Children Education Allowance – Hostel Subsidy Claim Form

FORM-1

PART 25

CHILDREN EDUCATION ALLOWANCE

Academic Year : 2010-11.

            Certified that my Child/Children mentioned below In respect of whom children’s education allowances is claimed is/are wholly dependent upon me and I am compelled to send my chilled/children away from the place of my posting/residence due to non-availability of the School of the requisite standard at the station of my posting/residence or due to non-availability of a vacancy in such a school at the station of my posting/residence :

Name of the Child	Date of Birth	School/College in which studying	The place where the Govt. servant is residing	Class in which studying	Monthly CEA Admissible	Amount of allowance claimed for the period June to May.
(1)	(2)	(3)	(4)	(5)	(6)	(7)

2.         Certified that my child/children respect of whom children’s education allowance is claimed is are studying in the School (s) mentioned in column (s) Which is/are recognized school (s) ( not applicable to School run by Central Govt/ Union Territory Administration /Municipal Corporation / Municipal Committee /Panchayat Samiti / Zila Parishad )

3.         Certified that:  -

(1)        My wife/husband is / is not a Central Govt Servant.

(2)        My wife/husband is a not Central Govt Servant and he/she will not claim children’s

(3)        My wife/husband is employed with………………………………… she/he is not

Entitled to children’s education allowance in respect of our child/children.

4.         Certified that during the period covered by the claim the child/children attended the school regularly and did not absent himself/herself/them selves from the school withour proper leave for a period exceeding one month.

5.           Certified that the child/children has / have been not studying in the same class for more than two academic season.

6.                In the event of any change in the particulars above which effect my eligibility for children’s Education Allowance, I undertake to intimate the same promptly and also to refund payments, if any made.

Encl :   

PLACE & Date:                                                  (Signature of the Govt. servant)