l-,\_

\ - Below Rs (Rupees in words)

\-t
rR, se(c)
2014
Vide G O (P)No 14912014lFin dated, 26 04.2014 & G.O.(P)No.306/2014lFin dated ,23 07
NATURE OF CLAIM.
Name of Treasury

Name of Dept Name of DDO/SDO

D D O Code /SDO Code Designation of DDO/SDO
PEN of DDO/SDO
Name of office
PAN/GIR

Bill No :(DDO Code + Type of payment+serial no)

Plan (P) / non Plan (N) Voted (V) / Charged ( C)

Expenditure Head of Account
Plan (P) / non Plan (f',1) Voted (V) / Charged ( C)
Salary Head of Account
CPS/CSS

Period of claim: (From)

Amount

Brief discription of transaction Number and Date Rs

Sl.No
of Sanction order

Total
accou nt/other accou nts/cash)

Payees particulars : ...

with the codal provisions, rules
Please pay the amount as detailed above' This bill is prepared strictly in accordance
and requaltions. The amount claimed in-this bill has not been drawn Previouslv.
nature of SDO/DDO

Appropriation for current year : ... " '

Expenditure till date : ....
Expenditure including in this bill : . ''

Signature of DDO/Cpnlcllng-el!9g
FOR TREASURY
(Rupees only) in CASH/cheque
Pay Rs
only) by RBR and
Rs
. only) by Transfer Credit to
Rs....
Treasury/Bank account

Pay Order Cheque No /UTR No.

Accountant

Pay Order Cheque issusg_by

Received Pay Order Cheque

Space for audit enfacement