Claim Form

Period of Visit: 30.06.2022 – 06.07.2022

Region : Kandhakumaran & Meensurutty
Name of the staff members :1 G.Venkatesan AP/ECE., 2. T.Thivagar, AP/ECE, 3.
Raghuraman R AP/ Mech, 4. Kabirdoss T LA/ Civil
Travelling Allowance (Eligible Rs. 3/KM) Total
Date Visiting Area of Timing Kilometres Amout Tea Lunch Amount
the Region Travelled in Rs. Rs.10/ Rs.60 in Rs.
Head/ Per day/
Session Per
Head
30.06.22 Veerathanapuram, 12.50 PM 98 294 20 120 434
Meensurutty, –05:30
Kandamangalam, PM
Kollapuram
01.07.22 Thirumoolasthanam 01.00 PM 92 276 20 120 416
, – 05.30
Edaiyar, pm
Ayangudi,
Reddiyur
02.07.22 Kurungudi, 01.00 PM 96 288 20 120 428
Kandamangalam, – 05.30
Keelakanjankollai, pm
Meelakanjankollai
04.07.22 Veeracholapuram 01.00 PM 104 312 20 120 452
Sokkalingapuram – 05.30
Odapperi pm
05.07.22 Veeracholapuram, 01.00 PM 102 306 20 120 446
Utkottai, – 05.30
Kanjankollai (S) pm
Kanjankollai (N)
Annaikarai
26.06.22 Boothamgudi, 09:00 AM 148 444 40 120 604
Kanthakumaran to 05:30
Sethiyathope PM
27.06.22 Kaliyamalai, 09:00 AM 152 456 40 120 616
Kollumedu, to 05:30
Thenpathi PM

Total 3396

Signature of the staff members

1. 2.

3. 4.
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