/ex officio Joint

Secretary (Environment & Climate Change).

Porvorim, 7th January, 2021.

———ttt———

Department of General Administration

Notification

23/1/87-GA&C (Vol.IV)/2593

In exercise of the powers conferred by

article 166 of the Constitution of India and all

other powers enabling him in this behalf, the

Governor of Goa hereby makes the rules so

as to further amend the Business of the

Government of Goa (Allocation) Rules, 1987,

as follows, namely:—

1. Short title and commencement.— (1)

These rules may be called the Business of

the Government of Goa (Allocation) (Thirty-

eighth Amendment) Rules, 2020.

(2) They shall come into force on the date

of their publication in the Official Gazette.

2. Amendment of Schedule.— In the

Schedule appended to the Business of the

Government of Goa (Allocation) Rules, 1987,-

(i) at serial number 28, under the

heading “Department of Personnel”,–

(a) under item (b), sub-item (iia) shall

be omitted;

(b) item (q) shall be omitted;

(ii) at serial number 36, under the

heading “Department of Revenue”, after

item (t), the following item shall be

inserted, namely:—

“(u) Establishment of Collectorates in

Goa.”.

By order and in the name of the Governor

of Goa.

Shripad Arlekar, Under Secretary (GA-II).

Porvorim, 5th January, 2021.

———ttt———

Department of River Navigation

Notification

RND/Accts/Toll Fee/2020-2021/1641

In exercise of the powers conferred by sub-

-section (2) of Section 4 of the Goa Ferries

Act, 1990 (Goa Act 9 of 1990) and in

supersession of earlier Notification No. RND/

Accts/Toll Fee/2019-20/1810 dated 06-02-2020

in this regard the Government of Goa hereby

fixes the rates of special trips for various ferry

boats in the State of Goa as specified in the

Scheduled hereto with effect from the date of

publication of this Notification in the Official

Gazette.

SCHEDULE

(1)

Sr.

Ferry Routes

Item

Fare

No.

(In Rs.)

1. Cumbharjua/Gaundalim Special Trip

100.00

2. Tonca/Sarmanas

Special Trip

100.00

3. Old Goa/Piedade

Special Trip

100.00

4. Volvoi/Maina

Special Trip

100.00

5. Volvoi/Surla

Special Trip

100.00

6. St. Pedro/Diwar

Special Trip

100.00

7. Panaji/Betim

Special Trip

100.00

8. Kerim/Tiracol

Special Trip

100.00

9. Camurli/Tuem

Special Trip

100.00

10. Ribandar/Chorao

Special Trip

100.00

11. Vaxim/Amboi

Special Trip

100.00

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1779

12. Narva/Diwar

Special Trip

100.00

13. Tolto/Dauji

Special Trip

100.00

14. Rassai/Durbhat

Special Trip

100.00

15. Adpai/Rassai

Special Trip

100.00

16. Rai/Shiroda

Special Trip

100.00

17. Pomburpa/Chorao

Special Trip

100.00

18. Cortalim/Madkai

Special Trip

250.00

(2) Hire charges of ferry boat/launch is

Rs. 2000/- per hour irrespective of size of ferry

boat/launch. Less than ½ hour will be

considered as ½ hour and more than ½ hour

as full hour.

By order and in the name of the

Governor of Goa.

Capt. Premlal Sirsaiker, Captain of Ports/

/ex officio Joint Secretary (RND).

Betim, 5th January, 2021.

———ttt———

Department of Science and Technology

and Waste Management

Addendum

227-10-2016/STE-DIR/965

Read Notification No. 227-10-2016/STE-DIR/

/15 dated 09-07-2020.

In the above read notification, the following

sub-clause may be inserted after clause 5

(iv), so as to amend the scheme, notified vide

above read notification, published in

the Official Gazette, Series I No. 5 dated

30-04-2020.

