H.P.T.R.
7
TRAVELLING EXPENSES CLAIM FORM
1. Establishment :______________________________________________ Month : ____________ 2006.
2. Name & Designation : ___________________________________________________________________
3. Basic Pay : ____________________________ Head Qrs : _________________________________
4. Purpose of Journey :_____________________________________________________________________
………………………………………………………………………………………………………………………….…
DEPARTURE ARRIVAL Km./ Rate/ Actual DAILY ALLOWANCE TOTAL
Station
Date Station Date Mode Class of Fare Hotel No. Rate Amount OF
& & of Travel Paid charges of Days Admiss- LINE
Hour Hour Travel (if any) ible
1 2 3 4 5 6 7 8 9 10 11 12
……………………………………………………………………………………………………………………………………………
GRAND TOTALS
( DETAILS OF THE CLAIM)
1. Total of column no. (B. F.) Rs. : ______________________________
2. Terminal Transportation Charges Rs. : ______________________________
3. Local Transportation Allowance Rs. : ______________________________
4. Transfer Grant Rs. : ______________________________
5. Personal Effects
Wt. ______________ Rate : __________ Amount Rs. : _____________________________
6. Conveyance Charges Rs. : _____________________________
7. Miscellaneous ( Specify ) ____________________ Rs. : _____________________________
8. GROSS AMOUNT Rs. : _____________________________
9. Less Advance of TA / TTA drawn vide
T/V No. __________________ Dt. ___________ Rs. : _____________________________
10. NET AMOUNT PAYABLE Rs. : _____________________________
( Signature of Claimant )
Passed for Rs. _________________________ ( Rupees ) ___________________________________
( Signature of Controlling Officer ) ( Signature of D. D. O. )
…………………………………………………………………………………………………………….
( TO BE USED IN AUDIT OFFICE )
Admitted for Rs. : ___________________________________
Objected to Rs. : ___________________________________
Reason for Objection : ______________________________________________________________
( Accounts Officer )
………………………………………………………………………………………………………….
INSTRUCTIONS
1. Tour Diary should invariably be attached with the claim.
2. In case of Transfer claim , the details of members of the family with age along with
details of personal effects be given.
3. The Receipt Nos. of Hotel and carriage charges bills be quoted against the relevant
column.
4. Ticket Nos. should be quoted , when journey are performed in a class higher than the
Ordinary class.
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