APPLICATION FOR CHILDREN EDUCATION ASSISTANCE
Ref: Railway Board's letter No:E(W)2008/ED-2/4 dtd 01.10.2008 (RBE No:135/2008)

Amount For Office Use Amount For Office use
(Number of sets ) (Number of sets )
Certified that with date

I hereby declare that the particulars mentioned above are correct to the best of my knowledge.
If any information furnished above is not correct, I am liable to be taken up under D A R.
Signature of the Employee
Signature of the Forwarding Official
My Wife / husband is / is not a Central Government Employee.
My Wife / Husband is a Central Govt. employee and that She / He will not claim reimbursement of
education expenses in respect of our child / Children
My child / Children in respect of whom reimbursement is claimed is / are studying in recognised school.
I have enclosed the original receipts for the amount claimed and I will not make duplicate claims for these items in subsequent quarters.
My Child / Children mentioned above in respect of whom reimbursement of education expenses is claimed is / are wholly dependent upon me.
The fees indicated against the child / each of the children had actually been paid by me.
Name of School
Nature of Claim : (tick
Number of times claimed so
far ( this academic year)
(e) Shoes
( 1 set allowed )
Education allowance / Hostel subsidy /
Disabled child
Amount Claimed ( based on
consolidated original receipts
enclosed )
Total claim for all children
Education allowance / Hostel subsidy / Disabled
child

Details of Claim
(a) Fees
(b) Others
whichever is applicable)
Name of the student
Date of Birth & Class

Name of the Employee
(c ) Text & Note Books
( 1 set allowed )
(d) Uniform
( 2 sets allowed )
Employee No. & Design
Shop / Token / Bill Unit
Particulars of Child Child1 Child2
For Office Use
Academic Year: