Below Rs.

19,925/-(Rupees Nineteen Thousand Nine Hundred Twenty Five only)

T.R.46
(See Rule 164 (a) of KTC Vol.1)
BILL FOR PAY AND ALLOWANCES / LEAVE SALARY OF A GAZETTED OFFICER
Name of Treasury: ……………….
FOR TREASURY USE
Computer Sequence No. / Token No. : Date:
Scroll No. :
SDO Code : Name : ……………
Designation : G.E.No :
Name of Office : PAN/GIR :

Head of Account : 2202-03-103-99-01 Plan (P) / Non Plan (N) N Voted(V)/Charged ( C) V

MAJ SMJ MIN SUB SSUB CPS / CSS Ratio
Received for the period : 1 / 6 / 2010 To 31 / 6 / 2010
A. Amount due Rate Amount B. Deductions Rate Amount
Pay/Duty Pay 0 0 GPF 0 0
Leave Salary GPF (Loan Recovery)
Special Pay 0 0 GPF (Arrear DA)
Personal Pay GPF (ADA)
Transit Pay Group Insurance 200 200
Dearness Allowances 0 0 State Life Insurance 500 500
House Rent Allowance 150 150 SLI (Loan Recovery)
Recoveries ordered by AG
CCA HBA - 1
DA Arrear HBA - 2
PCA HBA Additional
Special Allowance HBA Interest
Deduct Advance Drawn MCA
MCA Interest
Gross Claim A 21624 150 FBS
Total B 0 0 PLI
Net Balance = A-B Rent
Received Rs. 0 (Rupees Nineteen Income Tax
Thousand Nine Hundred Twenty Four Only) LIC
In Cash / TC to TSB : In Cash Computer Advance
Total B

Station : Signature Stamp

Date : 28.06.2010 Designation

FOR TREASURY USE ONLY

Pay Rs………………………………….(Rupees………………………………………………………………………………….
In Cash / Cheque Rs………………….(Rupees…………………………………………………………………………………..
by RBR and Rs………………………..(Rupees…………………………………………………………………………………..
……………………………………………………………………………..only) by TC
POC No. :………………………….Date :………/…………/……………….

Accountant Treasury Officer

Received by Order Cheque Pay Order Cheque issued by
Signature of Recepient Accountant

Note : Govt. accept no responsibility, for any fraud of misappropriation in respect of money or draft made over to messenger.

Certificate for claiming HRA : I certify that I did not occupy Govt. quarters during the period for which HRA is claimed in this bill.

Date : 28.06.2010 Signature

LIFE CERTIFICATE referred in No.7 : Sri/Smt……………………………………………………………………….is alive

on this ………………………………………(date)

Station :………………………………………………….. Signature :………………………………………..

Date :…………………………………………………… Designation :.........................................................

Space for Additional Certificates

Allotent Details (For PTA, PCA Claim)

Appropriation for current year Rs………………………………………………………………………………
Expenditure excluding the bill Rs………………………………………………………………………………
Expenditure including the bill Rs………………………………………………………………………………
Balance Rs………………………………………………………………………………

Signature of Drawing Officer

DIRECTONS FOR USE :

1. A salary bill may be endorsed to a banker or other recognised agent and submitted for collection through such
Banker or Agent if the Officer desires so.
2. An Officer appointed to the Goivt. Service must furnish a certificate that he has submitted proposals for
SLI (Official Branch), and applied for admission to the GPF as per rules.
3. Income Tax should be deducted as per rules.
4. Leave salary/transit pay should be claimed after getting pay slip from the AG.
5. Copy of LIC/Pay slip should be attached with the bills as per rules.
6. The details of salary encashed should be informed to the head of office with copy of FBS schedule.
7. An Officer who signs his own bills while absent on leave must either present it in person or furnish the above
life certificate, signed by a responsible officer of govt. or some other well known and trustworthy person known
to the Treasury Officer
8. If conveyance allowance is claimed in this biss, a certificate as per rules should be furnished.

FOR THE USE OF AG'S OFFICE

Classifications Details of objection
Debit Chargeable
Credit Head of Account
Total amount of bill Payable……………………………………..Treasury
Admitted Passed for Rs…………………………………………
Disallowed (Rupees for Rs…………………………………………)
Objected, See details of objection
Retrenchment slip No. GA…………………………dated……………………………………
Or objection slip No.………………………………….dated……………………………………
Accountant/CT
AAG
Sr. AO/AO
AAO/SO Dated :
AA AAG
 FORM T.R.104 210416A005
[See Rule 163(1) K.T.C Vol.I ]
Name of the Accounts Office who maintains the Accounts (See Note No. 5) : Accountant General Kerala,Kozhikode Branch.
Name of the Provident Fund : General Provident Fund
Statement showing deductions on account of subscription towards the State/General Provident Fund in the pay bill of the Sri …………………
Office of ……………………………... Officer noted below during December 2009
Details of Receipts

Service Head Account

Serial Number

Account Number

Name of the Subscriber

Salary as on 31st March.

