£¸«’ïú¡¸ ž¸»ž¸¸¾¢÷¸ˆÅú¡¸ ‚›¸º¬¸¿š¸¸›¸ ¬¸¿¬˜¸¸›¸
NATIONAL GEOPHYSICAL RESEARCH INSTITUTE
(¨¸¾±¸¸¢›¸ˆÅ ÷¸˜¸¸ ‚¸¾Ô¸¸½¢Š¸ˆÅ ‚›¸º¬¸¿š¸¸›¸ œ¸¢£«¸™Ã)
(Council of Scientific and Industrial Research)
„œœ¸¥¸ £¸½”õ/Uppal Road, í¾™£¸¤¸¸™ /Hyderabad-500007
œÏœ¸°¸ 2 / Form 2
(œ¸¾£¸ 25 / Para 25)
¬¸¿÷¸¸›¸ ©¸¾¢®¸ˆÅ ž¸î¸¸ ¡¸¸½•¸›¸¸ / Children Educational Allowance Scheme, 2008
›¸¸Ÿ¸/Name:_______________________________________________
œ¸.¬¸¿./I.D.No.:____________________________________________
œ¸™›¸¸Ÿ¸/Designation________________________________________
(¬¸Ÿ¸»í ‡¨¸¿ ŠÏ½” ¬¸¢í÷¸ / with Group & Grade)
1.
œ¸¢£¡¸¸½•¸›¸¸ ¬¸¿‰¡¸¸/Proj.No.:_________________________
‚¸¿÷¸¢£ˆÅ ûŸ½›¸ ¬¸¿./Intl.Tel.Ph.No.: __________________
œÏŸ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ ¢›¸Ÿ›¸¸½¢¥¥¸¢‰¸÷¸ ¬¸¿÷¸¸›¸, ¢•¸›¸ˆ½Å ¢¨¸«¸¡¸ Ÿ¸½¿ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅú œÏ¢÷¸œ¸»¢÷¸Ä ˆÅ¸ ™¸¨¸¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾, œ¸»µ¸Ä ³œ¸ ¬¸½ Ÿ¸º•¸ œ¸£ ‚¸¢ª÷¸ í¾ /íÿ :
Certified that the child/children mentioned below in respect of whom reimbursement of tuition fee is claimed is / are wholly dependent upon me:
ÇÅŸ¸ ¬¸¿. /
Sl. No.
1.
2.
3.
¬¸¿÷¸¸›¸ ˆÅ¸ ›¸¸Ÿ¸ / Name of the Child
•¸›Ÿ¸ ¢÷¸¢˜¸ /
Date of Birth
¢¨¸Ô¸¸¥¸¡¸ /Ÿ¸í¸¢¨¸Ô¸¸¥¸¡¸ ˆÅ¸ ›¸¸Ÿ¸ /
Name of the School/College
œ¸í¥¸ú ¬¸¿÷¸¸›¸/1st Child
™»¬¸£ú ¬¸¿÷¸¸›¸/2nd Child
***
*** ÷¸ú¬¸£ú ¬¸¿÷¸¸›¸ ˆ½Å ³œ¸ Ÿ¸½¿ ŠÏ¸à¸ í¾ •¸í¸Â ™»¬¸£ú ¬¸¿÷¸¸›¸ ˆÅ¸ •¸›Ÿ¸ ¤¸íº-¬¸¿÷¸¢÷¸ Ÿ¸½¿ œ¸¢£µ¸÷¸ íº‚¸ í¸½ —
*** Admissible as 3rd child where second child birth resulting in multiple births.
ˆÅ®¸¸ /
Class
ž¸ºŠ¸÷¸¸›¸ ¢ˆÅ¡¸¸ Š¸¡¸¸
Ÿ¸¸¢¬¸ˆÅ ¢©¸®¸¸ ©¸º¥ˆÅ
/ Monthly
tuition fee paid
Ÿ¸¸í / ¨¸«¸Ä
Month/Year
¬¸½ /From
÷¸ˆÅ/To
2.
