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Shantikunj Sevashram

Centre for Dignified Living for Senior Citizens

Project from Vidyadhiraj Charitable Trust ®

Rules & Regulations for Admission w.e.f. 1st April 2010

Harigram-Kevale Junction, New Panvel-Morba Road, Panvel 410206

Tel. ( 02143)-236097 / 236101 / (022) 24118895 / 24121535

INDEX

1. Establishment. pp. 4.2. Shantikunj Sevashram. pp. 5.3. Management and Administration. pp. 6.4. Objectives of Shantikunj Sevashram. pp. 7.5. Rules and Regulations Relating to Admission. pp. 8.a. Eligibility for Admission. pp. 8.b. Ineligibility for Admission. pp. 9.6. Admission Procedure. pp. 10.7. Mode of Life. pp. 13.8. Payment for Services. pp. 15.9. Medical Care / Treatment. pp. 18.10. Visitors. pp. 19.11. Spiritual / Wellbeing. pp. 20.12. Death and Funeral. pp. 21.13. Amendment of Rules and Regulations. pp. 22.14. Application of Rules and Regulations. pp. 15. Appndix. pp. 28.

1. Declaration by Applicant. pp. 29.

2. Application for Admission. pp. 30.

3. Letter of Undertaking. pp. 34.

4. Agreement. pp. 36.

5. Desirable. pp. 38.

1. Establishment :

Shantikunj Sevashram is a Charitable institution run under the auspices of the renowned Vidyadhiraj Charitable Trust ®, Wadala, Mumbai, a non-profitable Public Charitable organization, an NGO under the guidance of revered Shrimad Vidyadhiraj Teerth Sripad Vader Swamiji of Gokarna Partagali Jeevotham Math , Parthagali Goa.The Vidyadhiraj Charitable Trust ® (VCT) is a public charitable trust founded in November 1998 for undertaking various human welfare service activities for the benefit of the society at large. The VCT conducts its multifarious activities through four separate foundations, which function as its organic limbs. These limbs or units are as under

1. Sevashram Relief Foundation.

2. Jeevottam Medical Foundation.

3. Saraswathi Educational Foundation.

4. Shanti Seva Prathisthan

The Sevashram Relief Foundation has established an integrated complex at Harigram, Near New Panvel (Dist. Raigad) known as Shantikunj Sevashram, which has a Centre for Dignified Living for Senior Citizens.

2. Shantikunj Sevashram :

Shantikunj Sevashram is situated at Villages Harigram & Kevale , on New Panvel - Morba Road, Taluka Panvel,Dist. Raigad. This Sevashram is about 5 to 7 kms from New Panvel, New City Township under CIDCO, Government of Maharashtra. Nearest Railway Station is Panvel Junction, and the Nearest State Transport Bus Depot is at Panvel situated at NH-4, Highway.Mumbai – Pune express highway passes near New Panvel City. Proposed New Bombay Airport is planned near Panvel. The Shantikunj Sevashram is well connected by Autorikshaws and 10 seater larger rikshaws (locally called Tum Tum) from State Transport Depot

From Panvel railway station there are train services to Thane (Central Railway) and Andheri (Western Railway) , besides regular services

To Chatrapathi Shivaji Terminal). . The fare in Tum Tum for a seat is Rs from State Transport Depot to Hrigram. Whereas single Rikshaw charges are between Rs 60/= to Rs 80/= to Shantikunj Sevashram .

Limited State Buses operate between Panvel and Morba, via Harigram/ Kevale .

The Shantikunj Sevashram is housed near the bank of Kalundri river that flows during monsoon and on other days remains stagnant. Also the villages Harigram and Kevale are surrounded on three sides by hillocks.In all the Sevashram is located on beautiful and natural with all the associated scenery. This is a far cry from the hectic Bombay City.

The calm atmosphere of the Sevashram provides a lively environment in which the residents of the Ashram can live a happy and blessed life with confidence and independence.

3. Management and Administration :

The general management and administration of the Ashram is vested with an appropriate empowered committee 9 called the Supervisory committee) of active and dedicated individuals, under the overall guidance and supervision of the Trustees of the VCT. The role, responsibility and the power of the Committee will be to monitor the day-to-day administration and maintenance of financial accounts, work out ways and means for funds mobilization, and suggest to the Board of Trustees the necessary capital expenditure by budgetary allocation.

