Claim form for direct service charges/ IELTS (Annex-1 A)

Examiners Name:

Wajiha Khlail Labar

CNIC No.:

36302-5557743-2

Test Name:

IELTS

Test Dates:

12/6/2014

Invoice Date:
Venue Name and Centre Number:

Sr.

British Council Lahore - PK011

No. of interviews/
Writing Scripts

Description of items

Speaking Interviews

175

Rate
per interview/
Script
(PKR)

Total Amount*
(PKR)

495

86625

495

495

495

Writing T1
Writing T2
Total Writing Scripts

Speaking Jagged
Writing Jagged T1
Writing Jagged T2
Total Writing Jagged
Subsistence Charges

0
23712

23712

Total Amount: One Hundred Ten Thousand Three Hundred Thirty Seven
Rupees

110337

Amount payable in words: One Hundred Ten Thousand Three Hundred Thirty Seven Rupees
*All calculations to be shown separately;
Note: By default, the Cheque will be prepared in the name of the examiner, appearing on the contract letter. In case of changes required for
payees name, an application is required to be attached, along with a copy of CNIC of desired payee.

Examiners Signature

-------------------------------------------------------------For Office Use------------------------------------------------------------Checked By EOO (Name and Signatures)

Mehreen Altaf

Reviewed By EOM (Name and Signatures)

Atif Rauf

Authorised By HOO (Name and Signatures)

Nasar Shakil