Below Rs.

19,925/-(Rupees Nineteen Thousand Nine Hundred Twenty Five only)

T.R.46
(See Rule 164 (a) of KTC Vol.1) Name of Treasury

BILL FOR PAY AND ALLOWANCES / LEAVE SALARY OF A GAZETTED OFFICER : ««««««.
FOR TREASURY USE Date: Name : ««««« G.E.No : PAN/GIR : Plan (P) / Non Plan (N) CPS / CSS

Computer Sequence No. / Token No. : Scroll No. : SDO Code Designation Name of Office : : :

Head of Account : 2202-03-103-99-01
MAJ SMJ MIN SUB SSUB

N 6

Voted(V)/Charged ( C) Ratio

V

Received for the period : A. Amount due Pay/Duty Pay Leave Salary Special Pay Personal Pay Transit Pay Dearness Allowances House Rent Allowance CCA DA Arrear PCA Special Allowance Deduct Advance Drawn

1

/
Rate

6
0 0

/ 2010
Amount

To 31 /
0 GPF

/ 2010
Rate Amount

B. Deductions GPF (Loan Recovery)

0

0

0 GPF (Arrear DA)
GPF (ADA) Group Insurance State Life Insurance SLI (Loan Recovery) Recoveries ordered by AG HBA - 1 HBA - 2 HBA Additional HBA Interest MCA MCA Interest FBS PLI Rent Income Tax LIC Computer Advance Total B

0 150

0 150

200 500

200 500

21624 150 Gross Claim A 0 0 Total B Net Balance = A-B Received Rs. 0 (Rupees Nineteen Thousand Nine Hundred Twenty Four Only) In Cash / TC to TSB : In Cash

Station : Date : 28.06.2010

Signature Designation

Stamp

FOR TREASURY USE ONLY Pay Rs«««««««««««««.(Rupees««««««««««««««««««««««««««««««« In Cash / Cheque Rs«««««««.(Rupees«««««««««««««««««««««««««««««««.. by RBR and Rs«««««««««..(Rupees««««««««««««««««««««««««««««««« «««««««««««««««««««««««««««««..only) by TC POC No. :««««««««««.Date :«««/««««/««««««. Accountant Received by Order Cheque Signature of Recepient Treasury Officer Pay Order Cheque issued by Accountant

Note : Govt. accept no responsibility, for any fraud of misappropriation in respect of money or draft made over to messenger. Certificate for claiming HRA : I certify that I did not occupy Govt. quarters during the period for which HRA is claimed in this bill.

Date : 28.06.2010

Signature

LIFE CERTIFICATE referred in No.7 : Sri/Smt«««««««««««««««««««««««««««.is alive on this «««««««««««««««(date) Station :«««««««««««««««««««.. :«««««««««««««««.. Date :«««««««««««««««««««« :......................................................... Allotent Details (For PTA, PCA Claim) Appropriation for current year Expenditure excluding the bill Expenditure including the bill Balance Signature

Designation

Rs«««««««««««««««««««««««««««««« Rs«««««««««««««««««««««««««««««« Rs«««««««««««««««««««««««««««««« Rs««««««««««««««««««««««««««««««

Signature of Drawing Officer DIRECTONS FOR USE : 1. A salary bill may be endorsed to a banker or other recognised agent and submitted for collection through such Banker or Agent if the Officer desires so. 2. An Officer appointed to the Goivt. Service must furnish a certificate that he has submitted proposals for SLI (Official Branch), and applied for admission to the GPF as per rules. 3. Income Tax should be deducted as per rules. 4. Leave salary/transit pay should be claimed after getting pay slip from the AG. 5. Copy of LIC/Pay slip should be attached with the bills as per rules. 6. The details of salary encashed should be informed to the head of office with copy of FBS schedule. 7. An Officer who signs his own bills while absent on leave must either present it in person or furnish the above life certificate, signed by a responsible officer of govt. or some other well known and trustworthy person known to the Treasury Officer 8. If conveyance allowance is claimed in this biss, a certificate as per rules should be furnished. FOR THE USE OF AG'S OFFICE Classifications Details of objection Debit Chargeable Credit Head of Account Total amount of bill Payable««««««««««««««..Treasury Admitted Passed for Rs«««««««««««««««« Disallowed (Rupees for Rs««««««««««««««««) Objected, See details of objection Retrenchment slip No. GA««««««««««dated«««««««««««««« Or objection slip No.«««««««««««««.dated«««««««««««««« Accountant/CT AAG Sr. AO/AO AAO/SO Dated : AA AAG