œÏŸ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ ¬¸¿÷¸¸›¸ / œÏ÷¡¸½ˆÅ ¬¸¿÷¸¸›¸ ˆ½Å ¬¸¸Ÿ¸›¸½ ¬¸»¢•¸÷¸ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅ¸ Ÿ¸½£½ ׸£¸ ¨¸¸¬÷¸¨¸ Ÿ¸½¿ ž¸ºŠ¸÷¸¸›¸ ¢ˆÅ¡¸¸ Š¸¡¸¸ — (¤¸ÿˆÅ •¸Ÿ¸¸ ¨¸¸„•¸£ ˆÅú ›¸ˆÅ™ £¬¸ú™/‚š¸œ¸››¸¸ œÏ¸£¿¢ž¸ˆÅ ™¸¨¸½ ˆ½Å ¬¸¸˜¸
¬¸¿¥¸Š›¸ ¢ˆÅ¡¸¸ •¸¸›¸¸ í¾ —)/Certified that the tuition fees indicated against the child/each of the children had actually been paid by me (cash/receipt/counter foil
of the bank credit vouchers to be attached with the initial claim).
3.
œÏŸ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ/Certified that*(i)
Ÿ¸½£ú/Ÿ¸½£½ œ¸÷›¸ú/œ¸¢÷¸ ˆ½¿ÅÍú¡¸ ¬¸£ˆÅ¸£ú ˆÅŸ¸Ä•¸¸£ú ›¸íì í¾/í¾ — /my wife/husband is/is not a Central Government servant.
(ii) Ÿ¸½£ú/Ÿ¸½£½ œ¸÷›¸ú/œ¸¢÷¸ ˆ½¿ÅÍú¡¸ ¬¸£ˆÅ¸£ú ˆÅŸ¸Ä•¸¸£ú í¾ ¥¸½¢ˆÅ›¸ ¨¸í ퟸ¸£ú ¬¸¿÷¸¸›¸ ˆ½Å ¢¨¸«¸¡¸ Ÿ¸½¿ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅú œÏ¢÷¸œ¸»¢÷¸Ä ˆÅ¸ ™¸¨¸¸ ›¸íú¿ ˆÅ£½¿Š¸½ /ˆÅ£½¿Š¸ú — / my wife/husband is a Central
Government servant but he/she will not claim reimbursement of tuition fee in respect of our child /children.
(iii) Ÿ¸½£ú/Ÿ¸½£½ œ¸÷›¸ú/œ¸¢÷¸ /my wife /husband is employed with (¡¸¢™ ˆ½¿ÅÍú¡¸ ¬¸£ˆÅ¸£ ˆÅ¸½ Ž¸½”õˆÅ£ ˆÅ¸½ƒÄ ‚›¡¸ í¾ ÷¸¸½ „¥¥¸½‰¸ ˆÅ£½¿ /mention if other than Central
Govt.)_______________________________________________ Ÿ¸½¿ ˆÅ¸¡¸Ä£÷¸ íÿ — ¨¸í ퟸ¸£½ ¬¸¿÷¸¸›¸ ˆ½Å ¢¨¸«¸¡¸ Ÿ¸½¿ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅú œÏ¢÷¸œ¸»¢÷¸Ä ˆÅ¸ íˆÅ™¸£ ›¸íì í¾¿ /íÿ —
/he/she is/is not entitled to reimbursement of tuition fee in respect of our child/children.
4.
œÏ¸Ÿ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ ƒ¬¸ ™¸¨¸½ Ÿ¸½¿ ¬¸Ÿ¸¸¨¸½¢©¸÷¸ ‚¨¸¢š¸ ˆ½Å ™¸¾£¸›¸ „Æ÷¸ ¬¸¿÷¸¸›¸ ¢¨¸Ô¸¸¥¸¡¸ (¡¸¸½¿) Ÿ¸½¿ ¢›¸¡¸¢Ÿ¸÷¸ ³œ¸ ¬¸½ „œ¸¦¬˜¸÷¸ íºƒÄ ÷¸˜¸¸ ¨¸í/¨¸½ ‡ˆÅ Ÿ¸íú›¸½ ¬¸½ ‚¢š¸ˆÅ ‚¨¸¢š¸ ˆ½Å ¢¥¸‡ „¢•¸÷¸ ŽºØú ˆ½Å ¢¤¸›¸¸
¢¨¸™Ã¡¸¸¥¸¡¸ (¡¸¸½¿) Ÿ¸½¿ ‚›¸ºœ¸¦¬˜¸÷¸ ›¸íì íº‡ — /Certified that during the period covered by this claim, the child/children attended the school(s) regularly and did not
absent himself/herself/themselves from the school(s) without proper leave for a period exceeding one month.
5.
