walchand college of engineering · vijay patil) teqip coordinator (dr. v. b. dharmadhikari) i/c....
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WALCHAND COLLEGE OF ENGINEERING
VISHRAMBAG, SANGLI
EXPENDITURE CLAIM UNDER TEQIP - III
___________________________________________________________________________________________________________________________
Name of the Claimant: _______________________________________________________ Dept.: _________________________________
Mobile: ______________________________ Email: __________________________________________________________________________
Designation: ________________________________ Basic Pay: Rs. ___________________/- Grade Pay: Rs. _________________/-
Bank Name :___________________________ IFSC Code : _________________ Bank Account : _______________________________
Office Order No: ______________ Activity Name: ______________________________________________________________________
Conducted at (City Name): _______________________Activity Start on: _____________ Activity End on: __________________
Sr. No
Description Details of Travel (Travelled Route) (Source
& Destination)
Ticket / Invoice / Receipt
Number.
Travel DA as per
Travelling hours in Rs.
Amount claimed in Rs.
1
Travelling Expenses Mandatory Docs. 1. Original
Tickets / Original Boarding Pass)
2. In case of
Private Car – Permission from Director & RC Book Copy of the Vehicle is mandatory.
Departure Arrival Mode of Travel
A
Grand Total A + B
B
Date / Time & Place Date / Time &
Place
2
Local Convenience
(Only Auto / Taxi) Attached Separate sheet if place is not sufficient. (प्रती दिवस
रु. ४००/- पेक्षा जास्त
रकमेच्या दिलाांसाठी त्या
रकमेचे “ORIGINAL” दिल
सािर करावे.)
From To Mode of Travel
(Auto/Taxi/Ola/Uber)
Ref :
Alloc :
Register :
Page 2 of 2
Sr. No
Description Particulars (Details of Expenses)
You can claim either 3 or 4.
Receipt No OR Invoice
No.
Amount Claimed
(For TEQIP Office) Amount
Allowed
3
Food (&)
(OR) Stay
(सर्व बिले “ORIGINAL”
च पाबिजते)
4
Normal D.A. (जर र्रील प्रमाणे बिले
नसतील तर)
Number of Actual Activity Days _____________ @ Rs. 200/- for Non Metro
Number of Actual Activity Days ____________ @ Rs. 325/- for Metro
(मटे्रो बसटी : बिल्ली, म ुंिई, कलकत्ता, चेन्नई, िदै्रािाि, िेंगलोर) आबण प्रोजके्ट साठी जिलपूर
5
“Bill paid by Me” Particulars (२ पेक्षा जास्त दिलाांसाठी वेगळ्या
कागिावर त्याची “SUMMARY” जोडावी)
Bill No. / Receipt
No Amount Claimed
Summary: 1. ________________ + 2. _______________ + 3. _______________ + 4. _______________ + 5. ______________ ===== TEQIP Expenses Allocation for the Activity: 1.3. ______________ Total Amount (1+2+3+4+5): ₹________________
Amount in Words: ______________________________________________________________________________________________________
: Undertaking Before Claim by the Claimant : Expenditure shown above has been incurred by me wholly, necessarily and exclusively for the purposes of the College's Activity.
Only reimbursement of actual costs is sought; there is no element of profit.
No part of the claim relates to holidays, or private business activities. Any cost relating to the travel costs for partners, family or others who are not engaged on College Activity have not claimed.
No claim in this regards from the College or from any fund or from other institute claimed by me.
If found, I bind to reimburse the same to the TEQIP, which is a project of M.H.R.D., Govt. of India.
Please Pass and arrange to Pay the bills as
enclosed through PFMS.
Name: Sign of the Claimant & Advance receipt
Above bills are forwarded after verification.
Name: (Activity Coordinator)
Above bills are authorised
Name: (Head of Department)
Report
Received
Bills Checked
Checked for Pay
Bills are scrutinised to Pay
Passed
Approved for Payment
TEQIP
Office
TEQIP Accounts
(Prashant Gore) Walchand College Accounts (Gokhale Madam)
Accounts Office
(Shri. Vijay Patil) TEQIP Coordinator
(Dr. V. B. Dharmadhikari) I/c. Director
(Dr. P. G. Sonavane)
With this Claim Form Document following documents must be attached:
1. Original Bill
2. Report / Photos
3. Attendance of Event & Student sign for Kit received.
4. Claimant Signature on all bills
5. Certificates if any
6. Permissions / Copy of approval letter for activity.
7. Resume of External Speakers
8. Presented Papers
9. Photocopy of the Thermal Paper Printed Bills.
10. Undertaking for Amount. For Amt. Claim by you but paid by
others.
Total
WALCHAND COLLEGE OF ENGINEERING, SANGLI
VOUCHER FOR HONORARIUM AND TRAVEL
(FOR EXTERNAL MEMBER ONLY) (Under TEQIP – III)
Proposal No. _________ Allocation: ______ Voucher Date:
Pay to _____________________________________________________________________________
Towards Honorarium for (Title of Activity) _______________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Activity Start Date : ___________________ To ___________________ held at Dept. _____________
Particulars of Honorarium – ( A ) Amount Rs.
Pay by PFMS
Resource Person
Signature
Resource Persons Post :
Industry/Institute Name & Short Address :
Contact No:
Tick the appropriate category of Resource Person -
From IIT/NIT (Rs. 5000/-) From Industry (Rs. 5000/-) // Faculty from TEQIP-III
Institutions (Rs. 5000/-) // From Non-TEQIP-III Institutions (Principal/Professor/Associate
Professor) (Rs. 4000/-) // From Non-TEQIP-III Institutions (Assistant Professor/Contractual
Faculty) (Rs. 3000/-)
Particulars of Travel ( B ) Amount Rs.
From ____________________ To WCE Sangli
From WCE Sangli To ______________________
Local Convenience: ________________________ ----
Kms._________ x Rate/Km_________ = Rs. _________
Vehicle No:_______________ Total
Pay by PFMS
Resource Person
Signature
Please tick & attach appropriate valid documents with this claim.
Original Bus / Train Tickets. Bills Paid to Travel agency.
Car Travel prior permission from director.
RC book copy (for All Car/Hired Vehicle Travel) Toll Receipts.
Local Convenience without valid bills is allowed to claim Maximum up to Rs. 400/-
MANDETORY one page resume of concern person with photo. Rate for Petrol Vehicle: Rs. 15/- Km, Diesel: Rs. 12/- Km.
Total Claim Amount :
Honorarium ( A ) _____________ + Travelling ( B ) ______________ = Total : ______________
Activity
Coordinator H.O.D. TEQIP
Accounts
WCE
Accounts
Accounts
Officer
TEQIP
Coordinator I/C. Director
BANK DETAILS OF RESOURCE PERSON
Account Holder Full Name (As per Bank Passbook): ______________________________________
Bank Name : _______________________________________________________________________
Branch Name : ______________________________________________________________________
IFSC Code : ________________________________________________________________________
Account Number : ___________________________________________________________________
PAN No : __________________________________________________________________________
GST No : __________________________________________________________________________
Phone No : _________________________________________________________________________
Mobile No : ________________________________________________________________________
E Mail ID : _________________________________________________________________________
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