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:-
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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: