Specimen house rent allowance application Form

The following is Specimen house rent allowance application form for Centre or State Government permanent employee. Please consult your concerned office before submitting this proforma application to your respective office. This application form is only for guidance purpose.

--------------------------------------------------------------------------------------

A P P L I C A T I O N___ F O R M____ F O R___ H. R. A.

A N N E X U R E

____________________________________________________________________________

Certified to be furnished by a State/Centre Government Servant claiming House Rent as per Government of India/State Government of Punjab’s instructions/notifications issued from time to time and GOI, Ministry of Finance O.M. No. 11013/2/86-E, II dt. 23.8.86 and even No. dated 19.3.87.

1. I certify that I have not been provided with any Government owned or hired accommodation during the period with effect from __________________ in respect of which the allowances is claimed.

2. I certify that I am residing in a house hired/owned by me/my wife/husband/son/daughter/father/mother a Hindu undivided family in which I am a percener.

3. I certify that I am incurring some expenditure on rent contribution towards rent as property Tax or maintenance of the House.

4. I certify that I am not sharing Government hired or owned accommodation allocated of my parent (child) by the State/Central Government and autonomous public undertaking of semi-Government such as municipality, post trust etc. allotted rent free to another Government Servant.

5. I certify that my husband/wife/children/parents who is/are sharing Government owned or hired accommodation with me allotted to another employees of the Central/State Government autonomous undertaking or semi-Government Organizations like municipality, post trust etc.

6. I also certify 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 such as municipality, port trust.

Dated _____________________

Signature ______________________

(_______________________)

Designation ____________________

_________________________________________________________________________________________________________________________________________

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

_________________________________________________________________

Certified that Shri/Smt./Miss/Mr. _____________________________________ is not provided with any Government owned or government hired accommodation.

NOTE :

1)All the paras as much be attended

2)Words or sentences which are not office/Department required should be strike out

Signature of Head of Office/Department

( SEAL/Stamp )