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Rvant) 2. Designation (Deptt ) 3. Basic Pay 4.Grade Pay Date 5. Purpose of Journey 6. Expenditure Head 7. Contact No (Mobile) 8. Details of journey(s) performed: Departure Arrival Date & Time From Date & Time To Mode of journey and class of accommodation 1 2 3 4 Fare paid in Rupees Distance in KM Ticket No. Duration of Halt 5 6 7 8 9 9. Amount of TA advance drawn, if any Rs Date of drawal 10. CLAIM OF LOCAL CONVEYANCE CHARGES ON.

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