4. Objectives of Shantikunj Sevashram :

The main objective of the Sevashram is to provide residential accommodation (in the Sevashram) to persons who have retired from their profession, service or business and who want to live independently in serene atmosphere, with dignity and reasonable emotional security. Also to provide medical services, meditation-cum-prayer facilities, reading room and library, yoga centre etc. in the campus of the Sevashram.

5. Rules and Regulations Relating to Admission :

1. Eligibility for Admission :

Admissions are restricted to:

Persons and their spouse who have opted for VRS, retired from active service / business / profession and who are not engaged in any full time occupation are eligible to apply for Resident membership and accommodation.

A team of Doctors appointed by the Trust would examine persons seeking Resident membership and accommodation, and issue

certificates for admission or otherwise and, this will be final and binding on the Applicant.

The applicants must be financially in a position to pay their monthly maintenance fees / expenses as prescribed by the Trust from time to time. The applicant must give two sureties who would guarantee on behalf of the members..

2. INELIGIBILITY FOR ADMISSION.

Admissions are not open to people who are suffering from infections and mental diseases, or against whom criminal cases are pending in courts for offences or who is known to be alcohol or drug addicts.

6. Admission Procedure :

1. All persons desirous of becoming residents at the Sevashram are to apply on the prescribed form and execute a written agreement on stamp paper in the presence of two witnesses agreeing to abide by the Rules and Regulations of the Shantikunj Sevashram.

2. The mode of admission will be in accordance with the assessment reached at by the Trusties/ Committee members after having an interview with the applicant. The decision of the Trustees/ Committee members shall be final and binding on the applicant.

3. Every applicant applying for admission to Sevashram shall be required to be accompanied at the time of interview by a responsible

person who is none other than his near relative, failing which he shall produce a consent letter / credentials from such near relatives like children, brother/s, sister/s who have attained age of majority and are competent to contract and vouch for, or letter / credentials from the respected citizens / religious heads/institutions and such letter / credentials shall bear the signature, full address and contact telephone numbers for the purpose of personal interview jointly held by the Trustees / Comitee members, with the applicant to access his / her eligibility to admission.

4. The applicant should also furnish to the satisfaction of the Trusties and at the time of interview the following documents in original.

i. A detailed medical report issued by a qualified medical practitioner in accordance with the requirements of the Institution.

ii. The name, surname, family name and full address and contact telephone number/s mobile number/s of his/her near relative and applicant's relationship with such person.

iii. The details of applicant's spouse including his/her name, surname, family name, date of birth, address, contact telephone number/s etc. if the applicant is married.

5. Every admitted applicant shall remit at the time of admission the service charges / fees security deposit / service charges for special nurse etc. as prescribed in the Rules and Regulations.

6. Amount, if any, standing at his / her credit / according to the account of the Sevashram will be refunded to the inmate when he / she leaves the institution. But such amount will not carry any interest. Such amount/s at his / her account unclaimed for more than one calendar year from the date of leaving will be adjusted for the welfare of the poor Residents.

7. The of the Sevashram may refuse admission to any applicant whose character or antecedents has not been satisfactory or for any other reasons which the Trusties deem fit.

8. Any inmate who has obtained admission by means of false representation of any kind or who may be found guilty of indiscipline / misconduct shall be dismissed from the Institution.

9. No inmate will be re-admitted when once he / she is dismissed / sent away from the Sevashram. The decision of the Trusties shall be final and binding upon the applicant.

10. Application for admission as Resident Member and for accommodation will have to be made in the prescribed form. Every such application shall be recommended by a responsible person

(acceptable to the Trusties) and endorsed by relatives (close, blood relation) of the applicant.

11. The applicant on admission shall,

i. Become a Resident Member of the Sevashram on payment of non-refundable Admission fee of Rs. 11,000/- per person;

ii. Rs. 10,000/- Emergency Fund for Hospitalisation, etc., if any, which is refundable.

While admitting the resident, Complete Blood Test Report and Medical History Report need to be attached with the Admission form duly filled in mentioning at least 3 contact addresses (specifying lane, road, landmark etc.), with contact / mobile numbers of near and dear ones, together with 3 Passport size photographs of the prospective resident.

