A/c.

7a

CLAIM FOR REIMBURSEMENT OF TRAVELLING/CONVEYANCE EXPENSES

Name : Date
R. :
Shyam Sundar

Form No

I declare that I have incurred the following expenses in connection with official duties :-
Travel For Project Mode of Fare(s)
Date(s) Details of Travel / Conveyance
Name of Ship or Works Visited e.g.
/ Train,
Visit to Clients Bus, Taxi, Rs. P.
Auto etc.

02/04/2018 HCC-KOL-
BOGIBHEEL-
14016281
18/05/2018 HCC-KOL-
BOGIBHEEL-
14016281
18/06/2018 GEN PRJ-KOL

TOTAL : 7270 0

CHARGEABLE TO CLIENTS Rs. CHARGEABLE TO IRS / IRQS / IRSIS Rs.

Certified that the above trip(s) were for IRS / IRQS / IRSIS WORK

Signature of the Certifying Authority Signature of the Claimant

RECEIPT Received the above amount

Date :

FOR OFFICE USE ONLY

Verified By : By :
Checked