Tele

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

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

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

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

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

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

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

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

-
----------------------------- V IV EK A RYA

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

- for cost of rly wt claim in R/O No-------------------------------Rank--------------------Name V ivek
A rya 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 Goa to Delhi 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 V ivek A rya of ----------------------------------------for journey
performed from Goa to Delhi & 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

Goa to Delhi and back under own arrangements
while proceeding on lve/ TD/ permt posting :-
(a) Onward journey ( dt 03 Jul 2020)
(i) The indl and family has performed journey
by A ir A sia airlines from Goa to Delhi and ₹ 7714 ------------
claiming cost of rly wt (AC II/III tier), which is
less than airfare.
(ii) Airline e-tkt No V 9825U and boarding
passes in original are att.

(b) Return Journey (dt-------------)

(i) The indl and family has performed journey
----------------- ------------
by -------------- airlines from Delhi to Goa 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 2020 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 V ivek A rya)

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 V ivek A rya to travel
under own arrangement from Goa to Delhi 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 Goa Delhi

--Name V ivek A rya

(b) Date of onward journey 03 Jul 2020

(c) Date of return journey

(d) Details of family

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

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

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

------------------------------
2. Free railway warrant has not been issued to the indl for the yr 2020 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.