SBF Scholarship for 2023-2024

SCHOLARSHIP FOR HIGHER TECHNICAL/PROFESSIONAL EDUCATION

(Non Gazetted Staff @ Rs.18000/- p.a )
Last Date Of Submission 15/09/2023
Fresh Continuation Girl Child Male Child
GP 2800 & Above GP 2800 & Above Old Case Number Compulsory GP upto 2400 GP upto 2400
ML- 5 & above ML- 5 & above upto ML- 4 upto ML- 4

( Employee to fill suitable form from the above as per their eligibility and strike out which is not
applicable)
To,
The Secretary, Required Document
Staff Benefit Fund Committee, 1. Current year Bonafide(i.e 2023-2024)
HQ ________ /Div.___________/ W.Shop__________ 2. Previous Year Pass Marksheet

Name of Employee:_____________________________________________________________________________

Designation: ____________________________ Railway Telephone No./Mobile No ____________________________

Place of work & Office ________________________Bill Unit No. ____________ Pay Level______________________

Staff No. (Compulsory) ___________________________ Date of Appointment _____________________________

Name of the Child/Ward __________________________________BOY / GIRL _____________________________

CAST = UR / SC / ST / OBC __________________________1st or 2nd Child________________________________

Relationship with applicant (Son/Daughter/Dependent brother/ Sister) ______________________________________

Name of Institute/School/College ____________________________________________________________________

Name of the Course______________________ Present Year (ie 2023-24) ( 1st/ 2nd/ 3rd/ 4th )____________________
Date of Admission___________________________ Duration of the course__________________________________

State the stage at which Child/Ward failed or ATKT allowed. ______________________________________________

Amount Received from SBF (If so, year of receipt) _____ __________________________________________________

Period for which the payment received __________________ Period for which the payment due __________________

State the last Board Exam. Attended HSC /SSC (If FRESH)____________ Year ___________% _____________
* I declare that my, son/daughter/ dependent brother/sister are not employed for whom the scholarship is applied.
Further I declare that my child/ward is not in receipt of any other Scholarship / Concession from any other source and I
had not applied for more than two children.
Note:- Scholarship will be available to children and dependent brothers and sisters of non-gazetted Railway
servants whose pay does not exceed Rs 695/- p.m. Railway Board letter No E(W)74WL.81 dated 08.01.1974

* If it is subsequently revealed that the information provided is not true or that I had not disclosed any information relating
to my child/ward, I will be liable for disciplinary action and Administration reserve the right to recover the Scholarship
amount already paid to me and also cancel the Scholarship awarded.

Date & Place: ___________________________

Forwarded vide Memo No. Signature of the Applicant
To
The Secretary, Staff Benefit Fund Committee __________ (HQ/Div/Workshop) for further process. It is certified that the
particulars stated against item above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

CSBF MEMBER CSBF MEMBER CSBF MEMBER CSBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION
 BONAFIDE CERTIFICATE

Name and Address of the College :____________________________________________

________________________________________________________________________

This is to certify that Shri /Kum ____________________________________Son/Daughter

of Shri /Smt. _________________________________ is a Bonafide student of this College.

Name of the course in which admitted __________________________________________

Duration of the course ___________________ Years.

Year in which presently studying :- First Year / Second Year / Third Year / Fourth Year

He / She is currently studying in the academic year 2023-2024

Whether the course is full time or part time ______________

(Stamp/Seal of the College) (Signature of the College Authorities)

Dated : / /2023
 2023-2024 CSBF
Scheme : Spectacles
{Staff Pay Level upto 7 (Old GP Rs. 4600 including MACP) @ Rs. 3,500}
(This Grant is being allotted from the SBF head of RELIEF OF DISTRESS AND SICKNESS ETC. for
Staff in Old GP upto Rs.4600/-(ML-7) including MACP)

To,
The Secretary,
Staff Benefit Fund Committee,
HQ ______ /Div._________/ W.Shop______

I hereby apply for the re-imbursement of the cost of spectacles purchased by me. I have not claimed any reimbursement
of the cost of spectacles from the Staff Benefit Fund during the last 3 (Three) years.

