ROLL NO.

______________________

BHARAT ELECTRONICS LIMITED

CORPORATE OFFICE
OUTER RING ROAD, NAGAVARA,
BANGALORE 560 045

T. A. CLAIM
TA Claim of Shri / Smt ________________________________________ for attending the
Written Test on ______________________ for the post of Probationary Engineer.
DEPARTURE
DATE

TIME

ARRIVAL

PLACE

DATE

Certified that the candidate

appeared for the Test / Interview
on ____________________

TIME

PLACE

DISTANCE
KMS.

FARE
RS.

CLASS

Signature of the Claimant

Name

Address

TICKET/
RECEIPT NO.
(to be enclosed)

INVIGILATOR / AUTHORISED REPRESENTATIVE

(FOR THE USE OF ACCOUNTS DEPT ONLY)

Rs._____________________
TA claim passed for payment for Rupees _____________________________________________
______________________________________________________________________________

TA Claim passed by

FINANCE OFFICER IN-CHARGE

Received payment

(Signature of the Candidate)