12. The Trust / Management reserves the right of admission and the Management’s decision in this regard will be final.

7. Mode of Life :

i. Comprehensive accommodation services is made available to all Residents through out their life at the Sevashram. Applicants have a free choice of any of the following four types of housing / accommodations, subject to the availability of rooms.

ii. Type ‘A’ = Single Occupancy in Self-contained Room in Residential Building.

iii. Type ‘B’ = Single Occupancy in an independent spacious Room in independent Cottage with Verandah.

iv. Type ‘C’ = Double Occupancy in Self-contained Room in Residential Building – for two persons of the family.

v. Type ‘D’ = Double Occupancy in independent Cottage Room – for two persons of the family.

vi. To maintain a good family atmosphere the Residents should live in mutual love, friendship and respect and shall use their God - given health, and availability by voluntarily engaging in small jobs / works for the organization and thereby support the welfare of our society.

vii. To cultivate and develop amity and unity among themselves, the Residents shall try to co-operate with each other and join together for prayers, food, games, entertainment and other activities.

viii. All Residents shall maintain strict discipline and silence at the Sevashram and all Residents should be careful not to disturb the other brother/sister Residents in their sleep between 9.30 PM and 6 AM.

ix. All Residents should be punctual in their routine activities at the Sevashram including food, prayers etc.

x. Every Residents handling good/s or article/s of the Sevashram whether big or small shall be responsible for the safe custody and preservation in good condition of such goods / or articles as if they belong to them.

xi. Smoking, drinking alcohol and betel - chewing, cards playing for money within the Sevashram is strictly prohibited.

xii. Residents should not be allowed to eat at nearby restaurants and shops.

xiii. Residents should not be allowed to make outgoing telephone calls from the Sevashram.

xiv. The Sevashram reserves with it every right to dismiss inmate/s who indulge in serious acts of indiscipline, objectionable behavior and or any other act/s that disturb the peaceful atmosphere of the Sevashram.

xv. Presently, there is no facility for bed-ridden persons and or persons with unstable mental / physical health.

xvi. Separate Geriatrics / Gerantology unit may be introduced in future, at present these facilities are not exist in the Sevashram.

8. Payment for Services :

The monthly payment covers the following:

1. Maintenance of room,

2. Water,

3. Electricity,

4. Food, Vegetarian Food (no eggs also allowed)

. 07-00 a.m. morning tea

09-00 a.m. breakfast

01-00 p.m. lunch

04-30 p.m. tea with light snacks or biscuits

7-30 p.m. dinner

Consumption of alcohol and/or smoking within the Complex strictly prohibited.

5. Salary of the staff,

6. Entertainment,

7. Library,

8. Reading room and

9. Newspaper.

10 Accomodation :

Types of accommodation are as under :

i. Type ‘A’ = Single Occupancy in Self-contained Room in Residential Building.

ii. Type ‘B’ = Single Occupancy in an independent spacious Room in independent Cottage with Verandah).

iii. Type ‘C’ = Double Occupancy in Self-contained Room in Residential Building – for two persons of the family.

iv. Type ‘D’ = Rs. 5,900/- per month (Double Occupancy in independent Cottage Room – for two persons of the family).

There shall be three sets of charges depending upon the purpose and duration of stay :

i. Temporaray accommodation from one month to six months. This accommodation is provided to fresh inmates to familiarize with the ashram surroundings and atmosphere so that the Resident can take a decision to stay permananetly, subject to other reules aond conditions of the Asram are met. During thisperiod, both the Residents and Ashram authoirities ahall faimiliarise each other. Both have a right to discontinue the association without assigning any reason.

. Salientent terms for such an engagement are as under :

a) No Admission Fee.

b) For persons beyond 60 years of age, seeking admission, and on trial basis, Rs. 10,000/- refundable deposit for medical emergency, if any.

c) On expiry of six month trial period, if admitted, extra amount so paid could be adjusted.

d) .Boarding and Lodging (per day, Temporary period – shall be as per attachment - BBBB which shall be revised at the start of every finanacial year

ii. Permanent accommodation

Those who have completed six months of stsya may choose to convert their status as Permanent residents subject to the approval of the Asram Management, .Boarding and Lodging shall be as per attachment - BBBB which shall be revised at the start of every finanacial year.

