RK Ta&da Feb 2023

APTC - FORM - 52
TRAVELLING ALLOWANCE CLAIM FORM

Name : MANUGULA VENAKTA RAMAKRISHNA Designation : VILLAGE SURVEYOR
Office : VILLAGE SECRETARIAT- PENIKERU-2 (KALAVACHERLA) Month : FEBRUARY-2023
Basic Pay : Scale of Pay : 22460/- in RPS 2022 Head Quarters : ALAMURU
I.D.NO. 0389938 C.F.M.S.NO. 14811565
Particulars of Journey and Halts Mileage Allowance Daily Allowances
Total Charge
Mode of Journey
Time at which started Time at which returned Rs.
Train/Bus/Flight/ Other claim
Ticket No. Distance Total Amount Purpose of Journey
Steamer/ Own Rate Total Rate No. Of Days Total If Any
/P.N.R. in KMs.
Date / Place/ vehicle
Date / Time Place/Route number
Time Route
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
RC.NO.A1/04/2022,Dt.23.12.2022 (As per Proceeding

01.02.2023 / 7.30 AM KALAVACHERLA 01.02.2023 / 9.00 AM BILLAKURRU Bus 25 50.00 50.00 50.00 of the District Survey and Land Records Officer, Dr.
B.R. Ambedkar Konaseema District, Amalapuram )
01.02.2023 / 6.00 PM BILLAKURRU 01.02.2023 / 7.30 PM KALAVACHERLA Bus 25 50.00 50.00 300.00 1 300.00 350.00
02.02.2023 / 7.30 AM KALAVACHERLA 02.02.2023 / 9.00 AM BILLAKURRU Bus 25 50.00 50.00 50.00 BILLAKURRU RESURVEY WORK (QGIS WORK)
Particulars of Journey and Halts Mileage Allowance Daily Allowances
Total Charge
Mode of Journey
Time at which started Time at which returned Rs.
Train/Bus/Flight/ Other claim
Ticket No. Distance Total Amount Purpose of Journey
Steamer/ Own Rate Total Rate No. Of Days Total If Any
/P.N.R. in KMs.
Date / Place/ vehicle
Date / Time Place/Route number
Time Route
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
8400.00
Certificates:
1) Certified that the Journey performed above 8Kms. From the Head quarters. TOTAL BILL AMOUNT 8,400.00
2) Certified that the bill has not been claimed and drawn previously. DEDUCT ADVANCE 0.00
3) Certified that the no free boarding /lodging fecility was utilised during the Journies performed which are claimed in this bill. NET AMOUNT TO BE PAID 8,400.00 MANUGULA VENKATA RAMAKRISHNA
4) Certified that the no leave utilised in the above journey period. SIGNATURE OF CLAIMANT.
5) Certified that the journies performed on Govt.Duty only. DATE:
6) Certified that no advance has been taken regarding regarding this bill .
7) Certified that no Journey Performed on Govt.Vehicle while on tour in out of Dist. .
8)Certified that my family consists of self, wife, one son and one unmarried daughter aged 16 and 29 years respectively
9)Certified that this claim preferred in time by the claimant, but the delay is due to admn.grounds..
10)Certified that the TA adv.taken by the individual was adjusted in this and no TA adv.is pending for receovery.
11)Certified that the individual has not been provided with Govt.conveyance.
12)Certified that i have satisfied myself about the necessity, frequency and duration of journeys and halts claimed in this bill.
Passed for Rs. 8400/- Eight Thousand Four Hundred Rupees Only)

RK Ta&da Feb 2023

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APTC - FORM - 52

TRAVELLING ALLOWANCE CLAIM FORM

RC.NO.A1/04/2022,Dt.23.12.2022 (As per Proceeding

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