SPS-201

(In triplicate)
FORM ‘C’
Annexure-II
For Adjustment of Cash Advance/Advance of Cheque/for payment by Cheque/ NEFT
(Please Tick)
20 - 20 S.No.___
Deptt. Code (Financial year)

INDIAN INSTITUTE OF TECHNOLOGY : DELHI

SUMMARY SHEET
CONSUMABLE STORES
Name of Official who drew Advance : (Buyer) ______________________________________________

Emp. Code _________________________ Advance Amount Rs. _____________________________

Department/Section ___________________________ Project Code ___________________________

Budget Head _____________________________ Sanction No. (if any) _________________________

Sl. Name, Address of Supplier

Description of items Qty. Rate Amount
No. CM/Bill No. & Date

Total 0.00

P.T.O.
 Certified that the items of this sheet have been For Adjustment / For Payment
procured by me in good condition. Passed for Rs. _________________________
Deduction to be made Rs. ________________
On A/C of ____________________________
Sign. of Buyer (s) Already paid Rs. _______________________
Name (s) Balance now payable Rs. _________________
(in words) _____________________________
E. Code (s)
______________________________________

By Cheque/ NEFT directly to vendor/through

Sign. of Store Keeper (Name ________________________________)
Sign. HoD/PI
E. Code :
HoD/Nominee to sign after ensuring that S.No. as put at the top of the previous page is in order.

Sing. Of HoD or nominee

IRD A/Cs/Main Accounts/Audit/Stores

ISSUE RECORD

Quantity Issued to Sign.

Date Particulars of items Balance Name &
Received Issued E. Code