However, Management, at it’s discretion may waive of this period in part or full and make an applicant’s residence permanent,

.

iii. Daily accommodation :

9. Medical Care / Treatment :

The state of health of every Resident Member will be checked by a panel of doctors attached to the Medical Centre at the Sevashram as and when practicable. Members will be treated free of charge, as out-patients for any minor ailment, by the doctors at the Medical Centre.

Trust is not liable to inform the relatives of the inmate on a regular basis their health condition, unless the prescribed medical officer advises the authorities to do so. Howvever, the relatibes may go through the medical records at Ashram site. In case of any serious illness or ailment requiring treatment / surgery as in-patient, such a Member will be shifted to the Medical Centre of Administration’s choice, and the relatives of the Member concerned will be informed as soon as possible. All expenses including pre-admission deposit to be made with the Hospital will be provided by the in-patient or his/her relative immediately on requirement, at the Medical Centre /Nursing Home/Hospital and will have to be borne by the Member or his / her relative.

The respsonsibility of the administration ceases once the patient is admitted in the nursing home,

10. Visitors :

a. Relatives or friends of the Resident Member will be permitted to visit the campus only during daytime.

b. To maintain continuous contact with the Residents family and others, visitors are allowed on all days. The Residents shall use the visitors room for this purpose. Anyhow the ashram will not provide food and shelter for any of the visitors. Anybody wants to stay over night, rooms and food will be provided on payment.

c. It will be within the sole discretion of the Management whether to allow a visitor to stay overnight in the specified accommodation in the campus, on payment of prescribed charges.

d. Prior special permission from the authorities is required before going out of the Sevashram. Likewise, the authorities concerned shall be informed on return.

e. Residents who desire to visit their houses as per their requirements or wishes shall be allowed to do so. But no inmate will be allowed to go home unless responsible relative comes to take him / her and agrees to bring him / her back. If necessary, one of the ashram-staff will be allowed to accompany him / her provided the inmate concerned, meets his / her travel expenses.

11. Spiritual / Wellbeing :

The Sevashram pays much importance to the spiritual well - being of the Residents. Ashram has a holli temple of Sri Ram. This temple serves as prarthana mandhir and also caters for spiritual uplifting. Residents can do pooja and prarthana here and observe many Hindu religious functions.

12 Death and Funeral :

In the unfortunate event of death of a Resident Member, efforts will be made as soon as possible to contact his / her relative (s) at the address available in the office records. In case the relative fails to satisfactorily respond in a timely manner or fails to take possession of the body within 24 hours of the demise, the funeral rites will be performed by the Sevashram in such manner as may be deemed appropriate. No complaint or grievance what so ever as regards the medical treatment or alleged negligence of any sort and/or as regards the disposal of the body will be entertained.

On the death of any inmate at the Sevashram, if the relatives desire to take the body to their own native place, they can do so. In other cases funeral will

be done by the authorities in such manner as the authorities think fit and proper.

The address and telephone number of the nearest relative to be intimates, in the event of death or serious illness of the inmate should be given at the time of admission itself.

3. Amendment of Rules and Regulations :

The Rules and Regulations of registration of Residents will be subject to the changes effected from time to time by the Authorities in accordance with the change in time and circumstance.

4. Application of Rules and Regulations :

Every applicant admitted as Residents of Shantikunj Sevashram shall strictly follow the Rules and Regulations of the Bhavan.

1. Responsibilities:

a) It will be the responsibility of every Resident Member to take care of his / her personal articles and belongings and the Management will not be responsible for the loss of any such article or belonging. The Management will provide, subject to availability, limited storage space / steel cupboards for keeping the personal belongings under lock and key within the room.

b) Members and visitors should use the Sevashram accommodation and campus (including the common facilities and amenities) with due care, to avoid any loss, breakage or damage. In the event of occurrence of any such loss, breakage, damage etc. due to the negligence and / or misuse by a Member or his visitor(s), the cost of repair or replacement as determined by the Management will be recovered from the Member concerned.

c) Plucking flowers from the plants in the complex is simply prohibited. Strict action would be taken against any resident violating this code of conduct.

d) Each of the residents should actively participate in the common ‘Prayers’ before the lunch and dinner.

e) Each of the residents should pro-actively participate in group activities such as Yoga, Bhajan, Pravachan, Prayers etc.

