ईएसएसओ- भारतीय महासागर सूचना सेवा , हैदराबाद

ESSO-Indian National Centre for Ocean Information Services

(an autonomous body under Earth System Science Organization - Ministry of Earth Sciences, Govt. of India)

“Ocean Valley”, Pragathi Nagar (B.O), Nizampet (S.O), Hyderabad – 500090

APPLICATION FOR REIMBURSEMENT OF CHILDREN EDUCATION ALLOWANCE

2022-2023
-------------------- / Claim for the academic year : .............................

1. अपने / के आवेदन करता / करती हू ँ और नीचे गए है ।

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

का नाम और पदनाम
Name & Designation of Official :
का नाम / के नाम और एवं
Name of the child Date of
Birth Name & Place of the School Class &
/Institution Academic Year
1) Kidvilla School,
Tina Devender Shetty 01/06/2009 2022-2023
Pragathi Nagar

# Tuition fees Rs. 65,000/-

Purchase of books (one set/per child/per A/Y) Rs.
Purchase of Note books (one set/ per child/per A/Y) Rs.
Purchase of Uniforms (Two sets/per child/per A/Y) Rs.
Purchase of School Shoes (One Set/ per child/ per A/Y) Rs.
Other fees Rs.
Total Rs. 65,000/-

2)
Kidvilla School,
Angat Devender Shetty 09/08/2014 2022-2023
Pragathi Nagar

# Tuition fees- for the whole year /I/ II/III/IV- Term Rs. 60,000/-
Purchase of books (one set / per child/ per A/Y) Rs.
Purchase of Note books (one set/ per child/per A/Y) Rs.
Purchase of Uniforms (Two sets/per child/per A/Y) Rs.
Purchase of School Shoes (One Set/ per child/ per A/Y) Rs.
Other Fees Rs.

Total Rs. 60,000/-

..2..
:2:
2. Certified that the Education fees/expenses indicated against the child/children has
actually been paid by me.

2022-2023
3. Children Education Allowance claimed earlier Academic year : ........................
4. Certified that my child in respect of whom reimbursement of Children Education
Allowance applied is studying in the school/junior college which is recognized and
affiliated to Board of Education/University.

5. Whether the Bonafied certificate from Head of Institution has been attached : Yes / No.

6. Whether the child for whom the children education allowance is applied for is a disabled
child : Yes / No.
a) If yes, indicate the nature of disability :
b) Date of disability certificate:
c) Indicate the percentage of disability :

7. Certified that
i. My wife/husband is not a Central Government Servant.
ii. My wife/husband Smt./Shri.___________________ is presently working as
__________________ in _________________and that he/she will not apply/has not
applied for the children Education Allowance for the child/children mentioned
above.
iii. Certified that I or my wife/ husband has not claimed this reimbursement from any
other source and will not claim the same in future.

8. The information furnished above are complete and correct and I have not supressed any
relevant information. In the event of any change in the particulars given above which
affect my eligibility for reimbursement of children educational 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.

Note : # Tuition Fee Means Tuition fee, Admission fee, lab fee, special fee charged for agriculture,
electronics, music or any other subject, Fee charged for practical work under the programme of
work experience, fee paid for the use of any aid or appliance by the child, library fee, games/sports
fee and fee for extracurricular activities.

Hyderabad
/PLACE_____________ ( /Signature of the Employee)

13/04/2023
/DATE _____________ नाम/Name :

पदनाम/ Designation:
 Authority vide Government of India
Ministry of Personnel, P.G.and Pensions department of Personnel & Training
New Delhi,
Order No.No.A-27012/02/2017-Estt(AI)16 August 2016
(This Order shall be take effective from 1st July 2017)

CERTIFICATE FROM THE HEAD OF INSTITUTION /SCHOOL

For reimbursement of CEA

Ref.No

Date:

Tina Devender Shetty

It is certified that Master /Kumari ______________________________ having

200/2021
Admission No_______________ 01/06/2009
D.O.B_____________________Son/Daughter

Raju Devender
of Mr/Mrs _____________________________________________as Studying

6th
in Class __________Sec____________Roll 8
No__________during the previous

2022 2023
Academic year from _______________to_______________School/Institution,

Kidvilla School, Pragathi Nagar

Namely________________________________________ vide affiliation Regd

958/2011
No./Code________________and State
pattern____________________ Curriculum.

Place: -

Date: -

Signature of School Principal

Affix School Stamp