Name of Employee ______________________________________________________________________________

Designation_________________________________ Railway Telephone No.________________________________

Place of work/Office _________________________ Bill Unit No._______________ Mobile No.___________________

Staff No (P.F No.) _________________________ Date of Appointment_____________________________________

Pay Level __________________ Basic_______________ Pay Level___________ Grade Pay _________________

(Enclosed) Money Receipt No. _____________________ Date__________________ Rs._________________________

I declare that the statements made by me are true and if found incorrect, I will liable to be taken up under DAR.

Date & Place: ___________________________

Signature of the Applicant

As per the Service Register maintained, the applicant has received his / her last payment for reimbursement
for the cost of Spectacles on (date) ___________________ which has already crossed the period of 03
(Three) years. Necessary entry to the effect will be made in the Service Register after receipt of the Grant.

Date_____________________ Signature and Stamp of Bills Clerk

Forwarded and certified that spectacles are necessary for the above employee.

Signature and Stamp of Astt. District Medical Officer/DMO

Forwarded vide Memo No.
To
The Secretary, Staff Benefit Fund Committee __________ (HQ/Div/W. Shop) for further process. It is certified that the
particulars stated above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

SBF MEMBER SBF MEMBER SBF MEMBER SBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION
 2023-2024 CSBF
Scheme : Dentures

{Staff Pay Level upto 7 (Old GP Rs. 4600 including MACP) }

( Half set i.e. 2 teeth & above of either side Rs. 7500/- Full set Rs.15,000/-)
(Claims for full set once in entire Service) (claims for half set of denture, it can be claimed for twice in the entire
service.)
(This Grant is being allotted from the SBF head of RELIEF OF DISTRESS AND SICKNESS ETC. for
Staff in Old GP upto Rs.4600/-(ML-7) including MACP)

To,
The Secretary,
Staff Benefit Fund Committee,
HQ ______ /Div._________/ W.Shop______

I hereby apply for the re-imbursement of the cost of dentures purchased by me. I have not claimed any reimbursement of
the cost of dentures from the Staff Benefit Fund during my service as on date.

Name of Employee _____________________________________________________________________________

Designation___________________________ ___________ Railway Telephone No.__________________________

Place of work/Office______________________________ Bill Unit No.____________ Mobile No.________________

Staff No(P.F No.) ___________________________ __Date of Appointment ________________________________

Pay Level _______________ Basic_____________ Pay Level___________ Grade Pay _________________

(Enclosed) Money Receipt No.________________ Date__________________ Rs.___________________________

_ I declare that the statements made by me are true and if found incorrect, I will liable to be taken up under DAR.

Date & Place :___________________________

Signature of the Applicant

As per the Service Register maintained, the applicant has never applied for reimbursement of the cost of dentures as on
date. Necessary entry to the effect will be made in the Service Register after receipt of the Grant.

Date_____________________ Signature and Stamp of Bills Clerk

The above Scheme is only for reimbursement of Denture. Treatment of Root cannel is not permissible under this
scheme since the same is done free in Railway Hospital.
Forwarded and certified that Half /Full set of Dentures are necessary for the above employee.
.

Signature and Stamp of Astt. District Medical

Officer/DMO
Forwarded vide Memo No.
To
The Secretary, Staff Benefit Fund Committee __________ (HQ/Div/W. Shop) for further process. It is certified that the
particulars stated above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

SBF MEMBER SBF MEMBER SBF MEMBER SBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION
 2023-2024 CSBF
Scheme : Prosthetics (Artificial Limb)
{Application Once in 05 Years @Rs.40,000/-}
To,
The Secretary,
Staff Benefit Fund Committee,
HQ ______ /Div._________/ W.Shop ______

I hereby apply for the re-imbursement of the cost of Prosthetics purchased by me. I have not claimed any
Re -imbursement of the cost of Prosthetics purchased from the Staff Benefit Fund during the last five years.

Name of Employee : ___________________________________________________________________________

Designation :________________________________ Railway Telephone No. _____________________________

Place of work:___________________________ Bill Unit No. ___________Mobile No._______________________

Staff No._______________________________ Date of Appointment____________________________________

Pay Band______________ Basic______________ Pay Level___________ Grade Pay _____________________

(Enclosed) Money Receipt No._____________________ Date:________________ Rs._____________________

Last Date of Reimbursement made for claiming prosthetics date___________________

I declare that the statements made by me are true and if found incorrect, I will liable to be taken up
under DAR.

