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Kotak Mahindra Life Insurance Company LTD Lta Claim Form

This document is a leave travel allowance (LTA) claim form for an employee of Kotak Mahindra Life Insurance Company containing sections for the employee's personal details, details of travel including dates, locations, and ticket numbers, accounting of the LTA entitlement and payable amounts, and a declaration signed by the employee. Notes at the bottom provide additional information on LTA reimbursement policies and requirements including submission of travel documents and financial dependency of family members.

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Cricket Khelo
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156 views2 pages

Kotak Mahindra Life Insurance Company LTD Lta Claim Form

This document is a leave travel allowance (LTA) claim form for an employee of Kotak Mahindra Life Insurance Company containing sections for the employee's personal details, details of travel including dates, locations, and ticket numbers, accounting of the LTA entitlement and payable amounts, and a declaration signed by the employee. Notes at the bottom provide additional information on LTA reimbursement policies and requirements including submission of travel documents and financial dependency of family members.

Uploaded by

Cricket Khelo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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KOTAK MAHINDRA LIFE INSURANCE COMPANY LTD

LTA CLAIM FORM

A. Individual Particulars

*Name: __________________________________ *Emp_code: __________________________


*Location: ________________________________ *Dt_Joining: __________________________
*Confirmation date: _______________________ *Dt_Joining Group: ____________________

*Members who travelled:


Sr. No. Name Age Relationship
1
2
3
4
5
6

*Place of travel:______________________________ *Leave availed: from ______________ to ______________

B. Individual Particulars
*Onward Journey

Equivalent fare of Railway


Date From To Mode of Travel Ticket No Fare
Ist class A/C by shortest route

*Return Journey

Equivalent fare of Railway


Date From To Mode of Travel Ticket No Fare
Ist class A/C by shortest route
C. LTA Accounting

LTA Entitlement Rs. ______________ LTA Payable Rs.______________________

Permissible expenses for


LTA Payable Rs._____________________
personal tax exemption ____________

*Declaration:

1. I hereby declare that the LTA mentioned in this application has not been availed before. I further declare that
the particulars given hereinabove are true. In case the particulars are found incorrect or if any excess amount is
paid based on my above declaration, the Management is authorized to deduct the same from my salary at any
time.

2. The following members of my family are financially dependent on me.

Name Relationship

____________________
Signature of Employee

NOTES :

a) LTA reimbursement can be claimed only for amount expended on members financially dependent on you.
b) Leave period should be falling in the current financial year.
c) Exemption can be availed only on Rail and Air travel and not on stay or any other mode of travel.
d) Xerox copies of Rail tickets OR Original Air tickets OR Copy of Air Tickets with the Original Boarding pass should
be submitted failing which your claim will be fully taxed.
e) Forms received before 15th will be considered with the current month salary.
f) Submitted documents will be considered for tax exemption. However LTA amount will continured to be paid on monthly
basis.

P.S. Fields which are marked as * are compulsory.

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