Rural Reconstruction Nepal, (RRN) RRN Form No. 3.

14 (A)
Travel Request & Authorization form
Traveler’s Name : Purna Bdr Karki Date of request : 15th May 2022

Portfolio covered by: FFSMT

Date From: 18th May 2022 To: 21st May 2022 Total days

Place From: Boch To: Charikot, Baghkhor, Faskhu

Return from: To:

Travel Mode: By air by road

Major Purpose of the visit;

1, To attend procurement meeting at Charikot office for seed and agri materials supply in project areas.

2, To monitor project activities (IPM Class, Nurseries, seasonal and off seasonal vegetables training) of Shailung RM-03,
Baghkhor, 05 Katakuti and 07 Faskhu Dolakha.

Ticket Requested:

Travel date: Mode

Place: From … To… and Return from … to…

Requested Advance breakdown

Amount
Particular Days Rate Budget Head

Per-diem 4 700 2800

Accommodation 2 1000 2000

Airfare

Local Transportation

Communication

Printing & Stationery

Other (Please specify)

Grand Total 4800

Total advance in words : Four Thousand and Eight Hundred Rupees Only

Accessories requested

A. Office Camera B. Laptop C. LCD Multimedia

B. Others (Specify)
I hereby, declare that I don’t have any unsettled previous travel advance balance in the organization and will settled
this advance in a given period of time.

Submitted By: Recommended By: Approved By:

Name:Purna Bdr Karki Name: Name:
Date: 15th May 2022 Date: Date:
Designation: FFSMT Designation: Designation:

Note; Travel advance has to be settled within the given period as per the policy of RRN .