7th CPC Children Education Allowance: Guidelines and Sample of Claim Form, School Certificate Form, Self Declaration Form

I hereby apply for the reimbursement of Children Education Allowance / Hostel-Subsidy for

my child / children and relevant particulars are furnished below:- 

9. Distance of Hostel of child from residence of employee (in case Hostel Subsidy): NA

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10. Amount of CEA / Hostel-Subsidy already received up to previous quarter: NIL

11. The Academic year for which CEA / Hostel-Subsidy is applied now: 2017-18

12. (a) Whether the child for whom the CEA is applied for is a disabled child : ¥es / No

(b) If yes, indicate the nature of disability:

(c) Date of disability certificate:

(d) Indicate the percentage of disability:

13. Whether the Bonafide certificate from Head of Institution has been attached : Yes / No

14. For Hostel Subsidy, the Bonafide certificate from mentioning the amount is attached: NA

15. If Yes at Item No. 14, Amount claimed for Hostel Subsidy: Rs NA .

16. (a) Certified that I or my wife / husband is / is not a Central Government servant.

(b) Certified that my wife / husband Sri / Smt ……………………………………………….. is presently

working as ……………………………… in ……………………………………………….. and that he/

she shall not apply / has not applied for the Children Education Allowance for the child / children mentioned above.

(c) Certified that I or my wife / husband-has not claimed this re-imbursement from any other source and will not claim the same in future.

17. Certified that my child in respect of whom re-imbursement of Children Education Allowance is applied is studying in the School / Jr. College which is recognized and affiliated to Board of Education / University. 

18. Certified that I am claiming the CEA in respect of my two eldest surviving children only, The information furnished above are complete and correct and I have not suppressed any relevant information. In the event of any change in the particulars given above which affect my eligibility for reimbursement of Children Education Allowance, I undertake to intimate the same promptly and also to refund excess payments if any made. Further, I am aware that if at any stage the information / documents furnished above is found to be false, I am liable for disciplinary action.

(Signature of Govt Servant)

Name: ……………………………

Rank : ……………………………

P.No.: ……………………………

(This order shall be effective from 01 Jul 2017)

It is certified that Master/ Kumari ______________________________________ having Admission No _________ D.O.B ____________ Son / Daughter of Mr / Mrs. ___________________________

was studying in Class ______________ Sec ________ Roll No. _____________ during the Previous

Academic Year from 2017 to 2018 School / Institution, namely ____________________________________________________________vide affiliation Regd No. /

Code ______________________________ and pattern ____________________ Curriculum.

Signature of principal

(Affix School Stamp) 

I Service No. _____________ Rank ________________ Name ______________________________

of Unit ICGS Samarth do hereby certify that my Son / Daughter namely_________________________________ Studied in Class ________ Sec _______________ Roll No.__________________ during Previous Academic Year 2017-2018 in __________________________________________________________________________School. 

In the event of any change in the particulars 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.

Name: ____________________

Rank: _____________________

P.No. _____________________