From The Secretary, Rajya Sainik Board Haryana, Sainik Bhawab ...

-23-Application FormFORTHE AWARD OF STIPEND TO DEPENDENTS OF EX-SERVICEMEN OUT OF AMALGAMATED FUNDPART- I(To be filled in by the Father/Guardian of stipendiary after reading instructions carefully)1. Name of student (in Block letters) _____________________________2. Name of Institution where reading _____________________________3. Number, Rank and Name of Father _____________________________4. Regiment/Corps of the father _____________________________5. Date of Enrolment of the father _____________________________6. Date and cause of Discharge/Release _____________________________7. Character of the father _____________________________8. Whether father killed or disabled - _____________________________9. Home address : Village_______________ P.O.________________________10. Details of the family member Sr.No. Name Relation Age Occupationattach separate list of member 1. ___________________________________duly signed by the father/ 2. ___________________________________guardian , in case the number 3. ___________________________________is more than five4. ___________________________________5. ___________________________________11. Area of landed property, un-irrigated, owner, tenant etc. details to be given inthe affidavit.12. Present annual income from all source, i.e. land, pay including all allowances,pension, labour and other source.13. The above statement regarding landed property and annual income should besupported by an affidavit of the father/guardian and it should be attested bythe Oath Commissioner..Signature of the studentSignature of the father/guardianPART- II(To be completed filled by the Head of institution)1. Sr.No./R.No._____________________ Date of Birth ________________2. Name of student _____________________________3. Name of Father _____________________________4. Number, Rank and Name of _____________________________5. Class in which studying______________Date of admission _________________6. Boarder or day scholar _____________________________

-26-(i)(ii)(iii)(iv)(v)Assam RiflesLok Sahayak SenaGeneral Reserve Engineering ForceTerritorial ArmyMembers of INA (for any assistance they should approach the ChiefSecretary, Govt. of Haryana in Protocol and Publicity Branch, HaryanaCivil Secretariat Chandigarh.9. The stipend is allowed to one child of an Ex-serviceman where morethan one is entitled the student eligible for higher rate of stipend isaccommodated. The fact that no other brother or sister of the applicantis in receipt of stipend should be supported by an affidavit dulyattested by an Oath Commissioner.B.CONDITIONS APPLICABLE TO(I)(II)(III)Attested copies of discharge certificate of their parents/guardians when thefact of domicile is not mentioned in the discharge certificate, a certificateduly attested by a First Class Magistrate may be attached with theapplication confirming that the father/guardian of the applicant is bonafideresident of Haryana.The dependents of Ex-JCO’s and Emergency Short Service CommissionOfficers if such Ex-Officer had been the Ranks are entitled to stipendsunder the scheme.The stipends admissible to all eligible children of Ex-serviceman.

-27-SPECIMEN OF AFFIDAVIT TO BE GIVEN BY FATHER/GUARDIAN OF THESTUDENT ON 10 PAISE COURT PAPER AND TO BE ATTESTED BY ANOATH COMMISSIONERI____________________S/o_______________________Caste ______________Age______________________ resident of __________________ Father/Guardian of(Name of Student) for which I am Applying for the grant of stipend out ofAmalgamated Fund do hereby solemnly affirm and declare.1. That I am the owner of ___________________________ acres of land outof which ___________________________ acres is irrigated and_______________acres is un-irrigated. I am also a tenant of__________________acres of land which is irrigated/un-irrigated thedetails of the land is as under :2. That my present total income is Rs. ______________________ annuallyfrom all sources and the details are given below :-(i) Income from pay, DA and other allowances @ Rs.__________________ P.M. ___________Annually (Place of service).(ii) Pension/Children Allowance/Jangi Inam under H.O. No.__________________________ Annually (Class) Pension.(iii) Income from land Annually(iv) Income from labour and other Annuallysource.3. That my no other son or daughter is getting stipend from AmalgamatedFund or from other sources.4. That I have not ever served/have served in I.N.A.5. That I have applied for the grant of stipend to the following:-6. That my daughter is not married (In case of girl student)Name of student School Class Whether availing stipend from other sourceVerificationDepositVerified at on this day of thatthe contents of the affidavit are true to the best of my knowledge and belief and no part ofit is false and nothing has been concealed there from.Deponent

-29-CERTIFICATE6. (a) Highest military educational certificate (R.U.)Highest military educational certificate (Eng)Highest education (Civil)Degree of proficiency in reading and or writing (Eng.)(b) Roman urdu or any other language.Any other qualification such as mathematics.(c) Employment before enlistment.(d) Army trade qualifications.7. The holder of this certificate must understand that if he wishes to submit apetition he must do so to the office/I/C Records.By Commissioner/electorApplication for assistance in finding employment should be made to sub-Regional Ex-change.8. The contents of Para 7 above have been fully explained to me.DateStationDatedSignature of SoldierSignature and Rank

-30-Annexure ^A’to letter No. 2/1/06-1D IIDated 01 March 2006Enhanced Rate of stipend effective with 16-12-2005Rate of StipendSr.No. Class/Course Day Scholar Boarder1. 9 th & 10 th Rs. 100/- P.M. Rs. 120/- P.M.2. 10+1 & 10+2 Rs. 160/- P.M. Rs. 200/- P.M.3. B.A. I to III Rs. 200/- P.M. Rs. 240/- P.M.4. M.A./B.Sc. I to III Rs. 400/- P.M. Rs. 500/- P.M.5. B.Ed, LLB, B.Sc, Agri., Rs. 400/- P.M. Rs. 500/- P.M.G.A.M.S.,M.B.A.,B.A.M.S.6. Engg. and M.B.B.S. Rs. 500/- P.M. Rs. 600/- P.M.7. I.T.I., J.B.T., Govt. Institute Rs. 200/- P.M. Rs. 240/- P.M.of Surgical instrument andtechnology, Poly technics8. Prabhakar, Shastri Rs. 200/- P.M. Rs. 240/- P.M.9. OT Course, Vet Comp.,Stock Asstt. Diploma inManagement, SecretariatPractice10. Self Ex-servicemen forResettlement trainingRs. 200/- P.M.Rs. 400/- P.M.Rs. 240/- P.M.Rs. 600/- P.M.

-31-Income Slab for stipendClass/course Present Income slab Enhanced incomeslab9 th & 10 th Upto Rs. 3500/- Upto Rs. 5,500/- p.m.p.m.10+1, 10+2, GVEL, Upto Rs. 3500/- Upto Rs. 5,500/- p.m.B.A., B.Com, I to III, p.m.LLB, B.Sc. M.A.,MBBS, Engineering, Upto Rs. 3501/- to Upto Rs. 5501/- p.m.GAMS, BAMS, ITI, Rs. 4000/- p.m. to Rs. 6500/- p.m.IBT, Govt. Institute ofSurgical Instrument & Upto Rs. 4001/- to Upto Rs. 6501/- p.m.Technology, Stock Rs. 5000/- p.m. to Rs. 7500/- p.m.Assistant, Prabhakar,Shashtri, Diploma inDieties, OfficeManagement;Secretariat Practice,B.Ed, B.Sc,Agriculture, BBA,MBA and othertraining courses etc.stipendFull stipendFull stipend¾ stipend½ stipend