Scribd
Upload
90 views1 page

LTA Claim Form

This document is a Leave Travel Allowance (LTA) claim form for employees to report travel expenses eligible for LTA. It requires details such as employee information, dates of leave, travel destinations, and relationships of accompanying travelers. The form must be signed and submitted with supporting documents, and it outlines the rules for claiming tax exemptions on LTA for journeys within a specified block of years.

Uploaded by

Akky Patel
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
90 views1 page

LTA Claim Form

This document is a Leave Travel Allowance (LTA) claim form for employees to report travel expenses eligible for LTA. It requires details such as employee information, dates of leave, travel destinations, and relationships of accompanying travelers. The form must be signed and submitted with supporting documents, and it outlines the rules for claiming tax exemptions on LTA for journeys within a specified block of years.

Uploaded by

Akky Patel
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
You are on page 1/ 1

LEAVE TRAVEL ALLOWANCE (“LTA”)

Employee Code :

Employee Name :

This is to confirm that I have spent a sum of Rs _________ (Rupees ________________


_____________________________________________________ only), which is eligible for LTA.

The details are as follows:


Dates of leave taken (from/to) : _______________________________________

Place of origin of journey : _______________________________________

Place of destination : _______________________________________

Dates of travel : _______________________________________

LTA Claimed Since January 2022 : ______________________________________


(No of Times, Including previous employer)

Details of persons traveled:

Relationship with Mode of Journey fare in


Name me Dependence Travel (Air Rupees
(Y/N) / Train /
Bus/Private
Vehicle )
1. Y Train
2. Y Train
3. Y Train
4. Y Train
5. Y Train
6. Y Train
Total 0
The travel vouchers ( ) are attached herewith.

Signature : ________________________

Date : ________________________
Notes :
1. This Form must be duly filled, signed and should accompany the original supporting.
2. LTA can be claimed exempt from income-tax only in respect of two journeys performed in a block of four
calendar years. The current block of four years is Jan 2022 – Dec 2025.
3. The travel cost eligible for exemption should be for the shortest route to any place in India.
4. Please confirm the year in which exemption was last claimed by you.
5. Supporting document for fare amount for the shortest route
6. “Family” in relation to an individual, means
(i) Spouse and children; and
(ii) Parents, brothers and sisters wholly or mainly dependent on the individual.
------------------------------------------------------------------------------------------------------------------------

Name & Signature

You might also like