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Revised CEA Application

This document is a form for claiming reimbursement of children education allowance. It contains 7 sections where the claimant certifies details about their child/children such as name, date of birth, school and classes attended, tuition fees paid, and a self-declaration that the information provided is accurate and any changes will be promptly reported. Supporting documents like fee receipts and school certificates must be attached for initial claims.

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Uma Maheswararao
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196 views

Revised CEA Application

This document is a form for claiming reimbursement of children education allowance. It contains 7 sections where the claimant certifies details about their child/children such as name, date of birth, school and classes attended, tuition fees paid, and a self-declaration that the information provided is accurate and any changes will be promptly reported. Supporting documents like fee receipts and school certificates must be attached for initial claims.

Uploaded by

Uma Maheswararao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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FORM- 2

REIMBURSEMENT OF CHILDREN EDUCATION ALLOWANCE


(Ref: OM No.12011/03/2008-Estt(Allowance) dated 02.09.08)
Certified that the child /Children mentioned below in respect of whom reimbursement of
tuition fee is claimed is/are wholly dependent upon me:

Name of the Date of School in Class in Tuition fee Amount of


child Birth which which & others Reimbursement
studying studying actually Claimed
paid from

1.Tution fee
2.Computer fee
3.Admission fee
4. Games fee/Lab fee
5.Any other fee (Specify)
6. Purchase of Text Books and Note Books
7. Purchase of Uniform
8/ Purchase of Shoe
9.Hostel /Accommodation fee
10. Mess fee

2. Certified that the tuition fee indicated against the child/Each of the children had
actually been paid by me. Cash receipt/counterfoil of the Bank Credit vouchers to be attached
with the initial claim.

(contd.2)
:3:
3. Certified that:-
---------------
My husband is not a Central Govt. Servant.

My wife/husband is a Central Govt. Servant but she/he will not claim reimbursement of
tuition fee in respect of our child/children.

My wife/husband is employed with ……………………………………


She/he is /is not entitled to reimbursement of tuition fees in respect of our
child/children.

4. Certified that during the period covered by this claim, the child/children attended the
School(s) regularly and did not absent him/her selves/themselves from the school(s)
without proper leave for a period of exceeding one month.

5. Certified that the Child/Children mentioned has/have not been studying in the same
class for more than two years.

6. Certified that I or my wife/husband have/has not claimed and will not claim the
children’s educational allowance in respect of the children mentioned above.

7. Certified that my child/Children in respect of whom reimbursement of tuition fee is


claimed is /are studying in the schools which is/are recognized school(s) not applicable to
schools run by Central Govt/State Govt./Union Territory/Administration/Municipal
Corporation/Municipal Committee/Panchayat Samithi/ Zilla parishad.

8. In the event of any change in the particulars above which effect my eligibility
for reimbursement of Tuition fees, I undertake to intimate the same promptly and also to
refund excess payment, if any, made.

(Signature of the Govt. Servant)


Name in Block Letters:
Designation & Office:
Date:

(Strike out what is not applicable)


Authority vide Government of India
Ministry of Personnel P.G. and Pensions Department of Personnel & Training New Delhi
Order No. A-27012/02/2017-Estt(AL) 16 August,2017
(This office shall be effective from Ist July,2017)

CERTIFICATE FROM THE HEAD OF INSTITUTION/SCHOOL


(For reimbursement of CEA)
Ref No. Date:

It is certified that Master/Kumari ………………………………….

having Admission No…………………… DOB ……………………………. ………….

Son/Daughter of Mr/Mrs ………………………………………….. ……………………

was studying in class …………………………..Section………………………….Roll No.

……………….. during the previous academic year from……………..to……………..

School/institution namely …………………………………………………. vide affiliation

Regd. No.Code……………………….. and pattern ………………… Curriculum and paid

the following amounts

1.Tution fee :
2.Computer fee :
3.Admission fee :
4. Games fee/Lab fee :
5. Any Other Fee (Specify) :
6. Purchase of Text Books & Note Books :
7. Purchase of Uniform :
8.Purchase of Shoe :
9. Hostel /Accommodation fee :
10. Mess Fee :

Recognition stamp with Signature of Principal


Validity
SELF DECLARATION

I , …………………………………………………….. ………working as

………………………………………(Designation) at………………………….. (office of

working) under …………………………………….. HO, do hereby certify that my son/

daughter namely……………………………………………………………………………

has studied in class……………………………. section…………………. ………. Roll No.

………………… during the previous academic year …………………………………….

in………………………………….. . ………………………………School/ College at ………….

In the event of any change in the particulars given above which affect my

eligibility for children Education Allowance, I under take to intimate the same promptly

and refund excess payment, if any made to me.

Place: SIGNATURE OF GOVT. SERVANT


Date:

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