LTC Reimbursement
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Transcript of LTC Reimbursement
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SHREE CEMENT LTD., BEAWARFORM OF DECLARATION
( Signature of the Employee )Date :
(Prescribed under the Leave Travel concession rules Shree Cement Ltd.)
Employee Name Employee Code
Date of Joining / ProbationDepartment
07-JAN-2016
FOR OFFICE USE ONLY1. Claim Period / Year
Form No
Mr. Himanshu Choubisa124521534
06-SEP-1202-1-RCP1-INSTRUMENTATION
Give the following particulars of each members of your family for whom you are eligible claim leave travel concession.
2. Amount of Previous Calender year Salary
3. Amount Claimed
:
Head Quarter Ras-Pali
Date of ConfirmationClaimed YearLeave availed
::::
:
: 01-MAR-2013
:
:
S.No Name Relation Age1
2
HAVIT CHOUBISA
KIRTI CHOUBISA
SON
SPOUCE
1.9
27
Give the name and address ( including district and state of your Home town )
Sai Street No. 5, Jai Hind Nagar, New Colony,Dungarpur,Rajasthan 314001,RJ,IN
Distance in Kms.By Rail / Road. Road
4732
Class of Travel. BY ROAD TOYOT
Visit Description : BEAWAR TO PONDICHERRY AND PONDICHERRY TO BEAWAR TAXI FARE4732 * 12 = 56784RS
FIFTY SIX THOUSAND SEVEN HUNDRED EIGHTY FOUR ONLY
Rs.
Rs.
4. Leave travel concession passed for 8% of S.No.2 Rs.
5. Advance taken Rs.
6. Net Amount Payable Rs.
Claimed Passed for Rs.
Folio No.
Debit :- LTA STAFF / WORKER Payment ( Rs.
LTC Journey Block : 2014-2017
Bill Amount in words:-
01-JAN-2015 TO 31-DEC-2015
YesBill attached :- NoApproval Required :-
I here by declare that the particulars furnished above are true and to the best of my knowledge and belief.
06-MAY-15 TO 17-MAY-15
56784.00Total Bill Amt :-
35865