œÏ¸Ÿ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ Ÿ¸ÿ ¡¸¸ Ÿ¸½£ú/Ÿ¸½£½ œ¸÷›¸ú/œ¸¢÷¸ ›¸½ …œ¸£ „¢¥¥¸¢‰¸÷¸ ¬¸¿÷¸¸›¸ ˆ½Å ¢¨¸«¸¡¸ Ÿ¸½¿ ¬¸¿÷¸¸›¸ ©¸¾¢®¸ˆÅ ž¸î¸¸ ˆÅ¸ ™¸¨¸¸ ›¸íì ¢ˆÅ¡¸¸ í¾ ‚¸¾£ ›¸íì ˆÅ³ÂŠ¸¸/ˆÅ³ÂŠ¸ú/ˆÅ£½¿Š¸½ /ˆÅ£½¿Š¸ú —/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.
6.
œÏ¸Ÿ¸¸¢µ¸÷¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾ ¢ˆÅ Ÿ¸½£ú ¬¸¿÷¸¸›¸ ¢•¸›¸ˆ½Å ¢¨¸«¸¡¸ Ÿ¸½¿ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅú œÏ¢÷¸œ¸»¢÷¸Ä ˆÅ¸ ™¸¨¸¸ ¢ˆÅ¡¸¸ •¸¸÷¸¸ í¾, Ÿ¸¸›¡¸÷¸¸ œÏ¸œ÷¸ ¢¨¸Ô¸¸¥¸¡¸ (¡¸¸½¿) Ÿ¸½¿ œ¸•õ÷¸ú í¾/íÿ — / Certified that my child/children
in respect whom reimbursement of tuition fee is claimed is /are studying in the school (s) which is / are recognized school(s).
ˆ½¿ÅÍú¡¸ ¬¸£ˆÅ¸£ / £¸•¡¸ ¬¸£ˆÅ¸£ / ¬¸¿‹¸ £¸•¡¸ ®¸½°¸ œÏ©¸¸¬¸›¸ /›¸Š¸£ ¢›¸Š¸Ÿ¸ / ›¸Š¸£ œ¸¸¢¥¸ˆÅ¸ ¬¸¢Ÿ¸¢÷¸ / œ¸¿•¸¸¡¸÷¸ / ¢•¸¥¸¸ œ¸¢£«¸™Ã ׸£¸ ¬¸¿•¸¸¢¥¸÷¸ ¢¨¸Ô¸¸¥¸¡¸¸½¿ ˆ½Å ¢¥¸‡ ¥¸¸Š¸» ›¸íì í¾ —/Not applicable to
schools run by Central Government/State Government/Union Territory Administration/Municipal Corporation/Municipal Committee/Panchayat/Zila
Parishad).
7. …œ¸£ ˆ½Å ¢¨¸¨¸£µ¸ Ÿ¸½¿ ˆÅ¸½ƒÄ œ¸¢£¨¸÷¸Ä›¸, •¸¸½ ¢©¸®¸¸ ©¸º¥ˆÅ ˆÅú œÏ¢÷¸œ¸»¢÷¸Ä ˆ½Å ¢¥¸‡ Ÿ¸½£ú œ¸¸°¸÷¸¸ ˆÅ¸½ œÏž¸¸¢¨¸÷¸ ˆÅ£÷¸¸ í¾, ˆÅú ¦¬˜¸¢÷¸ Ÿ¸½¿ Ÿ¸ÿ „¬¸ˆÅ¸½ ÷¸º£¿÷¸ ¬¸»¢•¸÷¸ ˆÅ£›¸½ ‚¸¾£ ¢ˆÅ‡ Š¸‡ ‚¢š¸ˆÅ ž¸ºŠ¸÷¸¸›¸¸½¿ ˆÅú, ¡¸¢™ ˆÅ¸½ƒÄ í¸½
÷¸¸½, ¨¸¸œ¸¬¸ú ˆÅ£›¸½ ˆÅú ¢•¸ŸŸ¸½™¸£ú ¥¸½÷¸¸ í»Â —/In the event of any change in the particulars above which affect my eligibility for reimbursement of tuition fees, I
undertake to intimate the same promptly and also to refund excess payments, if any, made.
¢÷¸¢˜¸/Date:______________________
* •¸¸½ ¥¸¸Š¸» ›¸íì í¾, „¬¸½ ˆÅ¸’ ™½¿ — / Strike out what is not applicable.
(¬¸£¸ˆÅ¸£ú ˆÅŸ¸Ä•¸¸£ú ˆÅ¸ í¬÷¸¸®¸£ / SIGNATURE OF THE GOVT. SERVANT)