Scribd Logo
Upload

Welcome to Scribd!

  • 303 views

    Form Mci 14 (Ta)

    Uploaded by

    kumaraswamikalmath
    This document is a travel allowance claim form for the Medical Council of India. It requests information such as the traveler's name, designation, pay, purpose of journey, departure and arrival details including dates, times, mode of transportation, distance traveled, and details of hotel or guest house stays. It also includes sections for office use only to calculate total claim amounts and notes instructing the traveler to attach original tickets and receipts and sign certifying statements about the trip expenses and reimbursement.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Form Mci 14 (Ta)

    Uploaded by

    kumaraswamikalmath
    303 views2 pages
    This document is a travel allowance claim form for the Medical Council of India. It requests information such as the traveler's name, designation, pay, purpose of journey, departure and arrival details including dates, times, mode of transportation, distance traveled, and details of hotel or guest house stays. It also includes sections for office use only to calculate total claim amounts and notes instructing the traveler to attach original tickets and receipts and sign certifying statements about the trip expenses and reimbursement.

    Original Title

    Form Mci 14 (Ta)

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a travel allowance claim form for the Medical Council of India. It requests information such as the traveler's name, designation, pay, purpose of journey, departure and arrival details including dates, times, mode of transportation, distance traveled, and details of hotel or guest house stays. It also includes sections for office use only to calculate total claim amounts and notes instructing the traveler to attach original tickets and receipts and sign certifying statements about the trip expenses and reimbursement.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    303 views2 pages

    Form Mci 14 (Ta)

    Uploaded by

    kumaraswamikalmath
    This document is a travel allowance claim form for the Medical Council of India. It requests information such as the traveler's name, designation, pay, purpose of journey, departure and arrival details including dates, times, mode of transportation, distance traveled, and details of hotel or guest house stays. It also includes sections for office use only to calculate total claim amounts and notes instructing the traveler to attach original tickets and receipts and sign certifying statements about the trip expenses and reimbursement.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Form -MCI-14 (TA)

    MEDICAL COUNCIL OF INDIA, NEW DELHI


    TRAVELLING ALLOWANCE CLAIM

    ADDRESS NAME :

    DESIGNATION :

    PAY :

    PURPOSE OF JOURNEY :

    DEPARTURE ARRIVAL
    STATION DATE TIME STATION DATE TIME TRAVELLED BY AMT. DISTANCE DETAILS OF DAILY
    ALLOWANCE
    ROAD /RAIL/AIR (in TRAVELLED BY HALT IN
    Rs.) ROAD HOTEL/GUEST
    HOUSE ETC .

    Note : Please fill up the above Form and enclosed the Journey Ticket (original/copy/bill etc.) and bills issued by Hotel/Guest House for
    stay charges and Bills/Receipts issued by Taxi operators/unions for conveyance charges for prompt processing of the TA/DA Claim.
    Form -MCI-14 (TA)

    FOR OFFICE USE ONLY


    (Amount in Rs.)
    Journey Fare (Air/Rail/Road)

    Local Conveyance

    Stay Charges

    Meal Allowance

    Prof. Fee (for inspections only)

    Total

    Deduction of Advance (if any)

    Net Claim Passed for Rs.

    Please pay Rs. ________________

    (Rupees____________________________________________________________)

    to Shri/Dr.

    ASSISTANT ACCOUNTS OFFICER / SECRETARY

    CERTIFICATE
    1. Certify that I performed the journey by Air/Ist Class Rail fares etc. shown in the bill are correct & were actually paid by
    me.

    2. I certify that no Staff Car, Govt. Jeep, or any other Govt. transport was used for the journey. I did not perform the road
    journey for which road mileage allowance has been claimed at higher rates as prescribed under S.R. 46 by taking a single
    seat in taxi, motor, bus or motor lorry ply for me.

    3. I certify that I was actually and not merely constructively in camp on Sunday and holidays for which daily allowance
    claimed in this bill.

    4. I certify that TA/DA for this tour have not claimed from other sources.

    5. No return tickets were purchased for this journey.

    6. I certify that I was not a State Guest.

    7. The road mileage claimed in the bill is correct to the best of my knowledge and belief.

    8. The drawl of the amount in the bill is not a source of profit to me.

    9. Certified that my monthly emolument exceeds Rs. ____________ P.M.

    CONTENTS RECEIVED

    Revenue
    Stamp

    SIGNATURE

    You might also like