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    Claim Form

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    Archit Srivastava
    The document is a travel allowance/claim form for the Indian Institute of Technology Indore. It collects information such as the applicant's name, designation, pay level, budget head to charge expenses to, advance drawn if any, claimed travel fares with copies of tickets, local conveyance charges with dates and distances, and reimbursement of hotel/food bills with dates and amounts. The form is to be signed by the applicant and then processed by finance office staff including passing the claim for payment.

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    Claim Form

    Uploaded by

    Archit Srivastava
    61 views2 pages
    The document is a travel allowance/claim form for the Indian Institute of Technology Indore. It collects information such as the applicant's name, designation, pay level, budget head to charge expenses to, advance drawn if any, claimed travel fares with copies of tickets, local conveyance charges with dates and distances, and reimbursement of hotel/food bills with dates and amounts. The form is to be signed by the applicant and then processed by finance office staff including passing the claim for payment.

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    The document is a travel allowance/claim form for the Indian Institute of Technology Indore. It collects information such as the applicant's name, designation, pay level, budget head to charge expenses to, advance drawn if any, claimed travel fares with copies of tickets, local conveyance charges with dates and distances, and reimbursement of hotel/food bills with dates and amounts. The form is to be signed by the applicant and then processed by finance office staff including passing the claim for payment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    61 views2 pages

    Claim Form

    Uploaded by

    Archit Srivastava
    The document is a travel allowance/claim form for the Indian Institute of Technology Indore. It collects information such as the applicant's name, designation, pay level, budget head to charge expenses to, advance drawn if any, claimed travel fares with copies of tickets, local conveyance charges with dates and distances, and reimbursement of hotel/food bills with dates and amounts. The form is to be signed by the applicant and then processed by finance office staff including passing the claim for payment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Form: R7

    INDIAN INSTITUTE OF TECHNOLOGY INDORE


    TRAVELLING ALLOWANCE /CLAIM FORM
    (To be printed on back of Form R6)

    1.Name of the Applicant:__________________________


    2.Designation & Discipline/Unit :__________________________________________3.Pay
    level:___________
    Institute Name (In case of external members)…….............................………..
    ………………………………………
    Budget Head (to which TA/DA is to be debited)………..……………..........…………….........................…
    Amount of advance drawn, if any ......................................................Tour report : Enclosed/Not enclosed

    4. Claimed fares(Air /Rail/ Bus) (Copy of tickets and boarding pass, where applicable, be enclosed):
    Departure Arrival Train Fare
    Mode & Class of Journey
    Date /Flight
    Date & (Rail/ Road/ Air & IAC/II
    Place & Place No. & (Rs)
    Time AC/ II AC/ Economy etc.)
    Time PNR No.

    Total Fare (Rs)

    5. Details of local conveyance charges:


    Place visited/travelled Mode of
    Travel -
    Statio Fare
    Date Distance (KM) Taxi/ Remarks
    n From To (Rs)
    Auto/Othe
    r

    Total Local Conveyance (Rs)


    a. Certified that I have travelled by the class and mode of conveyance as indicated above.
    b. Certified that amount claimed above has been actually been spent by me.

    6. Reimbursement of hotel/food bills:


    Hotel Sr. Bill Amount
    Sr. No Date Amount (Rs) Date
    details No details (Rs)

    Total (Rs)

    Reimbursement of meals/food charges while on official tour on will be made on declaration basis
    within applicable limit.

    Signature of the Applicant


    _______________________________________________________________________________________
    (FOR FINANCE OFFICE USE)

    Claimed Rs……………………………………………..
    Disallowed/Added Rs …………….……………………….
    Passed for Rs ……………………….…..…………………

    Jr. Assistant Sr. Assistant/Superintendent AR/DR/JR


    Registrar

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