Bank Account Number: 10224475499 Bank Name: State Bank of India, IIT Kharagpur IFSC (Indian Nationals): SWIFT Code/ IBAN (Foreign Nationals):

SPONSORED RESEARCH & INDUSTRIAL CONSULTANCYINDIAN INSTITUTE OF TECHNOLOGY, KHARAGPUR

TRA V ELL I NG ALLOWANCE B I LL

Bill No Vr. No.

Approval No. & Date Dated

Name in full Foolan Barik Employee Code No.

Deptt./Centre/Section: Computer Sc. & Engg. Designation Assistant Professor Basic Pay Rs. Syndicate Bank A/c

PART I C U L A RS OF JO U RNEY A ND HA L T

Departure Arrival Mode of Journey Actual Exp.

Ticket No. &

Station Date &Time

Station

Date &Time

Air/Rail/Road

Class ofjourney

No. ofFares

X 12:00hrs y 14:00 Air Economy EUR 250

PURPOSE OF JOURNEY AND AUTHORITY:

* Ticket No. is to be mentioned for journey made by Air/Train (above 2nd class) as per government rule.1. Certified that I was / was not treated as Guest during my Halt at ………………………… and was/ was not provided with board and lodging only at State expense of the Government Of India or another organization.2. An advance of Rs……………………….was drawn by me for this purpose vide Bill No…………….dated……………. and is to be adjusted against the bill.3. Certified that this is not preferred to and paid from any other source.4. Certified that I stayed from ………………………… to……………………………………..at ……………………………………………………………….. (Name of Hotel/ Establishment) which provided me Board and Lodging at sanctioned tariffs.

Countersigned of Authority who approved the journey

FORWARDED

------------------------------------- ------------------------------ Signature of HOD/HOC/HOS/PI/PC* Signature of the Employee & Date *The signature of HOD/HOC/HOS is required only for faculty members/permanent staff of the Institute.