4

Date
5

Hour
6

Station
7

Hour
9

10

Class

11

12

Amount
13

14

Rate
15

Amount
16

Daily Allowance

17

Rate
18

Amount
19

Particulars of the deductions should be forth in the remarks column

deduct T.A. refunded as detailed on the reverse.
Net amount marked for payment

* Here enter deductions on account of permanent travelling allowances, conveyance allowances or other deductions.
.

in words

Date
8

By road
Trolley

FOR THE MONTH OF

FEBRUARY, 2015
Actual Expenses

Particulars

Station

Mileage for

Number of KM

Number of fairs

Actual Pay

Headquarter
1

Fair paid

Kind of journey
Railway/Road

Particulars of journey and halts

Name and designation

DEPARTMENT OF AGB

No of days

TRAVELLING ALLOWANCE BILL OF THE ESTABLISHMENT OF

20

Amount
21

Total of each line

Purposes of Journey

Remarks

22

23

24

Contents received
Head of Office