INDIAN INSTITUTE OF TECHNOLOGY, DELHI

LEAVE TR LAVEL CONCESSION BILL

 For the Block of Years__________________ to_______________.

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

 PART `A'

 ( To be filled by the Institute Employed)

1. Name_____________________ Code No.___________________ Designation__________________Basic Pay ______________ Declared place of journey ____________________ sanctioned nature of leave_________________ period from _____________ to _________________.

 Particulars of members of family in respect of whom the leave Travel Concession has been claimed:
 ___________________________________________________________
 S.No.          Name(s)                   Age                    Relationship with the
                                                                                Institute Employed.
 ___________________________________________________________
 
 
 
 
 
 
 

 _________________________________________________________

      Details of Journey(s)  performed by the Institute
   Employee and the members of his/her family

 __________________________________________________________
 Departure    Arrival     Distance       Mode of       Class of         Fares paid
                                    in KM.          Travel          Accmo             Rs.   P.
                                                                              used
 ___________________________________________________________
 
 
 
 
 
 

 __________________________________________________________

 Amount of Advance if any draw _________________________ Rs._______________________________.
 

CERTIFIED THAT

1. The information as given above is true to the best of my knowledge and belief :-

2. That my husband/wife is not employed in Government service/that my husband/wife is employed in Government service and the concession has not been availed of by him/her separately for himself/herself or for any of the family members for the concerned block of years ___________________ to _________________.

3. That my husband/wife is whom L.T.C. is claimed by me is employed in__________________ (name of the Public Sector undertaking/corporation but he/she has not preferred and will not prefer, any claim in this behalf to his/her employees.

4. That my wife/husband for whom L.T.C. is claimed by me is not employed in any public sector undertaking/separately autonomous body financed wholly or partly by the Central Government of a Local Body, which provides L.T.C. facilities to its employees and their familities.

Date_____________________.

 Signature of Institute Employees

 Part `B'

Certified that necessary entries have been made in the service book of Shri/Smt/Kum._____________________.

 Signature of the Officer Authorise
 to test entries in the Service book.

The net entitlement on account of Leave Concession work is out to be _____________ (Rupees________________ as detailed below:-
(a) Railway/Air/Bus/Steamer fare .....   .....   ..... ......
(b) Less amount of advance drawn
 

 Dated :

 Net Amount :

Passed for Rs. ______________________.
Passed for adjustment of Rs.___________________.
Against L.T.C. Advance of Rs.____________________.
Unspent amount Rs._____________Deposit_____________.
Vide Rec.No.___________________Date________________.
Chargeable to________________________________.
 
 

 A.R.(Accounts)

Acctt.