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)