ERA UNIVERSITY, LUCKNOW

# #
Examination Remuneration Bill Internal / External Examiner Date……………….....
Name of
Examiner -
Designation & Official Address-………………………………………………….……………………………………...………………………….
…………………………………………………………………………………...…………………………………………………………………………...….
Residential/Communication Address-…………………………………………………………………………………………………………..
…………………………………...……………………………………………………………………………………………………………………..………..
e-mail Address: ………………………………………………………………………….... Mobile/ Phone No.………………………..………

Detail of Payment Claimed: Date & Time of Exam:……………………………………………………...………………..…..………………..

Faculty of: …………………………… Course……………………. Semester / Year………….. Practical/ Viva/Project/Evaluation #
Subject: …………………………………………………….
Paper No……….. Paper Code.
Title of Paper / Thesis : …………………………………………………………………………………………...……………………………...….
S.No. Subjects Details* Remarks if any Amount (Rs)
1 Paper Setting
Evaluation of Answer Book /
2 Thesis/ Dissertation
3 Practical/Viva/ Project
4 Axuillary Expenses**
5 Total: In Words: In Figures:
*No. of Sets / No. Of Answer Book or Thesis Evaluated / No. Of Students Examined in Practical/Viva/Project. **Vouchers Attached

Option for Internal Examiners only: Payment be made to my salary account: Yes# No#
The Amount may kindly be transferred to bank account as detail below:.

Bank A/C No. Bank Name & Branch:…….

IFS Code: ……………………………………………..…………………..

PAN No. ………………………………………………………..…………
Aadhar No. …………………………..…………………………….…………
Revenue Stamp for bills above Rupees 5000/-
Note: 1:Please submit separate bills for question papers with
different codes. 2. Incomplete bills are not entertained.
3. Payments are made after declaration of result of the
examination.
# Strike off which is not applicable. Signature of Examiner with Date

For Office Use Only Reference No………………………………………………….

Verified that claimant was one of the Examiners and has performed work as detailed above as per our record. This

Authorised Signatory Signature of HOD/Principal

(Evaluation/Result Section) (for Practical/Viva/Project Examination)
PASSED FOR PAYMENT Payment made for Rs. ………………………………………..……………………………….
Dated: by NEFT/RTGS vide Transaction ID No…………….……………………….…………
Cheque/Draft No……………………..………Dated………………...………………...……..

Authorised Signatory
Controller of Examination (Accounts Section)