2. Rights:

A Resident Member or his/her nominee / legal heir shall not have, nor he/she shall be deemed to have acquired, at any time, any right, title or interest what-so-ever in the accommodation allotted to the Member, or in any part or parcel of the common facilities and amenities provided at the Sevashram for the use of the Member. The entire property shall be always in the possession of the Trust and occupants have no right, title or interest in the premises other than to live in the room allotted to them from time to

time. Trust is authorized to change the allotment of the room at any time at their sole discretion and the same shall bind the occupants, and no complaint will be entertained in this respect by the Trust.

3. Maintenance Fees & Facilities:

Every Resident Member will have to pay as maintenance fees/ expenses every month such amount in vogue as duly fixed by the Management. The Management from time to time may revise the said amount. The Member will have to always pay (and keep) three months’ maintenance fees/ expenses in vogue, in Advance, from time to time.

The food will consist of morning tea/coffee, breakfast, lunch, evening tea/coffee and dinner. The food served will be strictly vegetarian.

The Management will provide bed linen and pillow covers to the residents. Members will have to make their own arrangements for cleaning their personal clothing and linen. Laundry services will, however, be made available against payment, if required.

4. Conditions:

Every Resident Member will have to stay in the accommodation allotted to him / her, which may be changed at the discretion of the Management. In addition, he / she will be entitled to the use of common facilities and amenities, such as the Central Library, Meditation Centre, Prayer Hall, Garden, Yoga Centre etc. provided by the Sevashram for the welfare of the residents in general.

It will be the responsibility of the individual Member to keep the accommodation allotted to him/her in a neat and tidy condition. The Management will look after only the general cleanliness / maintenance of the residents’ rooms as well as of the campus of the Sevashram, including the common facilities and amenities.

5. Campus Atmosphere / Code of Conduct:

Every Resident Member will be obliged to create, foster and maintain a healthy, clean, cheerful and congenial atmosphere in the Sevashram campus. Any Member found misbehaving or causing nuisance to fellow Members or creating disharmony in the campus will render himself/herself liable to his/her membership being terminated forthwith and summarily evicted; the decision of the Trust / Management in that behalf will be final and binding on the Member concerned.

Use of or bringing the narcotics, alcohol or any other intoxicating item /

substance in the campus, is strictly prohibited. Smoking is prohibited in the campus.

A Member wishing to go and stay out of the campus for a short duration may do so only after recording the prescribed details in the Register kept in the Sevashram office for the purpose.

A Member may be permitted to stay out of the campus overnight with a friend/ relative, on giving prior intimation and prescribed information to the Manager, in writing. If a Member desires to go on a holiday or vacation for a period not exceeding 30 days (at a time), he/she may do so after securing written permission from the Management, and such permission will normally be granted as a matter of course. However, if he / she desires to stay out for more than 30 days, the Management will take the decision on such a request on its individual merits and after due enquiry. For the period of any such absence, the Member will have to continue to pay the normal monthly maintenance fees in vogue from time to time.

6. Notice of Termination:

A Resident Member wishing to terminate his / her membership and leave the Sevashram will have to give three clear calendar months’ notice of such intention and the Rule (supra) governing termination of membership shall apply.

7. General:

Vidyadhiraj Charitable Trust ® / Shantikunj Sevashram reserves the right to make any addition to, alteration in, or deletion from these Rules, from time to time, as may be deemed expedient and any such modification effected will be displayed in the Notice Board of the Trust at the office of the Trust and is binding on the Members.

15 Apendix:

Declaration by Applicant.

Application for Admission.

Letter of Undertaking.

Agreement.

Desirable.

DECLARATION BY APPLICANT

I do here by declare that I have read and understood the Rules and Regulations and the conditions of the eligibility for admission in the Sevashram for

which I seek admission and the Rules and Regulations of the Sevashram. I, the applicant, fulfill the eligibility criteria and I have provided necessary information which on being found incorrect and misleading, my admission shall be liable for cancellation by the authority of this Bhavan at any time without any notice to me.

Date:1) Signature of the applicant

2) Signature of the near relative

Referees: 1.

2.

APPLICATION FOR ADMISSION

Address of the applicant / InmateHouse name …………………………………………Post ………………………………………………….Village ………………………………………… Taluk…………………………………………District ………………………………………… State…………………………………………Tel. No. ……………………………………………..Police station Jurisdiction …………………………………………

N.B

Passport size

Photograph

Should be

affixed here.

