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G.A.R. 14-C
Sub – bill No. ………………..

LEAVE TRAVEL CONCESSION BILL FOR THE YEAR 2019

(COVERING GRACE PERIOD UPTO 31/12/2019)
Note :- This bill should be prepared in duplicate--- one for payment and the other as office copy.

PART—A (to be filled up by Government Servant)

1. Name : K. PRAVEEN KUMAR

2. Designation : SUB-INSPECTOR (GD)
3. Pay : Rs. 39,900/-
4. Headquarters : NORTH EASTERN SECTOR HQR, CRPF, SHILLONG, MEGHALAYA
5. Nature and period of leave sanctioned : 05 Days Earned Leave wef 15/06/2019 to
23/06/2019
(Additional LTC-2019 sanctioned for Self from Shillong
to Annaram and Back vide NES HQr O/O No. L.II-
1/2019-NES-Adm-6 dated 20/06/2019).

6. Particulars of members of family in respect of whom the Addl. L.T.C. has been claimed.
Relationship with the
Sl. No. Name(s) Age
Government servant
1. K. PRAVEEN KUMAR 30 YEARS SELF

7. Details of journey(s) performed by Government servant and the members of

his/her family.
Departure Arrival Mode of Travel
Distance & class of No. of
Date & Date & Fare paid Remarks
From To In Kms. accommodatio fares
Time Time
n used
14/06/19 Shillong 14/06/1 Guwahati 125 Kms Taxi 01 400.00 Ticket
(AN) 9 (AN) enclosed
14/06/19 Guwahati 15/06/1 Sealdah 981 Kms By Train 01 1800.00 Ticket
(AN) Rly Stn. 9 (AN) Rly Stn. enclosed
15/06/19 Howrah 16/06/1 Vijayawada 1231 Kms By Train 01 2125.00 Ticket
(AN) Rly Stn. 9 (AN) Rly Stn. enclosed
16/06/19 Vijaywada 16/06/1 Suryapet 140 Kms By Bus 01 257.00 Ticket
(AN) 9 (AN) enclosed
16/06/19 Suryapet 16/06/1 Annaram 38 Kms Own 01 00 No
(AN) 9 (AN) Claim
20/06/19 Annaram 20/06/1 Suryapet 38 Kms Own 01 00 No
(AN) 9 (AN) Claim
20/06/19 Suryapet 21/06/1 Vijaywada 140 Kms By Bus 01 285.00 Ticket
(AN) 9 (FN) enclosed
21/06/19 Vijaywada 21/06/1 Howrah 1231 Kms By Train 01 2075.00 Ticket
(FN) Rly Stn 9 Rly Stn. enclosed
(AN)
22/06/19 Sealdah 23/06/1 Guwahati 981 Kms By Train 01 1800.00 Ticket
(FN) Rly Stn. 9 Rly Stn. enclosed
(FN)
23/01/19 Guwahati 23/06/1 Shillong 125 Kms Taxi 01 400.00 Ticket
(FN 9 (FN) enclosed
TOTAL 9142.00

8. Amount of advance, if any, drawn: NIL

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9. Particulars of journey(s) for which higher class of accommodation than the one to which the
Government servant is entitled, was used. (Sanction No. & Date to be given).

Place Mode of Class to Class by No. of fares Fare paid

Conveyance which which
entitled actually
From To traveled Rs. P

10. Particulars of journey(s) performed by road between places connected by rail.

Place Mode of Class to which Fare paid

Conveyance entitled

From To Rs. P

Certified that the ----

1. Information, as given above is true to the best of my knowledge and belief, and

2. That my husband / wife is not employed in Government service and the concession has not
been availed of by him/her separately or himself/herself or for any of the family members of
the concerned block of 2019.

Signature of Government Servant

Date :………………………………

PART- B (to be filled in the Bill section)

1. The net entitlement on account of leave travel concession works out to

Rs………………………….. as detailed below :

(a) Railway/ Air/ Bus/ Steamer fare Rs. ………………………

(b) Less amount of advance drawn vide Voucher No. ………………… dated
………………….. Rs. ………………………..
Net Amount Rs. ………………………
2. The expenditure is debitable to

Initials of Bill Clerk Signature of Drawing and

Disbursing Officer

Countersigned
Signature of Controlling Officer

Certified that necessary entries have been made in the service book of Shri/Srimati/ Miss.
…………………………………………………………………
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Signature of the Officer Authorized to attest

entries in the Service Book
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CERTIFICATES TO BE GIVEN BY THE GOVERNMENT SERVANT

1. I have not submitted any other claim so far form Leave Travel Concession in respect of myself or
my family member in respect of the year 2019.

2. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by
me/my wife with ……………. Children. This claim is in respect of journey performed by my wife/ myself
with ………….… children none of whom traveled with the party on the earlier occasion.

3. The Journey has been performed by me/ my wife with children from the place of duty i.e.
SHILLONG to ANNARAM and back.

4. That my husband / wife is not employed in Government service and the concession has not
been availed of by him / her separately for himself / herself or any of the family members for the
concerned block of two years.

Signature of the Government servant

CERTIFICATES TO BE GIVEN BY THE CONTROLLING OFFICER

Certified -----
(i) that Shri/ Shrimati/ Kumari (name of the Government servant)
…………………………………………….. has rendered continuous service for one year or
more on the date of commencing the outward journey.
(ii) That necessary entries as required under Para. 3 of the Ministry of Home Affairs, O.M.
No. 43/1/55-Ests (A)-Part II, dated the 11 th October, 1996, have been made in the
Service Book if Shri/ Shrimati/ Kumari……………………..

(Signature of designation of the Controlling Officer)

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CERTIFICATE

(1) It is certified that the claim is genuine and not drawn previously.

