TOUR TRAVELLING ALLOWANCE CLAIM Expense Report No.

: 1000006360 Date : 19-01-2017

Employee Number Tour Commencement Date Destination

60003346 31-12-2016 Dharmapuri

Name : Sengazhani Saravanan Designation / Level : ET / ET

Scale of Pay : 24900.00 - 50500.00 Basic Pay : 24900.00 Mobile No.

Department : Trainees Head Office : Corporate centre

Note : Cheque drawn in favour of Powergrid must be inclosed if net claim is negative by more than Rs.200

Amount Claimed

1. Journey Fare (Ticket booked by Self) 1515

2.Journey Fare (Tkt booked by Co.) 0
3. Journey Fare (Tkt Booked by Co. Fin. Adj.) 0
4. Accommodation Charges 0
5. Daily Allowance 0
6. Conveyance & Misc. Charges 450
A. Total 1 to 6 1965
7. Less (Tkt Booked by Co. {2+3}) 0
8. Less Other Deduction (If any) 0
9. Less Advances Drawn 0
B. Gross Claim (A-7-8) 1965
C. Net Claim (A-7-8-9) 1,965

Claim Date: ........................ Pay Rs. ...............................Net

D. Refund by Cheque Recovered Rs............................

Cheque No. ................................. Dated ................................
on .................................................for Rs. ............................... Accountant AO/SAQ

Section-II Details of Miscellaneous Expanses incidental to Tour (Rule 5.4 & 5.19)
Note: Enclosed receipts for amount claimed.

S.No. Particulars of Expenses Amount

* The cancellation of booking was due to official reasons

Total

Signature of head of Department

Name
Date Designation

Tour Approval enclosed *To be filled furnished when cancellation charges are claimed
SECTION-II: JOURNEY DETAILS (Please indicate Ticket No. or attach M/R. wherever fare claimed is for other than IInd class and for air journeys and bus journeys enclose used
ticket/folder.)
Departure Arrival Mode Class
Train/Flight
S.No. of of Ticket No. Remarks Amount
Date Time Station Date Time Station No.
travel travel
06:00:0 SECO
1 31-12-2016 21:55:00 OFFICE 01-01-2017
0
OFFICE TRAIN
ND AC
17236 4127271169 1515.00
Total : 1515.00
Note: Where tickets are provided by the company the fare may be indicated in Remarks column.
SECTION-IV : DETAILS OF CLAIM FOR DA & EXPENDITURE INCURRED FOR ACCOMODATION (RULE 5.3)
(Excluding leave availed).
Daily Allowance

S.No. Type of City Station Accommodation type No. of Days Remarks Amount

Total : 0
Accomodation

No. of Taxes/Other
S.No. Type of City Station Accomodation type Occupancy Name of Hotel Room Tarrif Receipt No. Amount
Days Charges

Total : 0
NOTE: Please enclose the supporting bill & receipt for the amount paid on account of hotel/guest house accommodation charges
1. Leave availed (if any) at ........................................... from ................................................. to ...............................................
2. Both Boarding and lodging/Boarding only/Lodging only was provided free of cost at ................................from.....................
to.............................
SECTION-V : DETAILS OF CONVEYANCE CHARGES CLAIMED (RULE 5.2)
Place of Visit Distance in
S.No. Date Station Means of Travel Purpose Receipt No. Amount
From To Kms

KOVILPATTI
MOVING FOR
001 31-12-2016 JOURNEY KOVILPATTI RAILWAY AUTO 2.00
NEXT OJT
NO RECEIPT 50.00
STATION
DHARMAPURI MOVING TO NEXT
002 01-01-2017 JOURNEY
BUS STAND
INDUR AUTO 16.00
OJT
NO RECEIPT 400.00
Total :450.00
CERTIFICATE:
Certified that : (i) Wherever lodging charges for stay in a hotel have been claimed; company guest house accommodation
was not available
(ii) I am/am not in receipt of HRA or availing the facility of leased accommodation at any of the tour stations
for which daily allowance has to be claimed.

Counter Signed Signature of Employee