au. fat a. at 8 care & fq ERA arm Rare Rat Agama Sub Bill No. LEAVE TRAVEL CONCESSION BILL GAR-1 for the block of year [(See Rule 66(1) &90(1)} Rear - ae ft ah al tae Re omer any — yes are ary site GaP aorafor ARB we Note: This bill should be prepared in duplicate-one for payment «ind the other as office copy amet = (eee ae ATT WET TET) PART-A(To be filled up by Government Servant) 4.5 Name 2.579 Desigoton : “a7 Pay Head-quarters SAR oY we ee GA ote at Nature and period of leave sanctioned Fro 6. Boe B oe ware aH ARR rah ara eRe ar Rava or rat re TT Particulars of members of family in respect of whom the LTC has heen claimed aH a, =a ee Wane Ras WaT SLNo, Name Age Relationship with the Govt, Servant Tareantt Bae afte Gad era Sh ee ave St mE ae (arene) B aA Details of journey(s) performed by the Govt. servant and the members of his/her fami wert Pat WAT wT Nee wat) Barat ate | Wate | ae af | ote owt a ane atte site aig 3h ara al Departure aati Distance] Mode of ravel | Novaf | Fare | Reiarks in classot | tures | paid Date | From | Bate | To Kes. | Accommodation Time Tine “ — inn - (Rs) Lage 1 003echt mg sift at wer ae wT Amount of advance, ifany drawn. Rs SYST arayaraoHt Gt AARARNt Porra ferg eeaTe Aaa Ae Ah A, Are ae Ra t, Serre TOA A aie yee wr oratt fare | lars of Journey(s) for which higher class of accommodation than the one to which the Govt. servant is entitled, was used. (Sanction No. & Date to be given) ‘ A art ‘ares a rare | ae AA Poras | ae Ao rat areata [ey St ant tet a a fare erent aaa t ven w a. aaa ‘Mode of | ~ Class to whieh | Chiss by whieh actually | No.of Fave paid Conveyance entitled ‘avelled fares i | From Te Et P oda 8 GS wert S Ate vem B at wg an (Aran) at fafa Particulars of Journey(s) performed by Road between places cgnnected by rail Fae TH AT ae Sit fore fay ewer & Yet HT a we cr ‘Glass of which entitled fe Name of Places From ae safer rar oe - Certified thatthe 4. BRT Sarre AY herr wr afte Mears & orge wer 8; site Information, a given above is true tothe best of my knowledge and belief and 2. ‘aah arcanet Se 3 Phresh @ 1 eae WAY TOR rare ar HF Prehfre @, site io Ree at Saeko ore tar weet oF FRY aT apy wh rah A raver yw eas a & fay ah va an 2 | “That my husband / wile isnot employed in Government service) that my hus fe i employed in Government sevice and the ia has Beem avaled of him/her separately or mse’ or for any of the amily members Tor the concerned Block year. wranl tas & BRT ante ‘Signature of Government Servant fap 2 ga Dated:1. ara Reras a ae Ye ewETE, 8. Gr , Pras ate AA Ry we “The net entillement gn aecount of fe ‘as detailed below: (ee) Royaregeryar eter art aT, (a) Railway Aie/ Bus 7Stenmer fare (@) aon 4. sate, ab orgare tg safe wot et & sn dated Re. (b) Less amount of advance drawn: ye wo Net amount Rs. 2.0... ‘The expenditure is debitable t frat fertar & oreare {Initials of Bill Clerk. amen afte Bierean afte eet wfereeaenht ‘Signature of Drawing & Disbursing Officer Countersigned Prise aftent & geet Signature of Controlling Oificer seafi ran rat & Pr syste oA ar gfe H sera HAARRH we A me eT ‘Cartified that necessary enteies have been made in the service Book of Shri Shrimatl/ Miss Ban gitar § wAafeat at wank wer od ere safe earth ob weaTETe Signature of the Officer ‘Authorized to attest entries im the Service Book “pt 43