SUKANTA COLLEGE
Vill. & P.O.: Bhangankhali, P.S. & Block: Basanti, Dist.: South24 Parganas, West Bengal – 743329
HRA Declaration vide Higher Education Department Order No. 597-EDN (CS) DTD. 09.06.1999
I Do Hereby Declare That—
1. I am incurring/paying/contributing some expenditure on rent/towards the house on property tax or the
maintenance of the house owned by myself/parents/son(s)/unmarried daughters/spouse.
2. I am married/unmarried/widow/widower.
3. I and my spouse are not enjoying any accommodation provided or owned by the college authorities,
Universities, Govt. authorities or any Govt. undertaking/any statutory or local body.
a) I am paying Rs. ........................................... as rent for accommodation provided by Govt./any Govt.
undertaking/any statutory/local body.
4. My wife/husband is not in service under the Govt. of India or any State Govt. or any statutory or local body,
Educational Institution etc.
OR
My wife/husband is employed and following are the particulars of her/his employment and pay etc. drawn by
her/him.
a) Name and address of her/his Office/Institution/Organization:
...................................................................................................................................................................................................
..........................................................................................................................................................................
b) Present pay per mensum, scale of pay:
...................................................................................................................................................................................................
.......................................................................................................................................................................
5. House rent allowances drawn by him/her per mensum & date of next increment:
.................................................................................................................................................................................
OR
My husband/wife does not draw any HRA because:
...................................................................................................................................................................................................
...............................................................................................................................................................................
Date: ........................ Signature.........................................................
Name..............................................................
Designation.....................................................
I do hereby declare that the particulars given above are true.
Signature.............................................................
………............................................................. Name..............................................................
Signature of the spouse of the employee Designation.....................................................
NOTE: Please strike out which is not applicable.
1. If the employee of spouse enjoys free/rented accommodation/quarter, then she/he will not be entitled to get HRA.
2. Attested photocopy of the certificate of HRA issued by the employer of the spouse should be furnished.
………………………………………………………………
Signature of the Appointing Authority
of the Spouse with seal
……………………………………………………………… ………………………………………………………………
Signature of the Accountant Signature of the Head/Employer
of the College with seal of the College with seal
