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T.R. FORM NO. 24 See T.R. 4.107 Medical charges Reimbursement Bill D.D.O. Code Grant No. Head of Account Code Bill No. Date Token/T.V. No. Date Department/Office of Sl. No. 1 Section of establishment.

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How to fill out the Wbrsrsa online

Filling out the Wbrsrsa form online is a straightforward process that can be completed efficiently. This guide will provide you with detailed, step-by-step instructions to ensure that you complete the form accurately and completely, facilitating the reimbursement process.

Follow the steps to complete your Wbrsrsa form online.

  1. Click ‘Get Form’ button to access the Wbrsrsa form and open it for editing.
  2. Begin by entering the D.D.O. Code in the designated field to identify the department responsible for processing the bill.
  3. Fill in the Grant Number and Head of Account Code to associate the payment request with the appropriate financial records.
  4. Enter the Bill Number and Date to document when this reimbursement request is being made.
  5. Input the Token/T.V. Number and its corresponding Date for tracking and verification purposes.
  6. In the section for the Department/Office, clearly state the name of the department and relevant details about the individuals involved.
  7. List each claim in the designated columns, providing information on the gross claim, recovery of advance, and the net amount payable.
  8. Ensure that these figures are accurate to prevent delays in processing.
  9. In the Remarks section, provide any necessary explanations or notes related to the claims submitted.
  10. Write out the net amount required for payment both in numeric form and in words to confirm the requested payment amount.
  11. Indicate the allotment received, the progressive expenditure including this bill, and the balance available for transparency.
  12. Certify the claims by confirming that necessary receipts and certificates are appended, ensuring compliance with regulations.
  13. Complete the payment instructions section, indicating whether payment should be made to self, by order cheque, or by Account Payee cheque.
  14. Provide your signature and designation in the Bill Clerk and Accountant fields to validate the request.
  15. Finally, ensure that the form is reviewed, and all necessary signatures from the competent authority are included for approval.
  16. Once all fields are filled and reviewed, save your changes, download a copy for your records, or print and share it as necessary.

Start filling out your Wbrsrsa form online now to ensure timely reimbursement.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232