“5 (v) Guidelines of the Scheme:—

a) The Headmaster/Principal of the

institution should ensure selection of

students of Standard 8th, 9th or 10th of

their respective High Schools. To be

eligible, minimum marks obtained in

Science subject should be 50% for ST

category and 75% for General category for

the last 2 academic years. The ST Students

to be selected based on ST certificate

issued by Competent Authority.

b) Selection for Higher Secondary

students shall be based on marks obtained

in previous academic year i.e. either

Standard 10th or Standard 11th with

minimum of 50% for ST and 75% for General

category. Only students from Science

stream shall be eligible.

c) Schools have the choice to select an

Institution of Excellence of their interest in

the field of Science and Technology within

the Country for such visit.

d) A group can have maximum of 5

students and 1 teacher of the same School/

Higher Secondary or combination of

multiple Schools/Higher Secondaries of the

same taluka. In the event a group

comprises of more than one School/Higher

Secondary Grant in Aid shall be given to

the applicant School/Higher Secondary

which shall manage the amount for the

entire group. It may be noted that

maximum of 10 such groups are entitled to

avail the benefit per year under the

scheme.

e) A group must have minimum

2 students belonging to ST category.

f) If the group has even one girl child,

then the accompanying teacher must be

female.

g) An amount of Rs. 50,000/- to each

group of students/teachers shall be

provided per trip. A School can avail the

benefit of the scheme once a year.

h) Wherever, possible and available

Government accommodation should be

used for the visiting students/teachers and

travel mode shall be railway, bus etc.

i) The School shall apply in Form I

appended to the Scheme preferably 2

months prior to the visit.

By order and in the name of the Governor

of Goa.

Levinson J. Martins, Director (S&T&WM)

& ex officio Joint Secretary.

Porvorim, 6th January, 2021.

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1780

Department of Transport

Directorate of Transport

Notification

D.Tpt/Accts/TRANS/2021/54

Read: Notification No. D.Tpt/Accts/TRANS/

2015/2141

dated

19-06-2015

published in the Official Gazette,

Series I No. 13 dated 25-06-2015.

The Government of Goa is pleased to notify

the scheme after modification titled as “The

Goa State Interim Compensation to Road

Accident Victims, 2020”, which was earlier

titled as “The Goa State Interim Compensation

to Road Accident Victims, 2015”.

Preamble.— Increase in number of vehicles

results

traffic

congestion

and

consequentially in road accidents. While

Government does its best to minimize if not

eliminate, some tragic accidents are

inevitable. Every year an approximately 250-

300 people lose their lives and large number

are injured, some with permanent disability

and others with partial disability and more

often than not, the deceased/injured happen

to be the only bread earner of the family and

not covered by any life insurance cover and

in the event of death and disability of such

persons, the entire family is disturbed

emotionally, psychologically and financially.

And whereas Government has proposed

to provide such families Financial Assistance

irrespective of insurance cover enjoyed by

the victim.

And in order to fulfill the given assurance

as well as for effective implementation of the

assurance, the Government was pleased to

enact a scheme.

And whereas it has been observed that

the Existing Scheme is not meeting the

expected results due to the cumbersome

process in general and provision regarding

Insurance

coverage

any

nature

disqualifying the beneficiary in specific, and

therefore in view of the above, the Existing

Scheme is modified to that extent.

And therefore to make it simple and flexible

so as to meet the desired results i.e. for

immediate monetary help to road accidents

victims, the scheme is modified as under:—

(1) Title.— The scheme shall be called “the

Goa State Interim Compensation to Road

Accident Victims, 2020”.

(2) Commencement.— It shall come into

force from the date of publication in Official

Gazette and shall be valid for five years from

the date of its notification.

(3) Definitions.— In this scheme, unless

there is anything repugnant to the subject or

context—

(i) Beneficiary:— “Beneficiary” means

the person entitled to receive the

compensation/financial assistance paid

under the scheme. For the purpose of this

scheme entitlement of beneficiary to the

sum of compensation shall be in order of

priority as under:–

(i) In case of Death of the person/victim

of road accident his/her:- (i) spouse (ii)

son(s) and unmarried daughter(s)

(divided equally) (iii) parents of the victim

(iv) unmarried brother(s) and sister(s).

(ii) In case of permanent injury (i)

victim or in case he is unable to avail

the benefit himself (ii) his/her spouse (iii)

daughter(s)/son(s)/mother/father.

