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209:90/ObserverConsent/PrintBill

CLAIM FOR T.A./D.A. BILL FOR OBS FOR LOCAL/OUTSIDE DUTY

PERSONAL DETAILS

DESIGNATION PROFESSOR
NAME SHARATH CHANDRA SWAMY AND PLACE OF (ASSISTANT)
POSTING CHENNAI-B
NO 113 SRI KUNDUR MATH,
COMPLETE
FORT MOHALLA MYSORE
ADDRESS WITH EMAIL ID scswamy@gmail.com
NEAR AGRAHARA CIRCLE,
PIN NO
MYSORE KARNATAKA - 570004
LANDLINE NO - MOBILE No 9900128882
PAY BAND LEVEL 11 (6600) GRADE PAY 6000
DETAILS OF BANK ACCOUNT AS PER DETAILS GIVEN IN CONSENT (NOT EDITABLE)

Account Holder's Name: SHARATH CHANDRA SWAMY Bank's Name : STATE BANK OF INDIA
Bank Account No: 30409586474 IFSC Code: SBIN0003130
CENTRE DETAILS

CHETTINAD VIDYASHRAM (CENTRE - 1)

Examination
Examination CHETTINAD HOUSE RAJAH ANNAMALAIPURAM
511529 Centre Name &
Centre No OPPOSITE TO IYAPPAN TEMPLE CHENNAI TAMIL
Address:
NADU - 600028

DETAILS OF JOURNEY

(A) Details Of Journey (Including From And To Residence/Office And Airport/Railway Station Etc.)
Departute Arrival Details
Paid
Journey Air/Rail/Taxi Distance Amt
Date Time From Date Time To Document
Mode Receipt No (Kms) (Air/Rail
/Taxi)
04/05/2018 14:15 MYSORE 04/05/2018 22:00 CHENNAI RAIL 4556517115 500 2160
07/05/2018 06:00 CHENNAI 07/05/2018 14:00 MYSORE RAIL 4764138062 500 2135

(B) Details Of Hotel/Food Bill/Daily Allowance (DA)

Nos.
Name & Address of Hotel/Guest House Room Rent Food
Of Bill No. Bill Date Total Document
with Phone No. Paid Charges
Days
Hotel Golden Tower Periyamet,
2 635 07/05/2018 5544 800 6344
Chennai,
DETAILS OF REMUNERATION, MOBILE & OTHERS CHARGES
(C) Fixed Remuneration 2500 (D) Fixed Conveyence 1500
(E) OTHERS, IF ANY (DETAILS OF OTHERS PAYMENT DETAILS)
Description Amount Total (A+B+C+D+E) 14639

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DETAILS OF JOURNEY

(A) Details Of Journey (Including From And To Residence/Office And Airport/Railway Station Etc.)
Departute Arrival Details
Paid
Journey Air/Rail/Taxi Distance Amt
Date Time From Date Time To Document
Mode Receipt No (Kms) (Air/Rail
/Taxi)
A) Cerified that the particulars filled in the above are correct and true. All the money paid in the interest of organization.

B) Cerified that the particulars filled in the above are correct and true. All the money paid in the interest of organization.

C) Cerified that no T.A in respect of journey included in the bill has been claimed or is payable from other sources.

D) Cerified that I actually travelled as per entitlement for which T.A. has been claimed.

E) Cerified that I travelled by the shortest route.

F) Cerified that olace of permanent duty and the place of temporary duty fall in diffrent Municipalities.

G) Cerified that the distance by road for which mileages allowances has been claimed are correct to the best of my
knowledge & belief.

H) Cerified that the journey performed by road as there is no direct rail connection.

PAYMENT: ALL THE PAYMNETS MAKE ELECTRONICALLY IN THE ACCOUNT OF THE PAYEE
DIRECTLY

NOTE: PLEASE SEND THE CONFIRMATION PAGE ALONG WITH ORIGINAL BILL AS GIVEN ABOVE

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