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FROM
Name:-Sucheta Malik
Design :-OS/CHG/BCT
PF A/c No:-13679570
Office :-Sr.DEE/Coaching/Ber
Date:-21.10.2022
To,
DRM/E/BCT
Pay Bill Section
(Through proper channel)
Sub: - Self-Certification for grant children education allowance and Re-imbursement of
tuition fees.
Ref: - Your office letters No 146/2008 dtd. 10/11/08
Respected sir,
I the undersigned submit my self-certification for grant of children education allowance and reimbursement of
tuition fees may be considered. The particulars are as under (The original receipts are enclosed).
1. ' Name of the applicant : SUCHETA MALIK
2. Designation : OS/CHG/BCT
3. Working station/Unit : MUMBAI CENTRAL
4. Scale of Pay : 6th level.
5. Rate of Pay :41000.
6. PF A/CNo. : 13679570.
7. Pay Bill Unit No. :11089.
8. Period :2022-2023
9. No. Of Children :2
1. Name of Child : NINAD MALIK.
Standard : 8th

Name of School : POORNA PRAJNA HIGH SCHOOL.

10. Claimed for Admissible amount Rs.27000/-

(Amount in words: Twenty Seven Thousand only )

I hereby also declare that whatever state by me herein is true to the best of my knowledge. However, if it is
proved false subsequently, I render myself liable for disciplinary action.

Encl. Family Particulars and School bonafied certificate. ~~

Signature of the applicant
Na me: ..... ~ ~ e.h~.~ ...tf.\~~!-i LL
Design ......9.1.\~~-·-··········· .. ··
Station ....~!~.<:.:-:\ ...................... .

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Name:-Sucheta Malik
Design:-Os/Chg/BCT
Dt :- 21.10.2022

To,
Apo/Bills/BCT

Sub:-Family Particulars·

R/sir,

The family particulars of undersigned is as follows.

Family Member Relation Age DOB

lSmt Sucheta Malik self 45 11.09.1976

2.Gaurav Malik U/Son 19 12.02.2002

3.Ninad Malik U/Son 13 15.11.2008

This is for your information please.

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 Poorna Prajna "ig h School
Bharuc ha Road, Dahisa r (East), Mumba i - 400 068.

BON AFID ~ CERTIFICATE ' I

...,___ _ of 202 L
Ref No. _ __;_IJ.,;._l/
Sr. No. 1441

This is to certify that Master / M~ D?na d iuK/> L rna..Lt 'K w~

is/ was a bonafid e student ofthis·s chool, His/ Her birth date as recorded in the Genera l Regist er

___.__ _ of the School is _ __:..l..wS:_,.L.Lll_~..:::::~:a.oo

q_l/_S:f
No. ____ ____ ___ &' - - - - - -
: ;,. . ; ;. . ;~

(Inward s pPMb {J,fL. f'(Ov-t'rrlhea, ~ ' ~U-:5 Cl41d 6'?f0!= )

He / She is was studying in our School from 06/0 ~19 to /2~, ~

, 5/-uct-;;,7 /YI shl vti;<71 qi- .to~J-o?.3
He/ She bears a good moral charact er.
~oJtN} _g_
His/ Her caste is /-u'n d.u. .. rn C-l. ~ Head Mistress
HEAO MISTRE SS
POORl\lA PRAJNA ~GH SCHGCL
Bharucha Road . Oah:sar (E).
' Date /9/10/2 02 .:;_ Mumbai - 400 068.

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