In case of any dispute with respect to the

proportion of amount of compensation, the

decision of the Director (Transport) shall be

final.

(ii) Death:— “Death” means a death on

account of an accident on the spot or

within 12 months of accident on account

of any injury suffered during the accident

provided it be the sole and direct cause of

the death as certified by Registered

Medical Practitioner.

(iii) Family:— The term family shall

include spouse of the victim, son(s),

unmarried daughter(s), mother and father,

unmarried brother(s) and sister(s).

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1781

(iv) Permanent injury:— “Permanent

injury” means an injury that results in

victim not able to carry on any business or

occupation as he was carrying on before

the accident and so certified by

Superintendent, Goa Medical College or

Director of Health Services or their

designated officials for the purpose of the

scheme.

(v) Victim:– “Victim” for purpose of short

term relief means “any person who dies in

road accident within the State of Goa

irrespective of domicile” and for long term

relief means “any person who has suffered

injury requiring hospitalization having (15)

fifteen years of permanent residence in the

State of Goa.

(4) Scope of the Scheme.— The Scheme

provides for financial assistance to the

victims/families of victims against accidental

death or bodily injury caused by external,

violent visible means in road accidents.

(5) The Scheme shall provide for:–

(I) Short Term Reliefs: (a) In case of Death

on road/In case of Death in Hospital/any

other place but where cause of death

attributable to the accident-Upfront

(financial

assistance)

payment

Rs. 50,000/- (Rupees fifty thousand only)

based on the application as per Annexure

‘A’ made to the Director of Transport by

the member of the family of the victim. The

payment of financial assistance to be made

in the following order:–

(i) Spouse of the victim.

(ii) Daughter(s).

(iii) Son(s).

(iv) Mother.

(v) Father.

The above payment is to be made without

verification of any other conditions. The

compensation shall be paid as per clause (7)

below.

(b) In case of any serious injury suffered

in road accident and the injured requiring

hospitalization of more than 07 days period

– an immediate payment of compensation

of Rs. 25,000/- (Rupees twenty five

thousand only) based on the application

as per Annexure ‘A’ made to the Director

of Transport by the victim or any member

of the family of the injured. The payment of

the financial assistance to be made in the

following order:—

(i) Spouse of the victim.

(ii) Daughter(s).

(iii) Son(s).

(iv) Mother.

(v) Father.

The above payment is to be made without

verification of any other conditions. The

Compensation shall be paid as per clause (7)

below.

(II) Long Term Reliefs: The long term

reliefs shall be applicable to those, whose

family income i.e. cumulative income of

spouse/daughter(s)/son(s)

after

the

accident is less than 3.00 lakhs and the

same shall be paid as per clause (7) after

deducting any compensation already paid

under clause (I) above i.e. under Short

Term Relief.

(a) Rs. 2.00 lakhs in case of death;

(b) Rs. 1.50 lakhs in case of Permanent

injury;

permanent injury not leading to loss of

job/occupation but where hospitalization

exceeds 60 days immediately after

accident;

(d) Rs. 50,000/- in case of injuries other

than specified above but requires

hospitalisation upto 60 days after but

exceeding 7 days;

(e) Rs. 10,000/- in case of injuries

requiring 3 to 7 days of hospitalisation.

(6) The scheme provides for disbursement

of compensation to the families of Road

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1782

Accident Victims by the Transport Department

on the basis of procedure as at Annexure ‘A’,

‘B’ and ‘C’.

(7) The payment of compensation shall be

made as under:—

(i) In case of death:

(a) Surviving spouse;

(b) In absence of (a) above, the

amount of compensation to be divided

equally amongst the son(s) and

unmarried daughter(s).

(d) In case of absence of (a), (b), (c),

unmarried brother(s)/sister(s).

(e) In case of absence of (a), (b), (c)

and (d) then no compensation shall be

paid.

(ii) In case of permanent injury:

(a) To the survivor.

(b) To any other relation as indicated

in clause 7 (i) above, in order as

indicated in case the survivor is not

medically in condition to avail the same.

