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CEA Form

CEA form

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Md Imran Anwar
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59 views2 pages

CEA Form

CEA form

Uploaded by

Md Imran Anwar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
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arrgeter rar rer srarr-reha PTT INDIAN AUDIT & ACCOUNTS DEPARTMENT arenibrderas, err- err aT TATA, (HATED, BYETTAT OFFICE OF THE DIRECTOR GENERAL OF AUDIT (CENTRAL) KOLKATA oh aré.ch, fateanr, 8, Piscor eiane TB, BreTATAT — 700 001 ,. BUILDING, & KIRAN SANKAR ROY ROAD, KOLKATA - 700 001 EDUCATION ALLOWANCE/HOSTEL SUBSIDY PROFORMA FOR RE-MBURSEMENT OF CHILDREN LAIM F¢ Al 1. 1 hereby apply for the reimbursement of Children Education Allowance for my child/children and relevant particulars are furnished below:- iz ‘Name of the Employee [_2. [Employee 1.0. No. [3] Designation | 4] Section | Contact No. 2. Details of the children for whom CEA/Hostel Subsidy claimed: i ie T ae | T | Class& | Amount | i | Academic | Claimed | SL.NO. Name DOB Name of the School Year 1 2 Total Rs. 3. Distance of Hostel of child from residence of employee (in case Hostel Subsidy is claimed) : 4, Amount of CEA/Hostel Subsidy already received for previous Year : 5. (a) Whether the child for whom the CEA is applied for is a disabled child: Yes/No i. Iyes, indicate the nature of disability : ii, Date of disability certificate ili, Indicate the percentage of disability : (b) Whether the Bona fide certificate from He: ad of Institut : feicrosal sina stitution has been attached: Yes/No the Bona fide certificate from mentioning the amount is attached: Yes/No Contd..P/2 6. Certified that my husband/wife is not a Central Government Servant. 7. (i) Certified that my husband/wife is a Central Government Servant. is presently working (ii) Certified that my husband/wife Sri/Smt: .. * as: I sssossunsononne and that he/she shall not apply/has not applied for the Children Education Allowance for the child/children mentioned above. (ii) Certified that | or my wife/husband has not claimed this re-imbursement from any other source and will not claim the same in future. 8. Certified that my child/children in respect of whom reimbursement of Children Education Allowance is/are applied is/are studying in the School/sr. College which is recognized and affiliated to Board of Education/University. 9. The information furnished above are complete and correct and | 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, | undertake to intimate the same promptly and also to refund excess payments if any made. Further, | am aware that if at any stage the information/documents furnished above is found to be false, | am liable for disciplinary action. Signature: Name: Design Section: Date: FOR OFFICE USE ONLY Sl. ‘Name of Govt. Hostel Subsidy i Employee. 1.0 No, CEA Amount Total Amount if any Star

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