FORM T.R.104
[See Rule 163(1) K.T.C Vol.I ]
Name of the Accounts Office who maintains the Accounts (See Note No. 5) : Accountant General Kerala,Kozhikode Branch . Name of the Provident Fund : General Provident Fund Statement showing deductions on account of subscription towards the State/General Provident Fund in the pay bill of the Sri ««««««« Office of «««««««««««... Officer noted below during December 2009 Salary as on 31st March. Rs. Total Amount (6+9+11) Rs. Name of the Subscriber Service Head Account DA Arrears From««...GO No... Dated . Details of Receipts Subscription Proper Refund of Advance Rate of Subscription Rs. Month to which it relates Month to which it relates No of Instalments

210416A005

Account Number

Serial Number

1

2

3

4

5

6

7 Jan. 2010

8

9

10

11

12

13 8009-01101-99

14

1

12000

1000

1000

Nil

Nil

Nil

Nil

1000

In Figures Rs. 1000 Grand Total In words Rs. One Thousand Only has been deducted in the Establishment/Salary Bill of the officer. Cashed on«««««««««« Name of Treasury«««««««««««««« FOR USE IN AUDIT OFFICE Voucher««««««««««««.Dated of Encashment««««««««20«««.
1. Certified that the name shown in column 3,amount of individual deduction (Both subscription proper and refund of advance) and the total amount shown in column 6,9,11 and 12 have been checked with reference to the bill. 2. For schedules attached with march pay bills, certified that rates of salary / Pay as shown in column 4 have been varified with amounts actually drawn in the bills.

Head Office

Certified that a sum of Rs««««««««..(Rupees in words)««««««««««««««««««««««««««««««««««««««««««««««

Treasury Officer

Auditor,Department of Audit Section

Remarks

Amount Rs.

Amount Rs

Salary Details of Mr.Binu.C.Kurian, Lecturer in Commerce
Dat of Encashment Festival Allowance Group Personal Accident Insurance

Special Pay

Income Tax

Basic Pay

Arrear DA

Prof.Tax

8-Jun 8-Jul Aug-08 Sep-08 8-Oct 8-Nov 8-Dec 9-Jan Feb-09 9-Mar Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10

30 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150

1100

5040

6000 1250

4468

200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200

50 5131

50

500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500

1000

1000

Tresury

Month

Gross

G.P.F

HRA

GIS

Net

SLI

DA

STATE INSURANE DEPARTMENT
(LIFE - OFFICIAL BRANCH)

(This form is to be used for State Life Insurance Oficial branch only) Statement showing deduction on account of premia towards Official Branch Insurance Fund in the Establishment Pay or Salary Bill of Sri. ............... ......................................................... the month of Dec.-2009 for
Sl. No. Policy Nos. in Serial order Name of Policy holder Designation Month to which the premium relates Amount deducted Remarks

1

Jan.2010

500

-

(Rupees Five Hundred Only) Station : «««« Date 28.06.2010 Head of Office : Designation :

500 -

Certified that a sum of Rs««««««««««««««««has been deducted in establishment or salary bill cashed on««««««««««« Treasury Officer

KERALA STATE EMPLOYEES GROUP INSURANCE SCHEME (GAZETTED OFFICERS) G.O(P)655 /84 /Fin. Dated 13.11.1984

FORM - B
Schedule of deductions to "811-Insurance and Pension Funds (c) Kerala State Government Employees" Group Insurance Scheme - 1 - Insurance Fund and 2 savings Fund
1. Month to which the salary bill relates 2. Account Number 3. Name of Self-Drawing officer with designation

: December-2009

««««««««««««.
4. Group 5. Amount deducted (Rs. In figures and words) 6. Month / months to which deduction relates Place : «««««« Date 28.06.2010 :

: B+5 Units (Two Hundred Only) : Rs. 200/: Jan-2010

Signature, Name and Designation of Office address of the Self Drawing Officer

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