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Hra Claim Form

This document is a certification form for State/Central Government Servants claiming House Rent Allowance as per specific government orders. It includes declarations regarding the absence of government accommodation, personal housing arrangements, and related expenses. The form requires signatures from both the claimant and the head of the office/department for validation.

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403 views1 page

Hra Claim Form

This document is a certification form for State/Central Government Servants claiming House Rent Allowance as per specific government orders. It includes declarations regarding the absence of government accommodation, personal housing arrangements, and related expenses. The form requires signatures from both the claimant and the head of the office/department for validation.

Uploaded by

kirtishiva2002
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEXURE

Certified to be furnished by a State/Central Government Servant claiming


House Rent as per Government of India, Ministry of Finance O.M. No.11013/2/86-E(3)
dated 223.08.1986 and of even No. dated 19.03.1987.

1. Certify that I have not been provided with any Government owned or hired
accommodation during the period with effect from _________________________________
in respect of which allowances is claimed.
2. I certified that I am residing in a House hired /owned by me/my wife/
husband/son/daughter/mother/father of a Hindu Undivided Family in which I
am a co-parcener.
3. I certified that I am incurring some expenditure on rent contribution towards
rent as Property Tax or maintenance of the house.
4. I certified that I am not sharing Government hired or owned accommodation
allotted to my parent/child by the State/Central Government and autonomous
public undertaking of semi Government, organization such as Municipality/
Port Trust etc. allotted, rent them to another Government Servant.
5. I certify that my husband or wife/children/parents who is/are sharing
Government owned or hired accommodation with me allotted to another
employees of the Central/State Government, Autonomous Public undertakings
or Semi-Government Organization like Municipality/Port Trust etc.
6. I certified that my wife/husband has not been allotted accommodation at the
same station by the Central/State Government, Autonomous Public
Undertakings or Semi-Government Organization like Municipality, Port Trust
etc.

Dated __________________________ Signature :_______________________________

Designation :_______________________________

TO BE FILLED AND SIGNED BY THE HEAD OF OFFICE/DEPARTMENT

Certified that Pi/Pu/Dr._________________________________________________________


is not provided with any Government owned or hired accommodation.

Signature of head of Office/Department


(with seal)

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