Sub Bill No………………………….. G.A.

R-14 A{See Rules 66(1)&90(1)(1)}

TRAVELLING ALLOWANCE BILL FOR TOUR

Note: - This bill should be prepared in duplicate one for payment and the other as office copy.

1. Name : Basant Kumar Roy

2. Designation : ASI(Min)
3. Pay : 38100/-
4. Headquarters : Pers-I Branch, SSB, FHQ, New Delhi.
5. Detailed and Purpose of journey (s) :- To attend 7th Cash & Account Course w.e.f
11/02/2019 to 16/03/19

6. UIN : 14160895

PART A (To be filled by government servant)

Departure From Arrival TO Mode of Fare paid Distance in Duration of Purpose of
Date & Date & travel Rs. Kms days journey
Time Time

1 2 3 4 5 6 7 8 9
09.02.19 SSB FHQ 09.02.19 Old Railway By Auto 200 21 -
1800 hrs 2100 hrs station Delhi

To attend 7th Cash & Accounts Course w.e.f.

09.02.19 Old R.S 10.02.19 R.S. Amb By Train 655 399 Km -
2250 hrs Delhi 0830 hrs
10.02.19 R.S. Amb 10.02.19 CTC SSB By Bus 200 45 KM
0900 hrs 1100 hrs Sapri/
Aman Guest

11.02.2019 to 16.03.19
House
Halted at Aman Guest House, Jawalaji w.e.f 10.02.2019 to 16.03.19
(Total 36 Days)
16.03.19 CTC SSB 16.03.19 Railway St. By Bus 200 45 Km -
1830 hrs Sapri/ Aman 2000 hrs Amb
Guest
House
16.03.19 Railway St. 17.03.19 Old By train 655 399 Km -
2015 hrs Amb 0530 hrs Railway St.
Delhi
17.03.19 Old Railway 17.03.19 SSB FHQ By Auto 150 21 Km -
0615 hrs St. Delhi 0830 hrs New Delhi

1. Mode of journey:-
i) Air
ii) Rail
a) Whether travelling by mail/express/ordinary train. Yes/ No
b) Whether return tickets available Yes/ No
c) It available, whether return tickets Purchased. If not, state reason.

iii) Road
Mode of conveyance used i.e by Govt/transport/by taking a taxi a single seat in a bus or
other public conveyance/by sharing with another Govt. servant in a car belong to him or
to a third person to be specified.
2. Date of absence from place of half on account of :-
A) R.H and C.L
B) Not being actually in camp on Sunday and holidays.
3. Dates on which free board and /or lodging provided by state of any organization
financed by state funds.
 A) Board only
B) Lodging only
C) Board and lodging.
4. Particulars to be furnished along with hotel receipts etc. In cases where higher rate of
D.A is claimed for stay in hotel/other established providing board and or lodging
schedule tariffs.-

Period of stay Name of the Hotel Daily rate of Total Amount

from to lodging/boarding paid
charged
1 2 3 4 5
10.02.19 16.03.19 Aman Guest House, Rs 500/- per day Rs. 36000/-
Jawala ji lodging and (36 days x1000)
Fooding Rs. 500/- per
day

5. Particulars of journey (s) for which higher class of accommodation than the one to which
the Govt. servant is entitled was used.
Date Name of place Mode of Class to Class by Fare of the
conveyance which which entitled class
from To used entitled travelled

1 2 3 4 5 6 7

- - - - - - -

6. Details of journey (s) performed by road between places connected by rail-

Date Name of Place Fare Paid

1 2 3 4
- - -

7. Amount of T.A advance if any drawn:- NIL

Sig. of Applicant
Name:-Basant Kumar Roy
Rank ASI/Min
 CERTIFICATE

Certificate in respect of T.A claim of UIN-14160895, ASI/Min Basant Kumar Roy, SSB FHQ New
Delhi for the journey from 09.02.2019 to 16.03.2019 and back.

Certified that:-

1. T.A advance was drawn for the journey.

2. No advance was drawn for the journeys.
3. The claim has not been made before.
4. I traveled by the class of accommodation for which travelling allowance has been claimed.
5. I was not provided by any means of conveyance at Govt. expenses.
6. The journey was not performed in a conveyance of or which I did not incur charge of propulsion.
7. I did not perform road journey for which mileage allowance has been claimed at higher rate
prescribed in supplementary rule 45 by taking a single seat in a public vehicle which plies
between fixed points and charged fix rates.
8. I actually traveled by Mail/Express train as shown in a bill.
9. The road mileage has been claimed only for the places not connected by rail. Where however the
same are connected by rail the claim has restricted the rail mileage.
10. The distances shown in the bill are correct to the best of my knowledge and belief.
11. No railway warrant was issued.
12. D.A. in respect of halts at a station has been claimed for the performance of duties which were
necessary.
13. I was not provided free boarding or lodging at the expenses of the state for the days for which full
rate of DA has been claimed in the bill.
14. I was actually and not merely constructively present the camp for the days the DA is claimed.
15. I did not avail myself of any casual leave during the period for which DA is claimed.

Sig. of Applicant
ASI/Min Basant Kumar Roy
UIN-14160895
 Undertaking

I, UIN 14160895 ASI(MIN) Basant Kumar Roy posted at Force Hqr SSB
New Delhi, was reported at CTC SSB Sapri to attend 7th Cash & Accounts Course
scheduled w.e.f. 11.02.19 to 16.03.19 held at CTC SSB Sapri and stayed out of campus at
Aman Guest House, Jawala ji for the period 10.02.19 to 16.03.19 total 36 days and paid
Rs. 36000/- (Rupees thirty six thousand) only for lodging and fooding.

(Basant Kumar Roy)

Asstt Sub Inspector (Min)
UIN 14160895

Undertaking

I, UIN 14160895 ASI(MIN) Basant Kumar Roy posted at Force Hqr SSB
New Delhi, was reported at CTC SSB Sapri to attend 7th Cash & Accounts Course
scheduled w.e.f. 11.02.19 to 16.03.19 held at CTC SSB Sapri and stayed out of campus at
Aman Guest House, Jawala ji for the period 10.02.19 to 16.03.19 total 36 days and paid
Rs. 36000/- (Rupees thirty six thousand) only for lodging and fooding.

(Basant Kumar Roy)

Asstt Sub Inspector (Min)
UIN 14160895