Date & Place :___________________________ Signature of the Applicant

As per the Service Register maintained, the applicant has not applied for reimbursement of cost of
Prosthetics during the last 5 years. . Necessary entry to the effect will be made in the Service Register after receipt of
the Grant.

Date_____________________ Signature and Stamp of Bills Clerk

Forwarded and certified that set of Prosthetics are necessary for the above employee.

Signature and Stamp of Astt. District Medical Officer/DMO

Forwarded vide Memo No.

To
The Secretary, Staff Benefit Fund Committee _________ (HQ/Div/W.Shop) for further process. It is certified
that the particulars stated above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

SBF MEMBER SBF MEMBER SBF MEMBER SBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION

2023-2024 CSBF
Scheme : Cash Award to Non – Gazetted Staff’s Girl Child

SCHOLARSHIP FOR HIGHER TECHNICAL/PROFESSIONAL EDUCATION For Non – Gazetted

employees whose girl child is physically / mentally challenged and studying higher education
in any streams of Technical / Professional Education @ Rs. 25,000/- p.a.
(This scheme is being given from the SBF head of Women Empowerment)
(Last Date of Submission 15/09/2023)
To,
The Secretary,
Staff Benefit Fund Committee,
HQ ______ /Div._________/ W. Shop ______

Name of Employee _____________________________________________________________________________

Designation _______________________ Railway Telephone No. _____________Mobile No ___________________

Place of work __________________________________________ Bill Unit No. _____________________-_______

Staff No.__________________________ Date of Appointment ___________________________________________

Pay Level _____________ Basic___________ Pay Level___________ MACP Pay Level _____________________

Name of the Child/Ward _____________________________________ BOY / GIRL __________________________

CAST = (UR / SC / ST / OBC) ____________________________ 1st or 2nd Child ______________________

Relationship with applicant (Son/ Daughter / Dependent brother / Sister) ____________________________________

Name of Institute/School/College __________________________________________________________________

Name of the Course ______________________Present Year( ie 2023-24) (1st/ 2nd/ 3rd/ 4th ) ___________________
Date of admission ___________________________ Duration of the course ______________________________

Whether Child/Ward was Residing Railway Hostel ( Compulsory) YES / NO __________________________

* I declare that my, son/daughter/ dependent brother/sister are not employed for whom the scholarship is applied.
Further I declare that my child/ward is not in receipt of any other Scholarship / Concession from any other source and
I had not applied for more than two children.
* If it is subsequently revealed that the information provided is not true or that I had not disclosed any information relating
to my child/ward, I will be liable for disciplinary action and Administration reserve the right to recover the amount
already paid to me.

Date & Place :___________________________

Forwarded vide Memo No. Signature of the Applicant

To
The Secretary, Staff Benefit Fund Committee _________ (HQ/Div/W.Shop) for further process. It is certified
that the particulars stated against item above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

CSBF MEMBER CSBF MEMBER CSBF MEMBER CSBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION
2023-2024 (Last Date of Submission 15/09/2023) CSBF
One time Cash Award Scheme from SBF for wards of Railway employees for
outstanding performance in academic year 2022-23
(Non Gazetted Staff @ Rs.9,000/- one time )
SSC HSC Graduation Post Graduation CA & CS Cash Award to wards of
BA,B.Com.& MA,M.Com.M.sc, Railway Employee for
B.Sc Higher Education in
150 Cases 150 Cases 50 cases per 25 cases per Abroad after completion
stream stream 20 cases of course (Only
90% and 85% and 65 % and 60 % and above Technical & Professional
Above above above Course)

(Employee to fill suitable form from the above as per their eligibility and strike out which is not applicable)