1. Please read the following note before signing this application form.2. Please also read the Rules and Regulations of the Sevashram before signing this

application.3. This application form is an annexure to the agreement to be signed by the

applicant / his / her representative.4. The entries in the application should be made by the applicant / his / her

representative in his / her own handwriting. You should sign this application in front of Trustee of Sevashram and a witness.

5. This application and a copy of the Rules and Regulations supplied to you is an important document. Trustee strongly recommends that the applicant seek the advice of his/ her representative or other near relative before signing this application, the Rules and Regulations of the Ashram and the agreement.

I. PERSONAL INFORMATION.

1. Name :2. Surname :3. Male / Female :4. Age & Date of Birth :5. Identification mark :6. Name any of the following :

husband, wife, near relative /representative legal guardian with Phone No

7. Mother Tongue :8. Other languages known :9. Religion – Caste :10. Occupation :11. Dept and official address if in service :

II. FAMILY BACKGROUND.

1. Name and occupation of father :2. Name and occupation of mother :3. Name of spouse :4. Occupation of spouse with :

5. Name, occupation and address

2. 3. 4. 5. 6. Name, occupation and address

2. 7. Name and occupation of

2.8. Name, occupation and address of

9. Name and address and Telephone No.

III. MEDICAL HISTORY 1. Height :2. Weight :3. Complexion :4. Blood Group :5. Health condition : Sound / weak :6. Mental condition : Sound / weak :7. Physical condition : Handicapped / paralyzed / others :8. Deaf, dumb, Blind is any

9. Put tick mark if the applicant suffers from any of the following illnessa) Diabetes : b) Hypertension :c) Arthritis : d) Cancer :e) Alzheimer’s disease: f) Other serious illness :Specify if the applicant suffers from any other disease. (e.g. addiction to liquor etc.)10. Details of illness and the name :

and address of the doctor underwhom treatment was / is being taken.

11. Details of other serious illness if any you had :12. Details of sugeries if you had undergone in the past :13. Other important information :

(eg. Penciling reaction, allergy etc)14. Details of periodical medical check ups

recommended by the doctor, if any :IV. ANTECEDENTS.

1. Name and address of other institutionif the applicant / inmate was admitted / enrolledearlier and the reason for leaving here. :

2. Details of complaint/s leavedagainst and the charges framedagainst the applicant and the findingsof the court / present position of the case :

3. Is the applicant / inmate an abscondedperson or wanted criminal? :

V. FINANCIAL POSITION. 1. Yearly Income :2. Sources of income / Asset :3. Is the applicant an income

tax assessed :

VI. LIKES / DISLIKES AND WISHES / DESIRES. a) Food habits : Vegetarian / Non-vegetarian.b) Hobbies :c) Wishes / Desires if any :d) Burial / cremation after death :

REFERENCE:1. 2.

LETTER OF UNDERTAKING

TO,

The Trustee,Shantikunj Sevashram,Harigram –Kevale Junction,New Panvel-Morba Road,Panvel – 410206.Tel. ( 02143)-236097 / 236101 / (022) 24118895 / 24121535

Name and address of the applicant / inmate :

Name and address of the Introducer / Responsible authorized person. :

Relationship of applicant with introducer :

I, authorized representative / introducer of the above named applicant / inmate admitted here to secure him / her rest and care, do hereby state and undertake as follows :

a) That Sri/smt ……………………………………., the applicant, who is admitted now as inmate subject to other conditions and rules and regulations of the Vishranti Bhavan has now suffering ………………. From ………………………………………………..

For the last ………………… / several years, and that Dr. ……………………………Under whom the inmate has taken treatment vide his medical report dated …………..Appended herewith, has diagnosed the disease and appraised us

of the serious consequences which such patient may suffer.

b) That the authorities of the Bhavan has also explained in clear terms of the serious consequences of the disease including acute pain, stress, mental and other health problems the inmate may suffer.

c) That I / we have desided to get the applicant admitted as inmate after having fully

understood his physical and mental conditions.

d) That in the event of death of the inmate at the Bhavan either myself or any other near relative of the inmate authorized by me in writing would take back the body for burial / cremation. If no one turns up to claim the body within 24 hours on the receipt of the intimation of death, the authorities of the Bhavan shall have every right to bury the body at their discretion.

