APPLICATION FOR RE-IMBURSEMENT OF CHILDREN EDUCATION ALLOWANCE/ HOSTEL
SUBSIDY FOR THE YEAR 2023-24 IN TERMS OF RBE NO: 147/2017 & RBE NO: 114/2018.
I, hereby apply for the reimbursement of Children Education Allowance for my child/
children and relevant particulars are furnished below:
1. Name of the Employee
2. Designation & T. No:
3. Employee No
4. Office & Bill Unit No:
Particulars of Children Child – 1 Child-2
Name of the Student
Date Of Birth & Class
5.
Name of the School & Address
Nature of claim: (Tick (Education Allowance/ (Education Allowance/
whichever is applicable) Hostel Subsidy) Hostel Subsidy)
Amount of Children Education
Allowance applied for during
6
the Academic Year 2023-24
Amount of Hostel Subsidy
incurred during Academic Year
7 2023-24,
(Supported with documents.)
Whether Bonafide certificate
8
from school is enclosed.
Certified that:
* My child/ children mentioned above in respect of whom reimbursement of education
expenses is claimed is/are wholly depended upon me.
* My wife /husband is not a Central Government Employee.
* My wife /husband is a Central Government Employee and that she/he will not claim
reimbursement of education expenses in respect of our child/children.
* My child/ children in respect of whom reimbursement is claimed is/are studying in
recognised school.
* I hereby declare that reimbursement of children Education expenses has not been
claimed in respect of the child/children by a person other than me.
* I hereby declare that reimbursement of Children Education expenses is claimed for my
only/eldest two surviving children only.
I hereby declare that the particulars mentioned above are correct to the best of my
knowledge. If any information furnished above is not correct, I am liable to be taken up
under D&AR.
Signature of the forwarding Official Signature of the applicant
With date and Office seal Name:
Desgn. &T.No:
Employee No:
Annexure
BONAFIDE CERTIFICATE FROM THE HEAD OF THE
INSTITUTION/SCHOOL
This is to certify that Master/Baby/Mr./Miss _____________________________
____________________________, Roll No. _______, Admission No.__________________,
Son/Daughter of Sri/Smt. ____________________________________________ is a
bonafide student of this school and studied in Class__________ during the Financial Year
__________________ and as per school records his/her Date of Birth is
_____________________ , ( In words _______________________________________
__________________________________________).
He/She bears a good moral character.
**During the year Master/Baby/Mr./Miss _________________________________
had resided in the residential complex (Hostel) of the school and paid an amount of Rs.
___________________, towards boarding and lodging in the residential complex.
This Institution/School is affiliated/recognised by
_____________________________________ and the Affiliation/Recognition Number is
_________________________.
Dated: ……………………………..
Place: ………………………………. Signature of the Head of the Institution
(With Stamp and Seal)
