Cea Form New 6pc
Cea Form New 6pc
Cea Form New 6pc
Name of item applied for re- Period for which Cash Memo Amount
imbursement amount is being /Receipt No. & claimed.
claimed date
(5) (6) (7) (8)
Admission Fee
Laboratory fee
Spl fee charged for 0
(agriculture/electronics /Music / or any
other subject)
Fee charged for practical work under
the
Program of work experience
Fee paid for the use of any aid or
appliances by the child.
Library fee
Games/ sports fee
Fee for extra curricular activities
Cost of Book & Notes Books
(restricted to one set)
Cost of uniform (restricted to 02 sets)
Cost of school shoes (restricted to one
set)
Note: - Items shown in column 05 can be re-imbursement under “ children Educational
Allowance Scheme”.
Original Money receipt and cash memo should be attached with the application: -
Annual ceiling fixed for reimbursement of CEA is Rs 12,000/- in a academic session per
child and restricted to 02 child from Nursery to XII class.
2. Certified that my child /children in respect of whom children’s educational allowances
is claimed under new CEA scheme is /are studying in the school mentioned in column 3
which is/ are recognized school(s)/College (not applicable to school run by Central Govt/
State Govt. Union territory administration / Municipal committee/ Panchayat samiti / Zila
parishad).
3. Certified that:-
(i) My wife /Husband in not in central Govt. service.
(ii) My wife /husband is Central Govt. servant and that she/he will not claim
children’s educational allowance in r/o our children.
(iii) My wife /husband is employed with ________________. She /He is not entitled
to children’s educational allowance in r/o our child or children.
4. Certified that during the period covered by the claim the child /children attended the
school regularly and did not absent himself /herself /themselves from the school with out
proper leave for a period exceeding one month.
5. In the event of any change in the particulars given above which affect my eligibility
for children’s educational allowance, I undertake to intimate the promptly and also to refund
excess payments, if any made.
School fees as mentioned above in column-5 to 8 is correct and tallied with the
money receipt.
//CERTIFICATE\\
I certify that my child mentioned below in respect of whom claim is submitted is studying in
school and it is recognized by the educational authority/ state Govt/ any other authority/ jurisdiction in
which the school is situated:
2. Name of Child :
3. Date of birth :
4. Postal address of school where :
Child is studying
5. Class in which studying :
6. Date of admission in present class:
7. Date of admission in school :
8. Academic Session :
9. Scholarship by Edn Deptt/State Govt,if any:
10. The school is recognized by :
11. It is also certified that my wife is not a Central Govt employee and I have incurred a sum
of Rs. _______ ( Rupees _____________________________________________) only
towards education of my child
as per details given below for the quarter w.e.f___________to ___________ vide
vouchers/ cash memo
Attached in original .
(a) Tution fees/ admission fees/ Laboratory fees / Spl fees :
Charged for agriculture,Electronics,Music or any other
Subject.
(b) Fees charged for practical work under the programme of :
Work experience, fees paid for the use of any aid of appliances
By the child,Library fees/ Games, Sports fees & fees for extra
Curricular activities.
(c) Cost of one set of note books/ text books :
(d) Cost of one set of school shoes :
(e) Cost of two sets of uniform :