e) That I irrevocably and unconditionally promise to pay Rs………………. On 30 th of every month towards the service charges, special nurses’ charges and medical expenses if any, spend by the Bhavan for the inmate and other expenses as shown in (Art. 8,9, and other articles of) rules and regulations etc. It is agreed that this is in addition to the security amount of Rs. 25,000/-, which is to be paid at the time of admission.

f) That I hearby ratify confirm and agree to ratify and confirm any decision or commitment made by the inmate in writing in favour of Bhavan and I futher assure that no legal heir / successor / administrator shall dispute any decision or commitment made by the inmate infavour of the Bhavan.

Date this ……………….. day of …………………….. 200 .

Witnesses : Name and signature of the applicant………………

1). Name and signature of introducer / Responsible person ……………………………….

2).

Trustee:

AGREEMENT

This AGREEMENT is made at Harigram in Panvel district on this ……………………… Day of ……………………….., 200 between :

ShantiKunj Sevashram addresses at, Harigram –Kevale Junction,New Panvel-Morba Road, Panvel – 410206, Panvel Taluka, Alibaug District,

Maharashtra State (hereinafter referred to as “Sevashram” which expression shall include its successors and assigns) of the one part ;

ANDSri/smt ……………………………………s/o sri/smt ………………………………... aged ………………………………occupation, residing at ………………………………………………………….……………………………………… Village, Taluk, …………………………District, …………………………….. State ……………………………………

(hereinafter referred as “The Relative” which expression shall include his / her successors or nominees and / or assigns) of the other part;

WHEREAS, the relative finds that his / her, sri / smt ……………………………………. aged …………………. Years …………………………. By profession…………………. ……………………….. residing at village ……………………………………………….. Taluk ………………………….. District ……………………………….

State ……………………...requires care, shelter, treatment and other amenities on a permanent basis and that he / she is not in a position to provide adequate care, shelter, treatment, attention etc; in his / her place of residence, and WHEREAS the Relative desires that Bhavan provides complete care, shelter, treatment etc; to the aforesaid relative on a permanent basis in the manner hereinafter appearing, and Bhavan has agreed / consented to provide the same;

NOW THIS AGREEMENT WITNESSETH and it is hereby mutually agreed upon by and between the parties hereto as under:

1. Sevashram agrees to admit, take care and provide shelter, treatment and other amenities to sri / smt …………………………………………………………….. at ShantiKunj Sevashram addresses at, Harigram.

2. The Relative agrees to make a payment of Rs ………………… (in words ……… ………………………………………………. ) to the Bhavan being rent and expenses of shelter, care, treatment, other amenities etc.., and towards the same has remitted the said amount to the Vishranti Bhavan by means of a Demand Draft No. ………………………. Dated ……………………. Drawn on ……………………………………………. Bank in favour of Shantikunj Sevashram.

3. Both parties agree to abide by the Rules and Regulations of Shantikunj Sevashram which forms as Annexure No. 1 hereto

4. Any alteration or additions to this AGREEMENT can be done in writing by mutual consent of the parties.

IN WITNESS WHERE OF this Agreement has been executed at Harigram Panvel on the day and the year first above written.

ANNEXURE NO. 1 TO FROM THE PART OF THIS AGREEMENT

Rules & Regulations – 6 sheets

Name ………………. Designation ……………………………. Name………………………….. The RelativeFor Shantikunj Sevashram Seal

Witness:

1. ……………………………………..2. ……………………………………..

# Should be minimum 50 years of age (May be marginally less in some exceptional cases) and a tee-totaller.

# Should be healthy ( Mentally and Physically), self managing and mobile. Should not be bed ridden or needing intensive care at the time of admission.

# Should be educated, pleasant mannered, host and a social mixer.# Should be willing to undergo and pass prescribed medical fitness test

as desire by the management.# Should not have any criminal record in previous history and police

records.  Admission-Eligibility-Expulsion# Right of admission would be reserved at the discretion of

management committee/ governing body of the society.# Any type of offensive behavior, commercial activity, subletting,

gambling, rowdyism, prostitution, theft, willful damage to old age home premises or property and non payment of dues will result in summary physical expulsion.

# Any inmate may be expelled if any other three Residents give written complaints and request for his removal. This would be finally decided by the Managing Committee.