STATE BOARD OF TECHNICAL EDUCATION AND TRAINING

ANDHRA PRADESH::HYDERABAD.
T.A. BILL FORM
1. Name, Designation and Address of the Officer :
a) Basic Pay and the Scale of Pay in which pay drawn:
b) Head Quarters.
:
ONWARD JOURNEY
Purpose of Journey

4.

a) Places between which traveled

b) Date and Time of Departure and Arrival

:
:

5.

Mode of Travel and the Class in which traveled:

and Distance. ( If traveled in 1st Class or in IInd
A.C., the ticket No. should be furnished. )
Actual Fare Paid
:
Lodging Charges, if any, incurred
:
( Receipt to be enclosed )

3.

6.
7.

From:
Date:
Time:

To :
Date:
Time:

From:
Date:
Time:

To :
Date:
Time:

RETURN JOURNEY
8. a) Places between which traveled
b) Date and Time of Departure and Arrival

:
:

9.

Mode of Travel and the Class in which traveled:

and Distance. ( If traveled in 1st Class or in IInd
A.C., the ticket No. should be furnished. )
10. Actual Fare Paid
:
11. No. of days taken from the date & time of
:
commencement of onward journey to the date :
and minute of arrival to the Head Quarters on :
Return Journey.
12. Normal Daily Allowance claimed for the number :
of days shown in Column.11.
( If lodging charges are claimed, the normal D.A.
should be reduced by 25% )
13. Gross Amount of T.A, D.A & others claimed. :
14. Amount of Advance Taken and the date on which taken:
15. If so, the net amount of T.A, D.A & others claimed, after
deducting such advances.

Signature of the Claimant

CERTIFICATE
1. I do hereby certify that I have taken pains to ascertain the distance shown in the T.A. Bill and
have shown them according to the best of my knowledge and belief.
2. I certify that no D.A has been drawn for _____ days of Casual Leave or Sunday or Holiday not
actually spent in camp.
3. I certify that concessional fares were not obtained for any of the Railway Journeys advanced by
the Bill.
4. I certify that for Rail Journeys included in the Bill, I traveled by the _______ Class and I
claimed T.A. for the same class.
5. I agree to refund to the State Board of Technical Education and Training, A.P., Hyderabad any
amount that may be objected to in audit from out of the amount paid to me in this claim.
6. I certify that I have not drawn nor do I intended to draw T.A & D.A. for this journey form any
other source.
Counter Signed
Signature of the Claimant
Designation.
ATTENDANCE CERTIFICATE

Certified that Sri _______________________ working as _________________________ at

______________________________________________ appointed as per Boards Orders No.
____________________________________dated _____________ actually reported for duty by
__________ (time) on _______________ the date of Examination/Camp from _____________ to
___________ . He completed the Examinations on ________________ ( date to be specified ). He
was relieved by ______________ (time) on ________________ .

Signature of the Chief Superintendent/Camp Officer

FOR OFFICIAL USE ONLY

______________________________________________________________________________
Passed for Rs. __________ ( Rupees ________________________________________________
______________________________________________________________________________
____________________________________________________________________________ ).

SUPDT.

DY. SECRETARY

ADDL. SECRETARY

SECRETARY