(2) It is certified that R/W not issued from ________ to ___________ while on leave.

(3) He was issued ADFLP/FLP from …………………….. to ………………………. that

Railway Warrant No. …………………. dated …………………...

(4) Copy of the leave certificate also attached in this claim.

ATTESTED

G.A.R. 14-C
Sub – bill No. ………………..
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LEAVE TRAVEL CONCESSION BILL FOR THE 04 YEARS BLOCK OF YEAR 2014 TO 2017
(COVERING GRACE PERIOD UPTO 31/12/2018)

Note :- This bill should be prepared in duplicate--- one for payment and the other as office copy.

PART—A (to be filled up by Government Servant)

8. Name : KULAJIT TALUKDAR

9. Designation : INSPECTOR (GD)
10. Pay : Rs. 50,500/-
11. Headquarters : NORTH EASTERN SECTOR HQR, CRPF, SHILLONG, MEGHALAYA
12. Nature and period of leave sanctioned : 12 Days Earned Leave wef 22/10/2018 to
02/11/2018

(LTC sanctioned for Self and family members from

Shillong to Gangtok and Back vide NES HQr O/O No.
L.II/2018-NES-Adm-6 dated 18/10/2018).

13. Particulars of members of family in respect of whom the L.T.C. has been
claimed.
Relationship with the
Sl. No. Name(s) Age
Government servant
1. KULAJIT TALUKDAR 36 YEARS SELF
2. DHARITRI TALUKDAR 34 YEARS WIFE
3. PIYUSH TALUKDAR 04 YEARS SON

14. Details of journey(s) performed by Government servant and the members of

his/her family.
Departure Arrival Mode of Travel
Distance & class of No. of
Date & Date & Fare paid Remarks
From To In Kms. accommodation fares
Time Time
used
28/10/18 Shillong 28/10/18 Guwahati 125 Kms Taxi 03 1,200.00 Ticket
(0700) (1100) Airport enclosed
28/10/18 Guwahati 28/10/18 Pakyong 540 Kms By Air 03 7,530.00 Ticket
(1300) Airport (1405) Airport (Spicejet) enclosed
(Gangtok
)
Halted at Gangtok upto 01/11/2018 for tour
01/11/18 Pakyong 01/11/18 Guwahati 540 Kms By Air 03 8,223.00 Ticket
(1115) Airport (1220) Airport (Spicejet) enclosed
(Gangtok
)
01/11/18 Guwahati 01/11/18 Shillong 125 Kms Taxi 03 1,200.00 Ticket
(1300) Airport (1700) enclosed
TOTAL 18,153.0
0

8. Amount of advance, if any, drawn: NIL

9. Particulars of journey(s) for which higher class of accommodation than the one to which the
Government servant is entitled, was used. (Sanction No. & Date to be given).

Place Mode of Class to Class by No. of fares Fare paid

Conveyance which which
entitled
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From To actually Rs. P

traveled

10. Particulars of journey(s) performed by road between places connected by rail.

Place Mode of Class to which Fare paid

Conveyance entitled

From To Rs. P

Certified that the ----

3. Information, as given above is true to the best of my knowledge and belief, and

4. That my husband / wife is not employed in Government service and the concession has not
been availed of by him/her separately or himself/herself or for any of the family members of
the concerned block of 04 years (2014 to 2017).

Signature of Government Servant

Date :………………………………

PART- B (to be filled in the Bill section)

1. The net entitlement on account of leave travel concession works out to

Rs………………………….. as detailed below :

(a) Railway/ Air/ Bus/ Steamer fare Rs. ………………………

(c) Less amount of advance drawn vide Voucher No. ………………… dated
………………….. Rs. ………………………..
Net Amount Rs. ………………………
2. The expenditure is debitable to

Initials of Bill Clerk Signature of Drawing and

Disbursing Officer

Countersigned
Signature of Controlling Officer

Certified that necessary entries have been made in the service book of Shri/Srimati/ Miss.
…………………………………………………………………
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Signature of the Officer Authorized to attest

entries in the Service Book
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CERTIFICATES TO BE GIVEN BY THE GOVERNMENT SERVANT

1. I have not submitted any other claim so far form Leave Travel Concession in respect of my self
or my family member in respect of the block of 04 years 2014 to 2017.

2. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by
me/my wife with ……………. Children. This claim is in respect of journey performed by my wife/ myself
with ………….… children none of whom traveled with the party on the earlier occasion.

3. The Journey has been performed by me/ my wife with children from the place of duty i.e.
SHILLONG to GANGTOK and back.

4. That my husband / wife is not employed in Government service and the concession has not
been availed of by him / her separately for himself / herself or any of the family members for the
concerned block of two years.

Signature of the Government servant

CERTIFICATES TO BE GIVEN BY THE CONTROLLING OFFICER

Certified -----
(iii) that Shri/ Shrimati/ Kumari (name of the Government servant)
…………………………………………….. has rendered continuous service for one year or
more on the date of commencing the outward journey.
(iv) That necessary entries as required under Para. 3 of the Ministry of Home Affairs, O.M.
No. 43/1/55-Ests (A)-Part II, dated the 11 th October, 1996, have been made in the
Service Book if Shri/ Shrimati/ Kumari……………………..

(Signature of designation of the Controlling Officer)

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CERTIFICATE

(5) It is certified that the claim is genuine and not drawn previously.

(6) It is certified that R/W not issued from ________ to ___________ while on leave.

(7) He was issued ADFLP/FLP from …………………….. to ………………………. that

Railway Warrant No. …………………. dated …………………...

(8) Copy of the leave certificate also attached in this claim.

ATTESTED