GANGA INSTITUTE OF TECHNOLOGY & MANAGEMENT, KABLANA, JHAJJAR

EXPENSES REIMBURSEMENT / ADVANCE FORM

NAME:

DEPARTMENT:

DESIGNATION:

PURPOSE:

FOR OUTSIDE EXPERT

SR.
DATE OF VISIT ACTIVITY DEPARTMENT AMOUNT
NO.

TRAVELLING ALLOWANCE IF ANY

DISTANCE
SR. DATE OF PURPOSE OF MODE OF IN KM (TO
NO. VISIT FROM TO JOURNEY JOURNEY RATE AMOUNT
& FRO)

CASH PRIZE/AWARD/REIMBURSEMENT
FDP/CONFERENCE/ INDEXING
TITLE OF FDP/ CASH PRIZE PLACE
PAPER TITLE OF PAPER OF
SR. CONFERENCE/ / WAIVER OF
PUBLISHING/PATENT/ PUBLISHED/ BOOKS JOURNAL/
NO. PATENT VISIT
PURCHASE OF BOOKS PURCHASED CONFERENCE AMOUNT

DAILY ALLOWANCE, IF ANY

PLEASE SPECIFY (IF NOT COVERED ABOVE):

NET AMOUNT PAYABLE:

APPLICANT SIGNATURE: HOD SIGNATURE:

DIRECTOR
APPROVED / NOT APPROVED

FOR OFFICE USE ONLY

The amount Rs. verified and paid for the above said purpose.

ACCOUNTS DEPTT.