Headquarters

Particulars of Journeys and halts Actual Pay Departure Station

3 4

Kind of journey by rail (mail or passenger), steamer, air, road or trolly

Name and Designation

Arrival Hour
6

Railway Steamer fares Aeroplane Class

11

Mileage by order or trolly No. of miles

14

Daily Allowance No. of days

17

Actual Expenses Purpose of journey Total of each line Remarks

Date
5

Station
7

Date
8

Hour
9

No. of Fares
12

Amo unt
13

Rate

Amount

Rate

Amount

Particulars

Amount

10

15

16

18

19

20

21

22

23

24

(a) Appropriation for 20______

Expenditure including this bill

Balance
Deduct:- Undisbursed Travelling Allowance refunded as detailed on the reverse Net sum required for payment

Contents received Station : _

Date :________

(in words)

Head of Office / Group Leader

Traveling by road includes traveling by sea or river in a steam launch or in any vessel other than a steamer, and traveling by canal, (the particular kind should be specified). In cases where the steamer company has two rates of fares, on inclusive and one exclusive of diet the word "fare" should be healed to mean "fare exclusive of diet". (a) If there is a combined appreciation for traveling of gazette and non gazette Government servant the combined appreciation and expenditure should be shown in the column.