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    Children Education

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    debasissahu09471

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    © All Rights Reserved
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    Children Education

    Uploaded by

    debasissahu09471
    16 views7 pages

    Original Title

    Children Education[1]

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    16 views7 pages

    Children Education

    Uploaded by

    debasissahu09471

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    © All Rights Reserved
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    of 7

    PROFORMA FOR RE-IMBURSEMENT OF

    CHILDREN EDUCATION ALLOWANCE

    CLAIM FOR THE ACADEMIC YEAR: 2023-24

    I hereby apply for the reimbursement of Children Education Allowance / Hostel Subsidy for
    my child / children and relevant particulars are furnished below: -

    1. Name & Designation. of the Govt UPENDRA SAHU


    Servant : POSTAL ASSISTANT
    10012923
    2. Emp. No. :
    POSTAL ASSISTANT
    3. Designation :
    JUNAGARH SO
    4. Name of the Office :
    If Spouse is employed, state whether RANJITA SAHU
    in Central Govt., PSU, State Govt. STATE GOVT.
    5. (give details with name of the Spouse) :
    Designation, Office of spouse, TGT SCIENCE
    if spouse is employed. GOVT. SSD HIGH SCHOOL ,
    6. : PASTIKUDI
    7. Details of the child / children for whom CEA / Hostel Subsidy claimed: -
    Standard Name & Place of the
    Sequence Name of child DOB (A.Y. 2023-24) School / Institution
    DEBASIS SAHU 28.02.2008 XI
    KENDRIYA VIDYALAYA
    st
    1 Child BHAWANIPATNA
    24.03.2011 KENDRIYA VIDYALAYA
    NILIMA APARAJITA VIII BHAWANIPATNA
    nd
    2 Child SAHU

    8. Re-imbursement of Expenditure: -

    Sequence Period Rate of CEA (Rs) Amount claimed Remarks


    st
    1 Child Apr 23 to Dec 23 2250 X 9 20250.00

    Jan 24 to Mar 24 2813 X 3 8439.00

    2ND Child Apr 23 to Dec 23 2250 X 9 20250.00

    Jan 24 to Mar 24 2813 X 3 8439.00


    Total amount claimed Rupees fifty seven thousand three 57378.00
    hundred seventy eight only .
    2

    9. Distance of Hostel of child from residence of employee (in case Hostel Subsidy): NA

    10. Amount of CEA / Hostel Subsidy already received up to previous quarter: NIL

    11. The Academic year for which CEA / Hostel Subsidy is applied now: 2023-24

    12. (a) Whether the child for whom the CEA is applied for is a disabled child: Yes / No
    (b) If yes, indicate the nature of disability:
    (c) Date of disability certificate:
    (d) Indicate the percentage of disability:

    13. Whether the Bonafide certificate from Head of Institution has been attached: Yes / No

    14. For Hostel Subsidy, the Bonafide certificate from mentioning the amount is attached: NA

    15. If Yes at Item No. 14, Amount claimed for Hostel Subsidy: Rs___NA___

    16. (a) Certified that I or my wife / husband is / is not a Central Government servant.
    (b) Certified that my wife / husband Sri / Ranjita Sahu is presently working as a Asst.
    Teacher and that he / she shall not apply / has not applied for the Children Education
    Allowance for the child /children mentioned above.
    (c) Certified that I or my wife / husband has not claimed this re-imbursement from any
    other source and will not claim the same in future.

    17. Certified that my child in respect of whom re-imbursement of Children Education


    Allowance is applied is studying in the School / Jr. College which is recognized and affiliated to
    Board of Education / University.

    18. Certified that I am claiming the CEA in respect of my two eldest surviving children only,
    the information furnished above are complete and correct and I have not suppressed any
    relevant information. In the event of any change in the particulars given above which affect my
    eligibility for reimbursement of Children Education Allowance, I undertake to intimate the same
    promptly and also to refund excess payments if any made. Further, I am aware that if at any
    stage the information / documents furnished above is found to be false, I am liable for
    disciplinary action.

    Date: 10.04.2024

    Place: BHAWANIPATNA (Signature of Govt Servant)

    Name : UPENDRA SAHU

    PA , JUNAGARH SO
    SELF DECLARATION

    I Sri GAJARAJ MAJHI Employee Id No 10191695 Designation: POSTMAN


    BHAWANIPATNA HO KALAHANDI Division do hereby certify that my Son namely Dayasagar Majhi
    studied in Class-Viii Sec ‘A Roll No 10 Admission No.21/144 during previous Academic Year 2023-
    2024 in Delhi Public School, Bhawanipatna, Kalahandi, Odisha,766001.

    In the event of any change in the particulars given above which affect my eligibility for
    Children Education Allowance. I undertake to intimate the same promptly and refund excess
    payment, if any made to me.

    Signature of Govt Servant

    Name: GAJARAJ MAJHI


    Desgn: POSTMAN
    Emp.No.10191695
    Place: BHAWANIPATNA

    Date: 09.04.2024
    Authority vide Government of India Ministry of Personal
    P.G and Department of Personal &Training New Delhi
    Order No. A-27102/02/2017-Estt. (AL) 16 August 2017
    (This order shall be effective from 01 Jul 2017)

    CERTIFICATE FROM THE HEAD OF INSTITUTION /SCHOOL


    (FOR REIMBURSMENT CEA)

    Ref No……………… Date: 18.03.2024

    It is certified that MasterShivesh Kumar Majhihaving Admission No 32/71 D.O.B

    18.03.2018Daughter /Son of Mr /Mrs.Baikuntha Majhi was studying in Class –UKG Sec- “B” Roll

    No-16during the previous Academic Year from 2023 to 2024 School/Institution, namely

    Vrindavan Smart School, Bhawanipatna, Kalahandi, Odisha 766001 vide affiliation Regd. No/ code

    21260122801and Pattern CBSE Curriculum.

    Place: Bhawanipatna

    Date: 18.03.2024 Signature of principal


    (Affix School Stamp)
    Authority vide Government of India Ministry of Personal
    P.G and Department of Personal &Training New Delhi
    Order No. A-27102/02/2017-Estt. (AL) 16 August 2017
    (This order shall be effective from 01 Jul 2017)

    CERTIFICATE FROM THE HEAD OF INSTITUTION /SCHOOL


    (FOR REIMBURSMENT CEA)

    Ref No……………… Date: 18.03.2024

    It is certified that Master Hitesh kumar Nayak having Admission No D.O.B

    12.08.2007 Daughter/Son of Mr/Mrs Trilochan Nayak was studying in Class –X Sec- A Roll No-

    ____during the previous Academic Year from 2023 to 2024 School/Institution, namely Kendriya

    Vidyalaya, Bhawanipatna, Kalahandi, Odisha 766001 vide affiliation Regd. No/ code

    __________and Pattern CBSE Curriculum.

    Place: Bhawanipatna

    Date: 18.03.2024 Signature of principal


    (Affix School Stamp)

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