FORM C. V. 6

REQUISITION FOR TRAVELLING ALLOWANCE/DAILY ALLOWANCE (Higher Secondary Examination) Name of Chief Examiner:

Name of Venue School:

Designation and Address:

Headquarters (Place of School):

Scale of Pay/ Basic Pay: Date and hours of journeys From To Arrival Departure time

Route From (Headquarters)

To

Distance Mode of Travelled Conveyan ce used KM

Amount of T.A. claimed (Actual Fast/ II Class Ordinary Train fare

Days of halt From

To

Amount of D.A. Total D.A. claimed for + Bus fare halt

Remarks

Certified that I have travelled through the shortest route connected by Public Conveyance and that the particulars given above are correct. Countersigned Amount Claimed: Rs Amount Passed: Rs

Chief Supdt.

Name and Signature of Chief/ Asst. Examiner

requisition for travelling allowance/daily allowance - KHSTU

Name of Chief Examiner: Name of Venue School: Designation and Address: Headquarters (Place of School):. Scale of Pay/ Basic Pay: Distance. Travelled. From.

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