Tele

---------------------------------------

P IN ----------------------------------

C /O ---------AP O

-------------------------------------- 201---

---------------------------------------

----------------------------------------

---------------------------------------

FWD OF CLA IM : COST OF RLY WT IN RESPECT OF NO --------------------------- RA NK--------

-
----------------------------- ELA MURUGU ELA MURUGU

1. C ontingent bill No--------------------------- dt ---------------- 201-- for Rs -----------------------------

- for cost of rly wt claim in R/O No-------------------------------Rank--------------------Name
Elamurugu Elamurugu of this Unit is fwd along with fwg docus:-

 (a) Sanction of the competent authority for claiming train fare under travel regulations
(Revised Edition)-1991 P ara  TR 184 read in conjunction with P ara -------- in original.

 (b)  -------------------------------- leave C ert No/ Movement order ------------------------dt ---------

---- 20__ in original.

 (c)  Air Tickets from Delhi to Chennai and return along with boarding passes in original.

 (d)  P hotocopy of ------------------ lve P art II Order No---------------- dt --------------------------.

 (e)  Monthly pay slip for the month of ------------------201—

 (f)  Authority for allotment of course/temporary duty with ------------------

2  You are requested to audit the above documents and credit the payment in IRLA of the
individual concerned please.

Encls:- As Above.

In Lieu of IAFA-115
 CONTINGENT BILL

Voucher No-------------------------------dt----------------20__ for Rs-----------------------------------------

---------------- Expenditure claimed on account of expenditure incurred by No--------------------------
--Rank--------------------Name Elamurugu Elamurugu of ----------------------------------------for
journey performed from Delhi to Chennai & back under own arrangements while proceeding on
leave/TD/permanent posting/course:-

A uth: ADG of P ers Services letter No P C B/36736/LTC /AG/P S-3(P ) dt 24 Aug 2012 and ADGP S
letter No C /7036/Allowances/SAP C S/2018 dt 27 Apr 2018

Sr Date Details of Expdr Amount Amount

No Expended Entitled

1 The indl & his family performed  journey from

Delhi to Chennai and back under own
arrangements while proceeding on lve/ TD/ permt
posting :-
(a) Onward journey ( dt 17 Mar 2019)
(i) The indl and family has performed journey ₹ 6334 ------------
by SpiceJet airlines from Delhi to Chennai
and claiming cost of rly wt (AC II/III tier), which
is less than airfare.
(ii) Airline e-tkt No I73P5C and boarding
passes in original are att.

(b) Return Journey (dt-------------)

----------------- ------------
(i) The indl and family has performed journey
by -------------- airlines from Chennai to Delhi
and claiming cost of rly wt (AC II/III tier), which
is less than airfare.
(ii) Airline e-tkt No -------------- and boarding
passes in original are att.

Total amount claimed(Rs) -----------

Details of family:-

(a) -------------------------------------------------- Self
(b) -------------------------------------------------- Wife
(c) -------------------------------------------------- Dependent
(d) -------------------------------------------------- Dependant

C ertified that:-
(a) I have not availed free rly wt for self and family for the yr 2019 under TR 184
(b) The amount claimed is not more than amount spent by me.
(c)  The particulars given the claim are correct.
Date:----------------- Received P ayment
Stamp

(No----------------------Rank-----------
Name Elamurugu Elamurugu)

COUNTERSIGNED

Station: C /O --------- AP O
Date: -------------------------
 SA NCTION OF THE COMPETENT A UTH FOR TRAV EL UNDER OWN A RRA NGEMENT A ND
CLA IM THE COST OF ENTITLED RA ILWAY WA RRA NT UNDER TRAV EL REGULATIONS
(REV ISED EDITION-2014) PA RA 184 REA D IN CONJUNCTION WITH PA RA ------

1.  Under the provisions of P ara 184 read in conjunction with P ara ------ of Travel Regulations
(Revised Edition 2014), sanction of ---------------------------------------------------------------------is
hereby accorded to No----------------------------Rank---------------Name Elamurugu Elamurugu
to travel under own arrangement from Delhi to Chennai and back while proceeding on
leave/temporary duty/course-------------------------and claim the cost of entitled warrant or actual
expenditure, whichever is less:-

Ser No Rank and Name Mode of From To Remarks

No Journey

(a) No-------------------Rank------ By Air Delhi Chennai

--Name Elamurugu
Elamurugu

(b) Date of onward journey 17 Mar 2019

(c) Date of return journey

(d) Details of family

Smt-----------------------

-----------------------------

-----------------------------

------------------------------
2. Free railway warrant has not been issued to the indl for the yr 2019 under TR 184.

3. The indl will produce original tickets while preferring claim to the PAO(OR).

C ase No:

----------------------------------

----------------------------------

---------------------------------

Date:---------------------------

Distr:-

1. Indl concerned.

2.  Office C opy.