(Download) HRA declaration format for Teachers and employees

 Teachers and government employees have to submit HRA declaration in January and July every year.  HRA declaration consists of two parts A and B text. Click on the image below to download HRA declaration format.


HRA DECLARATION FORMAT


(As on 1st January/July. ……...(Year) (Go. No. 97SE(B), Di-07.03.2001)


PART-A

I am Married / Unmarried / Widow / Widower: (Strike out which is not applicable)


1. Name of the office/School:....................... … … … … .. 


2. Name of the Employee:................................................. 


3. Designation of the Employee:....................................... 


a) Employees' Present Pay (Band Pay+Grade Pay):


b) HRA: c) Opted for Swasthya Sathi? (Yes/No)


c) Opted for Swasthya Sathi? (Yes/No)


d) Whether you get a Swasthya Sathi card? Yes/No


If, Yes then write the no. of card. …. … …. … .. 

I do hereby declare that the details furnished in PART-A are true to the best of my knowledge.


Date:.                                                 Signature of Employee




PART-B

My wife/husband is/was not in service under the Government of India or Government undertaking or any statutory/local body, educational Institute. (Strike out which is not applicable) Or,


My wife/husband is/was in service and following are the particulars of her/his employment and pay etc drawn by her/him: (Strike out which is not applicable)


i) Name of the Spouse:...................... 


a) Name of the office:.......................... 


b) Address of the Office:.................... 


c) Spouse's Present Pay (Band Pay+Grade Pay)...


d) Spouse's HRA:................................ 


e) Whether spouse is opted for Govt. Housing:.. … … 

f) Whether the spouse is opted for W.B. Health Scheme:........ 


g) Whether spouse is opted for under Swasthya Sathi Scheme: Yes/No


I do hereby declare that the details furnished in PART-B are true at the best of my knowledge.


Date:.                                                  Signature of Spouse


Enclosed: Salary Certificate of Spouse


Verified by


… … … … … … … … ..                              … … … … … … … … … …                                                 S.I.S/HOI/HOO.                                           Sign of HT/TIC with seal


                                                                   (In case of Primary Teachers only)

Click here to download the HRA declaration format. 



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