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T. R. FORM NO.

66

[See T.R. 8.17(1)]


ACQUITTANCE ROLL
(Payment of Salary by Cash)

Acquittance Roll of Permanent (or Temporary) Establishment of


…………………………………………………… for pay or

Dated signature (with


Item Name Designation Net amount stamp where
No. payable necessary, unpaid items
to be noted as such and
attested)
Rs. P.

Total unpaid
Total Rs……………..
Rupees
……………………….

Passed for
Rs……………………………………………….(Rupees……………………………..) on
the authority of Establishment Bill of

(in figures) (in words)

…………………..for ………………………..

Cashier
Drawing Officer

105

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