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A : Army officers
CDA (O)
Golibar Maidan
Pune - 1
Total - Rs
14,000/-
2. You are requested to remit the amount to the Officer’s Bankers at the
earliest :-
(ABCD)
Col
Form-1
1 2 3 4 5 6 7
ARMY PUBLIC
XYZ
22 FEB 2222 SCHOOL NEW III Rs 1000/- Rs7000/-
DELHI
Total- Rs 14000/-
3. Certified that :
(b)My wife is a Central Government servant and that she/ he will not claim children's educational
allowance in respect of our child/children.
(c)My wife is employed with _______________ (*) She is not entitled to Children's Educational
Allowance in respect of our child/children.
4. Certified that during the period covered by the claim the children attended the school
regularly and did not absent himself /herself /themselves from the school without proper
leave for a period exceeding one month.
5. Certified that children have not been studying in the same class for more than two
academic years.
6. Certified that the allowance for the period has been claimed for the first time and the
amount claimed has been actually expended by me for fees etc of the school.
7. 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 same promptly and also refund
excess payments, if any made.
Place of Posting
(strike out whatever is not applicable)