TA/DA Claim Form

Name:

Designation:

BigBirdGroup/HR- 020
Rev. 00 Oct 3, 2011
Grade:

Department: ________________________________ Visiting Location: ______________________

Brief Visit Report: ....................................

...
...
Departure: date: _______________ time: ______ am/pm. Return: date: ________________time _______am/pm
Note: Attach a copy of Approved Travel Authority.
Sr. #

Description / Expense Detail

Total DAs:

Fuel-Mileage/Fare Tickets:

Hotel Bills or Night Stay Allowance:

Other Expense:

Amount

Total Tour Expense Rs.

Advance Rs.
Total Payable/Refundable Rs.

Total Expense (in words) .

...
___________________
Claimant Signature)

___________________
Auditor

____________________
Department Head

______________________
Chief Accountant

TA/DA Claim Form

Claim(s) over & above of Rs. 25000/- needs MDs approval.

BigBirdGroup/HR- 020
Rev. 00 Oct 3, 2011