Authority vide Government of INDIA Ministry of personal

P.G.and Department of personal & Training New Delhi

Order No. A-27102/02/2017-Estt.(AL) 16 August 2017

CERTIFICATE FROM THE HEAD OF INSTITUTION/SCHOOL

(FOR REIMBURSEMENT CEA)

Ref No…………………. Dated:………………………

It is certified that master/ Kumar ___________________________________________

having admission No. _____________________ D.O.B _______________ SON/ Daughter Of Mr/
Mrs ______________________________________________ was studying in Class
_________________ Sec _________________ Roll No. ____________________ during the
academic year from _______________ to _______________ school / Institution, namely
__________________________________________________________________________ vide
affiliation Regd No. / Code ___________________________ and pattern
_________________________ curriculum.

Place: ___________________

Date: ___________________ Signature of Principal

(Affix School Stamp)

SELF DECLARATION
I Service No. ________________ Rank _______________ Name
____________________________________________ of Unit _______________________ do
hereby certify that my Son/ Daughter namely _____________________________________ studied
in Class ______________ Sec__________ Roll No. ____________________ during Academic Year
_____________to________________ in __________________________________________
______________________________School.

In the event of any change in particular given above which affect my eligibility for Children
Education Allowance. I undertake to intimate the same promptly and refund excess payment, if any
made to me.

Signature of Govt. Servant

Name:_______________________
Rank:________________________
IRLA/Regt No. ________________
Unit _________________________
Place: ________________________
Date: ________________________