Form For Reimbursement of Tuition Fee
Form For Reimbursement of Tuition Fee
Form For Reimbursement of Tuition Fee
Certified that the child/children mentioned below in respect of whom reimbursement of Tuition Fee is claimed is/are
wholly dependent upon me.
NAME OF THE CHILD SCHOOL IN WHICH CLASS IN MONTHLY TUITION FEE AMOUNT
& DATE OF BIRTH STUDING WHICH TUITION FEE ACTUALLY REIMBURSEMEN
STUDDING ACTUALLY PAID T CLAIMED
PAYABLE
2. Certified that the Tuition fees indicated against the child/each of the children have actually been paid by i.e.
Vide fee receipt and certificate (s) from the institution (s) attached.
4. Certified that during the period covered by this claim/the child/children attached the school (s) regularly and did
not absent himself/herself themselves from the school (s) without proper leave for a period exceeding one
month.
5. Certified that the child/children mentioned above has/have not been studying in the same class for more than two
years.
6. Clarified that I or my wife/husband have/has not claimed and will not claim the children’s educational allowance in
respect of the children mentioned above.
7. In the event of any change in the particulars given above which affect my eligibility for reimbursement of tuition
fees I the undersigned to intimate the same promptly and also to refund excess payments if any made.
8. Certified that I am claiming Tuition fees for my first/second child. Whose name has been declared in the family
particulars.
SIGNATURE…………………………………………
NAME………………………………………………...
DESIGNATION………………………………………
DEPARTMENT………………………………………
4. Certified that this is a school/College run by Central Government / State Government / Union Territory /
Administration / Municipal Committee / Panchayat Samithi / Zilla parishad.
5. Certified that this is a school / college recognized by the educational authorities of……………………………….
State/Union Territory administration.
6. Certified that the fee structure has been approved by the education Department, Government of
…………………………………………
Principal/Headmaster/Headmistress
Date:……………………