Sub Bill No:-----------

(Note-This bill should be prepared in duplicate –One for payment and the other as office copy.)

Leave travel Concession Bill for the Block year 2005-2009

Part A ( To be filled by Government Servant)

1. Name:- 2. Designation
3. Pay:-
(Grade Pay 4200) 4. Head Quarters

5. Nature and Period of leave :

6. Particulars of family members of family in respect of whom the LTC has been
claimed.

Sl Name Age Government Servant

No:
1
2
3
4

7. Details of journey performed by Govt. Servant and the members of his/her

family:-
Departure Arrival Dista Mode of No. Fare paid Remarks
travel and of
nce in class of fares
KMs accommodati
on used.
28.04.09 Kottara 28.04.09 Trivandrum 71 KSRTC 4 188.00
1600 Hrs kara Superfast
Bus

28.04.09 Trivan 30.04.2009 Nizamudeen 3149 By Train 4 9780.00 Ticket

1915 Hrs drum 1400 Hrs Rajadhani attached
Exp – 3
Tier AC
30.04.09 Nizam 30.04.09 New Delhi 29 Ordinary 4 16.00 Ticket
1430 Hrs udeen 1500 Hrs train attached

30.04.09 New 30.04.09 Kalka 303 By train 4 1880.00 Ticket

1725 Hrs Delhi 2120 Kalka attached
Shibdi
Exp
Chair
Car
01.05.09 Kalka 01.05.09 Simla 96 By train 4 972.00 Ticket
0600 1100 Kalka attached
Simla
Exp
 First
Class
03.05.09 Simla 03.05.09 Kalka 96 Simla 4 668.00 Ordinary
1500 Hrs 2000 Hrs Kalka ticket
Exp converted into
Chair Chair Car
car
03.05.09 Kalka 04.05.09 New Delhi 303 By Train 4 2264.00 Ticket
2355 0625 Kalka attached
Mail 2
Tier AC
07.05.09 New 07.05.09 Trivandrm Kingfisher 4 13720.00 Ticket
0950 Delhi 1415 Airlines attached
07.05.09 Trivan 07.05.09 Kottarakara 71 KSRTC 4 188.00
1600 drum 1800 Superfast
Bus
29676

8. Amount of Advance, if any drawn Rs 18900/-.

9. Particulars of Journey for which higher class of accommodation than the one to
which the Government servant is entitled was used. (Sanction number and date to be
given.)
Place Mode of Class to Class by No Fare paid Sanction
conveyance which which of Number
entitled actually fares and Date
traveled
From To Rs Ps
Delhi Trivandrum Kingfisher 2 Tier Economy 4 13720.0 E6/LTC/68
Airlines AC in Class by 0 dtd
Exp Air 03.04.09 of
Train SSPOs
Kollam

10. Particulars of journey performed by road between places connected by rails:-

Certified that the

1. Information as given above is true to the best of my knowledge and belief and

2. That my husband/wife is not employed in Government service / that my

husband/wife is employed in Government and the concession has not been availed
of by him/her separately or himself/herself or form any of the family members for
the connected block 2002-2005 grace period.
3.

Signature of Government servant.

 Part B ( To be filled in the bill Section)

1. The net entitlement on account of leave travel concession works out to Rs

------------------ as detailed below.

(a) Railway/Air/Bus/Steamer fare Rs -------------------------------------------

(b) Less amount of advance of drawn vide Voucher No: ------- date --------Rs --------

Net amount Rs --------

2. The expenditure is debitable to -------------------------------------------------------------

Initials of bill Clerk Signature of DDO

Counter signed

Signature of the Controlling officer

Certified that necessary entries have been made in service book of Shri/Smt/Miss----------

----------------------------.

Signature of the Officer authorized to attest entries in the service book.