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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 :

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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 : _________________________________________________________________________