H.P.T.R.

7
TARVELLING EXPENSES CLAIM FORM
1. Establishment GSSS BHUTHI. MONTH :- OCT,
NOV

2. Name & Designation. : DEVINDER SINGH TGT (NON.MEDICAL)

Head Qrs: GSSS
3. Basic Pay. 41600.00 BHUTHI

4.purpose of journey:- TO CONDUCT GENERAL ASSEMBLY

ELECTION 2022

Ho TOTA
DEPARTURE ARRIV Km Rat L
Act tel DAILY
AL ./ e/ O
ua Ch ALLOWANCE Amou
Station D Mo Cla f
D l arg nt
Station at de ss NO. Rate LI
at Fa es
e Of of Of Admi N
e re (i
& Tra Tra Days ss- E
& Pa f
H vel vel Ible
H id a
o
o n
ur
ur y
)
1 2 3 4 5 6 7 8 9 1 11 12
0
BHUTHI 25.10.11. MANALI 25.10.22. BY 120 1 70% OF 50 170.00
4PM 7PM BUS 72

HALT AT MANALI FROM 25.20.22, 7PM To 1 180 180.00

2710.22 ,7AM 180/day

MANALI 27.10.22. BHUTHI 27.10.22 BY 120 1 70% OF 50 170.00

7AM 10AM BUS 72

BHUTHI 03.11.22 MANALI 03.11.22. BY 120 1 70% OF 50 170.00

4PM 7PM BUS 72

HALT AT MANALI FROM 03.11.22 ,7PM TO 1 180 180.00

05.11.22 ,7AM 180/day

MANALI 05.1122. BHUTHI 05.11.22 BY 120 1 70% OF 50 170.00

7AM 10AM BUS 72

BHUTHI 07.11.22 MANALI 07.11.22. BY 120 1 70% OF 50 170.00

4PM 7PM BUS 72

MANALI 08.11.22. ANNI 08.11.22. BY - - - - -

10AM 7PM GOVT
BUS
HALT AT ANNI WEF 08.11.22 TO 09.11.22 2 180 360 360.00

ANNI 10.11.22. NIGAN 10.11.22.BY - - - - -

6PM 6:30PM GOVT
BUS
HALT AT POLLING STATION NIGAN W.E.F 3 180 540 540.00
10.11.22 TO 12.11.22 GENERAL ASSEMBLY
ELECTION
NIGAN 12.11.22 GDC 12.11.22 BY - - - - -
9 PM ANNI 9:30PM GOVT
BUS
GDC 13.12.22 KULLU 13.11.22 BY - 1 180 180 180.00
ANNI 11AM 8PM GOVT
BUD
KULLU 14.11.22 BHUTHI 14.11.22. BY 20 20 20.00
10AM 10:30AM BUS

TOTAL 620.00
 (DETAIL
S OF THE CLAIM)
1. Total of Column no. 12 (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. G R S S AMOUNT Rs
9. Less Advance of TA/TTA drawn vide
T/V No………………….Dt………….. Rs…………………………………………………...
10. N E T A M O U N T 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)
INSTRU
CTIONS
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 journeys are performed in a class higher than the ordinary class.
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