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LTC Claim Form

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48 views

LTC Claim Form

Uploaded by

13ndrfrrcsrinagar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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G.A.R.

14-C
Sub-bill No………

LEAVE TRAVEL CONCESSION BIL


FOR THE CALENDAR YEAR 2023-24

(Note.- this bill should be prepared in duplicate – one for payment and the other as office copy)

PART – A(To be filled by the Government servant)

1. Name : G/5023141 J P Pal 2. Designation : Ct/Gd

3. Pay : 33300 /- Level: ( 4 ) 4. Headquarters :13th BN NDRF

5. Nature and period of leave sanctioned: - 20 Days EL


Nature of leave __20 Days El_from _14.07.24 to 04.08.24 Particulars of members of family
in respect of whom the Leave Travel Concession has been claimed.
Sl. No. Name Age Relationship with the Govt. Servant
(a) J P PAL 35 Self

6. Details of journey(s) performed by Government servant and the members of his/her family.

Departure Arriva Distanc Mode No. Fare paid Remarks


l e in of of
Date From Date To kms travel fares
& &
Time Time
ONWARD JOURNEY

13.07.2024 13 Bn HQ 13.07.2024 Ludhiana Railway 16 Km By Govt - - -


1235 Hrs Ludhania 1335 Hrs Station Bus

13.07.2024 Ludhiana 13.07.2024 New Delhi 312 Km By Train 01 1055.75 Ticket


1932 Hrs Railway Station 2300 Hrs Railway Station Attached
14.07.2024 New Delhi 15.07.2024 Lumding Station 2055 Km By Train 01 4150.75 Ticket
1620 Hrs Railway Station 2240 Hrs Attached

16.07.2024 Lumding Station 16.07.2024 Diphu 32 Km By Train 01 540.75 Ticket


0002 Hrs 0045 Hrs Attached

16.07.2024 Diphu 16.07.2024 (Home Town) 20 Km By Private - - -


0100 Hrs Mohongdigua Veh

RETURN JOURNEY

One Side Claim Only

Total Rs. 5747.25/-

(Rupees Five Thousand Seven Hundred Forty Seven) only

7. Amount of advance if any drawn : NIL

8. Particulars of journey(s) for which higher class accommodation then the one to which the
Government servant is entitled, was used. (sanction No. &Date to be given).

Place Mode of Class to Class by No. Far


From to Conveyanc which which actually of e
e entitled travelled fares pai
d

9. Particulars of journey(s) performed by road between places connected by rail:

Name of Class to which Rail


place entitled fare
Fro To
m
Contd…...........2/-
2

Certified that the :-

(a) The information as given above is true to the best of my knowledge and belief; and

(b)................................................................................... That my husband/wife is not


employed in Govt service/that my husband/wife is employed in Govt service and the
concession has not been availed of by him/her separately or himself/herself or for any of the
family members of the concerned block of...........................year.

Dated:……/….../2021 Signature of Government servant

PART – B(To be filled in the bill Section)

1. The net entitlement on account of leave travel concession works out to Rs........./-
(Rupees…......................................................................................................................) only as detailed
below:-

(a) Railway/Air/Bus/Taxi fare : Rs.

(b) Less amount of advance drawn :


Rs. vide Voucher No………………………..….. Dated……………..

Net amount : RS.

(Rupees…...................................................................................................................................) only

2. The expenditure is debit able to 14.01.01 Salaries FY-…………………….

Initials of Bill Clerk


Signature of Drawing
and Disbursing Officer

COUNTERSIGNED

Controlling
Officer
(Signature)

Certified that necessary entries have been made in the Service Book of No…………..
…………………..
……………………………………………………………………….

Signature of the Officer


authorized to attest
entries in the Service
Book

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