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CERTIFICATE

1. Certified that I did not perform the road journey for which mileage allowance has been claimed as higher rate prescribed
by taking a single seat in any public conveyance (including a steamer) which plies regularly for hire between fixed point
and charge fixed rates. I also certify that journey was not performed any other vehicle without payment of it hire charges
or including expenses.
2. Certified that I actually travelled in the class of accommodation for which rail fares have been claimed.
3. Certified that staff car was not available.

signature ...............................
Date: Designation .................................
Delete whichever is not applicable ।
Controlling officer’s certificate for hire road mileage etc.

Certified that journey by road between place connected by rail where performed in the interest of the company and to
save time. Higher road mileage allowed which prior approval of the controlling Officer

Date: Signature of controlling Officer

Space for other certificate

For use in Account Offices

CO 6 No :
Amount admitted Rs :
Deduction :
Net amount payable Rs. :
Amount (in words) :
Accounts Officer
Checked to be drawn in favour of ................................................................................................................................................ ……………………
Rs.........................................................................................................( Rupees………………………………………………………………………………………….

Accounts Officer
Classification

Bill No. .......................................... Net Amount Passed ......................................................... Unit ........................................

Major Head Sub- Major Head Detailed Head Amount (Rs.)

Auditor Superintendent Account Officer