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Bill For Reimbursement of Travelling Allowance/ Honorarium/Other

This document is a bill for reimbursement of travel expenses including travelling allowance, honorarium, and other expenses. It requests personal details, purpose of travel, travel dates and distances, mode of transport, and fare paid. Fields are also included for certifying travel details and bank information for electronic funds transfer.

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Rihlesh Parl
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90 views1 page

Bill For Reimbursement of Travelling Allowance/ Honorarium/Other

This document is a bill for reimbursement of travel expenses including travelling allowance, honorarium, and other expenses. It requests personal details, purpose of travel, travel dates and distances, mode of transport, and fare paid. Fields are also included for certifying travel details and bank information for electronic funds transfer.

Uploaded by

Rihlesh Parl
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BILL FOR REIMBURSEMENT OF TRAVELLING ALLOWANCE/

HONORARIUM/OTHER

FULL NAME: ____________________________________ DATE: ______________________

DESIGNATION: ______________________________________________ E-MAIL ID: ____________________


NAME OF INSTITUTE AND ADDRESS: _______________________________________ MOBILE NO: _______________

__________________________________________________________________________________________________

PURPOSE OF JOURNEY: _____________________________________________________


Date of Distance Mode of Journey Fare Paid
(A) TA Journey From To (km) (By Car, Bus, Train, Class Remarks
Air)
NA

Total (A)
(B) Honorarium No of days Rate per day Total (B)
/Other:
(If applicable)
Gross Total Rs:
(A)+(B)

This is to certify that:


1) I have travelled by Railway _____________class. (Attach copy of Rail Ticket.
2) I have travelled by Air & the air fare claimed is limited to Economic class air fare. (Please attach copy of air ticket & boarding
pass)
3) I have travelled by my own car with vehicle No.________________________ (petrol/ diesel/ CNG) vehicle
(Fill appropriate fuel mode and attach copy of R/C book.)
4) I have travelled by public road transport. (Attach actual ticket)
I confirm that this amount is not claimed elsewhere and if it is found, I undertake to refund the same to the University.
Received
Bank information for Electronic fund transfer
Bank Name: Branch & Branch Code: A/C Type (SB/CB)
A/c No. (Full digits) IFSC Code:

The above information provided by me is correct. Any consequences arising due to wrong information is solely mine.

Signature:
Name:

CERTIFICATE

I hereby certify that above details are correct and I am a resident of India and that the provision of the Income tax-act 1961 is
applicable to me and I shall comply with it.

Date: Signature of Examiner:

FOR OFFICE USE ONLY

Passed for Rs.____________________ (in words ______________________________________________) Date: _______________


INSTITUTE UNIVERSITY

Clerk H.O.D. Principal (Sign. & College Stamp) Controller of Examination Account Officer

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