1. Name of Employee:- ___________________________________________________________

2. Designation:- ________________ Office-_____________________________________

3. Date of Appointment:- ________________________ Pay Level:-__________________________

4. Basic Pay(Encl.Payslip):-________________RUID or Employees No.:-_____________________

5. Name of the Student:- ___________________Date of Birth of the Student:- _________________

6. Relationship with the applicant :-_____________________________________________________

7. Name and Address of the Institution of Which Studying :-__________________________________

8. Particular of Class/Course Studing :- _________________________________________________

9. Duration of the Course:- ____________________________________________________________

10. Scholastic record of the Student ( to be supported by copies of certificate/mark sheet duly verified by

Principal of School/College)

Name of the Year in which Institution Total marks Marks %age Position
Exam.Passed passed for the Exam. Obtained (Compulsory) in Class

11. Details of Other the Scholarships and educational

Assistance from SBF or any other source :- __________________________________________

Signature of the applicant

Railway Phone No/Mobile No.________________________________

To
The Secretary, Staff Benefit Fund Committee __________ (HQ/Div/W.Shop) for further process. It is certified that the
particulars stated against item above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Stamp of Office

CSBF MEMBER CSBF MEMBER CSBF MEMBER CSBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCRE ASSOCIATION
 CSBF 2023-2024
Scheme : 1) Development of Occupational Skills of Physically/Mentally Challenged wards of Railway employees
2) Annual Maintenance grant to such wards who are completely blind (100%) or bed-ridden with
paralytic, amputation of both legs, muscular dystrophy, cerebral palsy or spastics(40% & above)
(Last Date of Submission 15/09/2023)
To,
The Secretary,
Staff Benefit Fund Committee,
HQ ______ /Div._________/ W.Shop______

I hereby apply for financial aid in favour of my son/daughter/dependent brother/sister as per the condition enumerated below

Name of Employee- ______________________________________________________________________________

Designation______________________________________ Railway Telephone No: ____________________________

Place of work __________________________ Bill Unit No. __________________ Mobile No.___________________

Staff No.________________________________ Date of Appointment :-_____________________________________

Pay Level ___________________ Basic_______________ Pay Level___________ MACP Pay Level ______________

Name of the Ward:- ____________________________ Date of Birth of the Ward____________ ________________

Relationship with applicant (Son/ Daughter / Dependent brother / Sister) :- ________________________

Name and address of the Institution where training for Occupational Skills is being imparted (as distinct from academic
course for which there are separate educational Scholarship schemes) ____________________________________

Whether in receipt of any Financial Aid from other source. Yes / No :____________________________

Whether the child is in receipt of Financial Aid from SBF

(if so give full particulars stating year or receipt.) ______________________________________

Nature of disability :- ____________________________________________________________

(Latest certificate from competent authority in original to be attached)
 Reimbursement of fees upto Rs.18,000/- p.a., paid to any institution for development of
occupational skills of physically/mentally challenged wards of Railway employees. Claim will be
made in this format and will be accompanied with receipt of the fees paid. It is to be noted that
occupational skill courses are different than normal degree/diploma courses for which a separate
scheme of educational scholarship/cash award is already in force.
 An annual grant of Rs.18,000/- for such children who are completely blind or bedridden due to
affliction with diseases like paralysis, muscular dystrophy, amputation of both legs, mental
retardation and cerebral palsy or spastics (40% and above) who need constant care and
attendance. Applications should be accompanied with doctors report.
 This form should not be used for purchase of wheel chair or other equipments and devices.

If any information provided by me is false, I will be liable for DAR and Amount will be recovered from me

Date & Place: _____________

Forwarded vide Memo No. Signature of the Applicant

To
The Secretary, Staff Benefit Fund Committee __________ (HQ/Div/W.Shop) for further process. It is certified
that the particulars stated against item above have been verified and found correct.

(Signature of forwarding Supervisor/Depot Incharge)

Encl:- 1) Fee Receipt in Original Stamp of Office
2) Disability certificate duly issued by Government Medical Authority.
3) Doctor’s report in the case of diseases like paralysis or muscular dystrophy compelling the ward to be
bed-ridden and in the case of mentally retarded compelling the parents to provide constant attendant
and care

SBF MEMBER SBF MEMBER SBF MEMBER SBF MEMBER

CRMS NRMU AISCSTRE ASSOCIATION AIOBCREASSOCIATION