INDIAN INSTITUTE OF TECHNOLOGY BONIBAY
(at new rates 6'h cpc) To be filled by Admn. Section
Sr. No. of TA Inward Register
Date of Receipt
NAME: DESIGNATION: Salary Code:
Grade Pay: Rs.
Amount of Advance drawn, if any : Rs.
Ceoified that I was on tour from (dt.) to (dt.) for the purpose of
and that I traveled
by the class and mode of conveyance as indicated
below:
1. Claimed fares (Air/RatBus):
Depanure Arrival Mode of Journey Class of PNR No.(if Fare in Trail
Rail Road Rail / Journey applicable) R.. Flight No.
Bus Air/Rail Bus
Place Date & Time Place Date & Time
2. Details of Local Conveyance charges incurred:
Date Station Place visite aveled Distance Mode of travel Fare in Remarks
T Auto Rs.
From To
3. Hotels/Guest House charges incurred
5tatio Name of HotelPeriod of Stay No. of Mode of Remarks
n Days TAutoRs.
travel
4. Reimbursement of Food 8ills
Sr. No. Date Amount in Rs. Sr. No. Date Bill Details Amount in Rs.
5. Further paniculars required to be furnished Replies
a i) Whether you availed of Saturday,Sunday & holidays or any leave during
the days of halt? ii) If yes, please give details about the period and date:
b Ii Whether the EA. is to be borne by IIT Bombay/ProjecUAny other Budget Head:
source? Please give Expenditure Budget Head. if applicable:
6. Summary of Claimed Amount : in Rs. To be completed by the Official To be filled by Office
i (a) Fare
(b) Conveyance Charges
(c)HoteF'Accommodation Charges
(d)Fo Boarding Charges
(e) Other claims (details to be furnished)
Total
Less:Advance Taken on dt.:
Net Amount
Countersigned
DIRECTOWDEAN (R & D) / REGISTRAR H.O.D.
Forwarded herewith T.A. Claim for necessary action
Admn.
To : Accounts Secñ on
Admitted for Rs.
for Rs.
Disallowed / Added Rs.
Asstt. Registrar
(Audit)
Passed for Rs.
(F & A)