CEFA Form for GDS

CEFA Reimbursement Form

PROFORMA FOR RE-IMBURSEMENT OF CHILDREN EDUCATION FACILITATION ALLOWANCE

Employee Information

I hereby apply for the reimbursement of Children Education Facilitation Allowance for my child/children and relevant particulars are furnished below:

1. Name of the Employee
2. Employee Code/UID
3. Category/Post
4. Office
5. Residential Address of the Employee
6. Name of Spouse
7. If spouse is employed, State whether in Central Government, State Government, Public Sector Undertaking. (Give Details)
8. Designation, Office & Employee code Number of spouse, if spouse is employed in Department of Posts.
9. Intimate as to whether Reimbursement of CEFA/CEA/Hostel Subsidy is admissible in the Department in which the spouse is working
10. If so, whether Joint Declaration for not claiming the amount from that Department is submitted.

11. Details of all the children of the Gramin Dak Sevaks:

Sl. No. Sequence Name of the Child Date of Birth Age
1. 1st Child
2. 2nd Child
3. 3rd Child

12. Details of the children for whom CEFA is claimed:

Sl. No. Sequence Name DOB Age
1.
2.
3.

13. Academic year, Name of School/Residential School and Class in which children studied:

Details 1st Child 2nd Child 3rd Child
Name of the Child
Name of School/residential School and address
Class in which the child studied in last year

15. Disability Information (if applicable)

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