Temporary duty claim of TA/DA

Authority: HRI / 3 /12.

Employee No: Name: Designation: Unit:

Details of duty: *Travelled by : Road/ Air.

Company Vehicle: * Shared/Independent * Delete whichever is inapplicable.

Date Left on Time Date Arrived on Time

Upward Journey:

Downward Journey:

Claims: Rs Paisa

 Car maintenance for______kilo meters @ Rs 5 per km.

 DA for______days @ of Rs ______ per day.
 Fuel expenditure of ____ liters @ of Rs_____ per litre.
 Room rent for ____days @ of Rs________ per day.
 Fare for upward travel by air /road.
 Fare for downward travel by air/road.
 Entertainment.

Total:

Signatures of:

Claimed by:______________________Auditted by___________________ Approved by: ______________________________