(8)

Procedure

for

claiming

the

compensation. — (a) Upon the happening of

any event which may give rise to a claim

under this scheme, an application in the

prescribed proforma with full particulars must

be submitted online on the Department

website goatransport.gov.in or manually to

the Director, Directorate of Transport within

a period of 180 days of the happening of such

event for Long Term Relief and within 30 days

for Short Term Relief.

(b) Documentary/Satisfactory proof upon

which a claim is based, shall be furnished to

the Government along with the claim.

person of the Government shall be allowed

to examine the injured person(s) to verify the

nature of alleged injury or disablement if it is

reasonably required by the Department for

finalization of the claim.

(d) No relaxation for payment to any person

including legal heirs.

(e) No relaxation in time period for

application.

(9)

Procedure

for

disbursement.—

Compensation under this scheme shall be

disbursed by the Directorate of Transport, 1st

Floor, Junta House, Panaji-Goa.

(10) Applicability.— (a) To any victim in

the State of Goa for Short Term Relief.

(b) To any victim with 15 years of Residence

in the State of Goa for Long Term Relief.

(11) The modified scheme shall be

applicable to all cases on or after 19-06-2015.

(12) This compensation paid is not

insurance but it is a compassionate payment

by State Government to overcome plight faced

by the victim and his family due to trauma

and expenses incurred. It is not right of any

one and it is totally at the discretion of

Government and subject to budgetary

provision.

(13) The said compensation paid is not

subject to any deductions by insurance

company (Refer Clause 12).

(14) Constitution of the Screening

Committee.— The Screening Committee shall

consist of the following Members:-

1. Director of Transport

Chairman.

2. Deputy Director of

Member.

Transport, North, Panaji

3. Deputy Director of

Member.

Transport, South, Margao

4. Accounts Officer

Member

Secretary.

This issue with the concurrence of the

Finance Department vide inward No. 4020/F

dated 12-11-2020.

By order and in the name of the

Governor of Goa.

Rajan Satardekar, Director & ex officio Addl.

Secretary (Transport).

Panaji, 7th January, 2021.

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES I No. 42

14TH JANUARY, 2021

1783

ANNEXURE “A”

PROCEDURE FOR CLAIMING COMPENSATION

I - Short Term Reliefs:–

1. Name of the claimant.

2. Name of the Road Accident Victim.

3. Relationship with the victim/deceased.

4. Permanent Residential Address.

5. Details of Accident:

(i) Place, day, date and time.

ANNEXURE “B”

PROCEDURE FOR CLAIMING COMPENSATION

II – Long Term Reliefs:–

1. (a) Name of the claimant:

(b) Name of the Road Accident Victim:

Permanent Residential Address:

(Enclose Residence/Domicile Certificate issued by the Competent Authority).

Profession/Occupation/Trade of Business of the Road Accident Victim:

No. of Dependant on the Claimant/Road Accident Victim:

Details of Accident:

(i) Day, date & time:

(ii) Full particulars of the cause and the injuries sustained:

(attach medical report in original)

Whether the accident is registered by the Traffic Police?

(Attested copy of the FIR/Panchanama be enclosed)

Give name & address of the witness of the accident if any:

The nature and extent of injuries:

(specify death, permanent disability or partial disability)

9. (a) Is the Road Accident Victim insured?

(b) If so, please give full details of such company or insurer:

(Attach an Affidavit in the prescribed format as per overleaf).

I, …………………………………………………. declare that the information given is true and correct to the

best of my knowledge and belief and that I have not concealed or suppressed any material facts and incase

any such things are noticed at later stage, compensation paid shall be forfeited.

Signature

Name & Address

ANNEXURE “C”

PROCEDURE FOR CLAIMING COMPENSATION

Documents to be submitted for Road Accident Claim:

1. Copy of FIR issued by the concerned Police Station OR Police Station Diary in case of self accident.

2. Copy of Police Panchanama.

3. Residence/Domicile Certificate/Satisfactory documents of the deceased/victim of minimum period

of 15 years preceding his/her date of demise issued by the Competent Authority.