Authority vide Government of india Ministry of Personnel, P.G. and Pensions Department of Personnel & Training New Delhi Order No. N..A-27012/02/2017-Estt.(AL) 16 August, 2017. (this order shall be effective from 1” July, 2017) CERTIFICATE FROM THi (FOR REIMBURSEMENT OF CEA) RefNo. Date: Iis certified that master/Kumari having, Admission No Dos Son/Dauther of Mr/Mrs se ‘was studying in class Sec Roll No . during the previous academic year from to . - School/institution, namely vide affiliation Regd. No./Code and Pattern seevimnmnsnnee CURTICULUM, Place: Date: Signature of Principal (Affix Schoo! Stamp}UNDERTAKING APPLICATION FOR RE-IMBURSEMENT OF | CHILDREN EDUCATIONAL ALLOWANCE j [1 T NAME OF GOVT. EMPLOYEE ] | | | aw stock teTrers) | | ee ess 2. | DESIGNATION 3. | NAME OF CHILD 4. | DATE OF BIRTH OF CHILD : 5._| NAME OF INSTITUTION /SCHOOL CLASS 7 | ACADEMIC SESSION ] FROM TO 8. | WHETHER SPOUSE IS GOVT. Yes/No SERVANT a) If yes, name of Department in which Spouse is employed ) Whether he/she is claiming CEA [Yes/No from Department concerned Certified that | am claiming the CEA in respect of my two eldest surviving children only and in the event of any change in the particular given above which affect my eligibility | for CEA, | undertake to inform the same promptly and also to refund excess payment, || ifany made Signature of Govt. Servant | Name : Designation| CERTIFICATE FROM THE HEAD OF INSTITUTION/ SCHOOL FOR CLAIMING HOSTEL SUBSIDY ATIFICATE Ff This 1s 10 certify that Master/Baby/ME/MISS nn si RON WB AA 88109 NOvaeasnonemnnsn $09 OF S/S ann seam {6 2 bonafide student ofthis sehoo! and studied In C1485... daring the financial year. and as per School ecards hisfher date of birth is - In words This is t0 also certify that the above named child had studied in this schoo! in the previous academic Year nes He/She bears a good moral character. ** During the year Master/Baby/Mr. frais. se had resided inthe residenval complex (Hostel) ofthe school and paid an amount of Rs. toward boarding and lodging in the residential complex This insttutlon/Schoo! is affilated recognized by and ‘the affiliation/recognition Number fn Dates: Pace: Signature Head ofthe Institution/Schoo! (with stamp and sea) **(strike out tis not applicable)