Total Amount (6+9+11)

Subscription Proper Refund of Advance

From……...GO No...
Rate of Subscription

No of Instalments
Month to which it

Month to which it

.
DA Arrears
Amount

Amount
Rs.

relates

relates
Rs.

Dated
Rs.

Rs.
Rs
1 2 3 4 5 6 7 8 9 10 11 12 13

8009-01101-99
Jan.
1 12000 1000 1000 Nil Nil Nil Nil 1000
2010

In Figures Rs. 1000

Grand Total
In words Rs. One Thousand Only Head Office
Certified that a sum of Rs……………………..(Rupees in words)…………………………………………………………………………………………………………………………
has been deducted in the Establishment/Salary Bill of the officer.
Cashed on…………………………
Name of Treasury…………………………………… Treasury Officer

FOR USE IN AUDIT OFFICE

Voucher……………………………….Dated of Encashment……………………20……….
1. Certified that the name shown in column 3,amount of individual deduction (Both subscription proper and refund of advance) and the total amount shown in column 6,9,11 and 12 have been checked w
reference to the bill.
2. For schedules attached with march pay bills, certified that rates of salary / Pay as shown in column 4 have been varified with amounts actually drawn in the bills.
Auditor,Department of Audit Section
 210416A005
.I ]
rala,Kozhikode Branch.

bill of the Sri …………………

Remarks
14

Head Office
…………………………………………………………………………

Treasury Officer

f advance) and the total amount shown in column 6,9,11 and 12 have been checked with

with amounts actually drawn in the bills.

Auditor,Department of Audit Section
 Salary Details of Mr.Binu.C.Kurian, Lecturer in Commerce

Accident Insurance

Dat of Encashment
Festival Allowance

Group Personal
Special Pay

Income Tax
Basic Pay

Arrear DA

Prof.Tax

Tresury
Month

Gross

G.P.F
HRA

GIS

Net
SLI
8-Jun DA 30
8-Jul 150 200
Aug-08 150 1100 200
Sep-08 150 200
8-Oct 150 200
8-Nov 150 200
8-Dec 150 200 50 500
9-Jan 150 5040 200 500
Feb-09 150 200 5131 500 1000
9-Mar 150 200 500
Apr-09 150 200 500
May-09 150 200 500
Jun-09 150 6000 200 500
Jul-09 150 200 500
Aug-09 150 1250 200 500 1000
Sep-09 150 200 500
Oct-09 150 200 500
Nov-09 150 4468 200 50 500
Dec-09 150 200 500
Jan-10 150 200 500
Feb-10 150 200 500
Mar-10 150 200 500
Apr-10 150 200 500
May-10 150 200 500
 STATE INSURANE DEPARTMENT
(LIFE - OFFICIAL BRANCH)
(This form is to be used for State Life Insurance Oficial branch only)
Statement showing deduction on account of premia towards Official Branch Insurance
Fund in the Establishment Pay or Salary Bill of Sri. ...............
......................................................... for the month of Dec.-2009

Month to which
Sl. Amount
Policy Nos. in Serial order Name of Policy holder Designation the premium Remarks
No. deducted
relates

1 Jan.2010 500 -

(Rupees Five Hundred Only) 500 -

Station : ………… Head of Office :

Date 28.06.2010
: /12/09 Designation :

Certified that a sum of Rs…………………………………………has been deducted in establishment or salary bill

cashed on……………………………

Treasury Officer

KERALA STATE EMPLOYEES GROUP INSURANCE SCHEME (GAZETTED OFFICERS)

G.O(P)655 /84 /Fin. Dated 13.11.1984
FORM - B
Schedule of deductions to "811-Insurance and Pension Funds (c) Kerala State Government
Employees" Group Insurance Scheme - 1 - Insurance Fund and 2 savings Fund

1. Month to which the salary bill relates : December-2009

2. Account Number
3. Name of Self-Drawing officer with designation
……………………………….

4. Group : B+5 Units

5. Amount deducted (Rs. In figures and words) : Rs. 200/ (Two Hundred Only)
6. Month / months to which deduction relates : Jan-2010

Place : ………………
: .12.09
Date 28.06.2010 Signature, Name and Designation of Office address
of the Self Drawing Officer