RE-IMBURSEMENT OF HOSTEL SUBSIDY

CERTIFIED THAT THE CHILD/CHILDREN MENTIONED BELOW IN RESPECT OF WHOM RE-

IMBURSEMENT OF TUTION FEE/HOSTEL FEE IS CLAIMED IS/ARE WHOLLY DEPENDENT
UPON ME:-

NAME DATE SCHOOL CLASS IN MONTHLY TFEE AMOUNT OF

OF OF IN WHICH WHICH TUTION HOSTEL REIMBURSEMENT
CHILD BIRTH STUDYING STUDYING FEE ACTUALLY
ACTUALLY PAID
PAYABLE FROM
--------
TO------

2. WHETHER SPOUSE IS GOVT. SERVENT :-

a) if yes, name of department in which spouse is employed.

b) whether he/she is claiming y

APPLICATION FOR REIMBURSEMENT OF HOSTEL SUBSIDY ALLOWANCE
01) FORCE NUMBER
02) RANK
03) NAME
04) NAME OF CHILD
05) DATE OF BIRTH OF CHILD –
06) NAME OF INSTITUTION/SCHOOL/COLLEGE -
07) REGISTRATION NO. OF SCHOOL -
08) CLASS/ STD -
09) ACADEMIC SESSION : FROM-

CERTIFIED THAT I AM CLAIMING THE CEA IN RESPECT OF MY TWO ELDEST SURVIVING

CHILDREN ONLY AND IN HE EVENT OF ANY CHANGE IN THE PARTICULAR GIVEN ABOVEWHICH EFFECT
MY ELIGIBILITY FOR CEA, I UNDERTAKE TO INFORM THE SAME PROMPTLY AND ALSOTO REFUND
EXCESS PAYMENT, IF ANYMADE.

I HAVE NOT CLAIMED AND WILL NOT CLAIM CEA IN RESPECT OF MY AFORESAID WARD
FOR WHOM I AM CLAIMING HOSTEL SUBSIDIY.

DATED: SIGNATURE OF GOVT SERVENT

NAME:-

UNIT :- 84 BN CRPF

COY:- C/84 BN CRPF

 CERTIFICATE

I NO. ……………………….. RANK ………….. NAME ……………………………………………… HEREBY

CERTIFITY THAT MY SON/ DAUGHTER (NAME) ………………………………………………….. HAS
BEEN ADMITTED IN SCHOOL HOSTEL (NAME WITH FULL ADDRESS AND
PIN……………………………………………………………………………………………………………….. , WHICH IS
AT ADISTANCE OF FROM MY RESIDENCE
( ……………………………………………………………………………………HOME ADDRESS WITH PIN CODE
IS ENCLOSED.

SIGNATURE OF GOVT SERVENT

FORCE NO:-
NAME:-
RANK:-
COY:- C/84 BN CRPF
 RE-IMBURSEMENT OF HOSTEL SUBSIDY

CERTIFIED THAT THE CHILD/CHILDREN MENTIONED BELOW IN RESPECT OF WHOM RE-

IMBURSEMENT OF TUTION FEE/HOSTEL FEE IS CLAIMED IS/ARE WHOLLY DEPENDENT
UPON ME:-

NAME DATE SCHOOL CLASS IN MONTHLY TFEE AMOUNT OF

OF OF IN WHICH WHICH TUTION HOSTEL REIMBURSEMENT
CHILD BIRTH STUDYING STUDYING FEE ACTUALLY
ACTUALLY PAID
PAYABLE FROM
--------
TO------

2. WHETHER SPOUSE IS GOVT. SERVENT :-

a) if yes, name of department in which spouse is employed.

b) whether he/she is claiming y

APPLICATION FOR REIMBURSEMENT OF HOSTEL SUBSIDY ALLOWANCE
01) FORCE NUMBER
02) RANK
03) NAME
04) NAME OF CHILD
05) DATE OF BIRTH OF CHILD
06) NAME OF INSTITUTION/SCHOOL/COLLEGE
07) REGISTRATION NO. OF SCHOOL
08) CLASS/ STD
09) ACADEMIC SESSION : FROM------------ TO-----------
10) WHETHER SPOUSE IS GOVT. SERVENT

b) IF YES, NAMEOF DEPARTMENT IN WHICH

SPOUSE IS EMPLOYED.
c) WHETHER HE/SHEIS CLAIMING CEA/HOSTEL SUBSIDY
FROM DEPARTMENT CONCERNED

CERTIFIED THAT I AM CLAIMING THE CEA IN RESPECT OF MY TWO ELDEST SURVIVING CHILDREN
ONLY AND IN HE EVENT OF ANY CHANGE IN THE PARTICULAR GIVEN ABOVEWHICH EFFECT MY
ELIGIBILITY FOR CEA, I UNDERTAKE TO INFORM THE SAME PROMPTLY AND ALSOTO REFUND EXCESS
PAYMENT, IF ANYMADE.

I HAVE NOT CLAIMED AND WILL NOT CLAIM CEA IN RESPECT OF MY AFORESAID WARD
FOR WHOM I AM CLAIMING HOSTEL SUBSIDIY.

DATED: SIGNATURE OF GOVT SERVENT

NAME:-

UNIT :-

COY:-
 CERTIFICATE

I NO. RANK NAME HEREBY

CERTIFITY THAT MY SON/ DAUGHTER (NAME) HAS BEEN
ADMITTED IN SCHOOL HOSTEL (NAME WITH FULL ADDRESS AND PIN)
WHICH IS AT
ADISTANCE OF FROM MY RESIDENCE ( HOME ADDRESS WITH PIN CODE IS ENCLOSED.

SIGNATURE OF GOVT SERVENT

FORCE NO:-
NAME:-
RANK:-
COY:-

FORM NO- 02
 SEE RULE 4 (12A)

NAME OF THE GOVT SERVENT

Designation
Date of birth
Date of enlistment
Home address ( as per record)
Details of the members of my family Given below
as on

s.no Name of the members of my Date of Relationship with Initialis of

family Birth the officer / the head
employee of office

Signature of govt. servent

Place:- Force No:-
Date :- Rank:-
Name
Note:- wife and husband shall include respectively judicially separated wife and husband

Attested
 RE-IMBURSEMENT OF HOSTEL SUBSIDY

CERTIFIED THAT THE CHILD/CHILDREN MENTIONED BELOW IN RESPECT OF WHOM RE-

IMBURSEMENT OF TUTION FEE/HOSTEL FEE IS CLAIMED IS/ARE WHOLLY DEPENDENT
UPON ME:-

NAME DATE SCHOOL CLASS IN MONTHLY TFEE AMOUNT OF

OF OF IN WHICH WHICH TUTION HOSTEL REIMBURSEMENT
CHILD BIRTH STUDYING STUDYING FEE ACTUALLY
ACTUALLY PAID
PAYABLE FROM
--------
TO------

2. WHETHER SPOUSE IS GOVT. SERVENT :-

a) if yes, name of department in which spouse is employed.

b) whether he/she is claiming y