L.T..C.

CERTIFICATES :

1. Certified that the actual Bus/Rail fares are only claimed.

2. Certified that I have not availed L.T.C. other than Home Town during the
block period of 2003-2004 previously.
3. Certified that the persons for whom claim preferred in the L.T.C. T.A. Bill are
only dependents on me.
4. Certified that the tickets for lthe journey performed by me and my family are
herewith enclosed in original.
5. Certified that the claim has been preferred by me with in the stipulated time of
30 days from the date of return journey.
6. Certified that the journeys performed from 28.11.03 (night) to 6.12.03
( Morning)
7. Certified that I have not taken any advance against this bill.
8. Certified that the distance and timings noted in the claim are to the best of my
knowledge.
9. Certified that the ticket Nos./tickets furnished /enclosed in original by me in
the/along with the claim are true/genuine, and I am personally liable for any
punishment if the claim is found false.
10. Certified that I have travelled in the direct route and claimed the fares
accordingly

( V.BHAKTAVATHSALAM )
TYPIST.

CERTIFICATES:

1. Certified that necessary entries as required by Rule 11(h) of the L.T.C. Rules
have been made in the Service Book of the Government servant.

2. Certified that apart from normal checks, I have verified the claim after
obtaining all the required details to actual travel, correctness of family
members, distance , travelled rates, fare and mileage claimed and I am satified
that the claim is in order and passed.

Deputy Superintendidng Engineer,

S.S.L.C. & S.B.Circle, Nellore