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Editable and printable TA Claim Form as per Rule 160 of Odisha TA Rules
PARTICULARS OF JOURNEY
(See Rule 160 of O.T.A. Rules)
(a) Name:
(b) Designation:
(c) Department / Office:
(d) Headquarters:
(e) Journey on Tour / Transfer:
(f) Pay & Special Pay:
(g) Amount of advance drawn for this Journey:
(h) Particulars of family Members for whom TA is claimed -
| Departure | Arrival | Distance | Purpose of journey | Mode of journeyAir/Rail/Road etc. (Type of train and class for train journey and conveyance used for road journey.) | Fare paidConveyance and transport charges Cost of Propulsion etc. | Charges, if any paid for accommodation[under Rule 65 (d) 1] | REMARKSIndicate whether leave or free hospitality availed, if any. | ||
|---|---|---|---|---|---|---|---|---|---|
| Place | Date & Time | Place | Date & Time | ||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |