Government of India
                          National Informatics Centre
                      Assam State Unit, Guwahati 781006
        
                   TA/DA Bill for Local Journeys Under 8 KM.     
        
                      For the month of: ________________                
        
        Headquarter: _______________________  Employee Code: _____________
        Name: ______________________________  Designation: _______________
        Division/Section: __________________  Basic Pay: _________________
        __________________________________________________________________
        Date |    Travel      | Scooter| Claim  | Fare     | Purpose of
        Time | From  |   To   |  Taxi  | in KM  | Paid     | Journey
        _____|_______|________|________|________|__________|______________
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |
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             |       |        |        |        |          |   
             |       |        |        |        |          | 
             |       |        |        |        |          | 
             |       |        |        |        |          | 
             |       |        |        |        |          | 
             |       |        |        |        |          | 
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |
             |       |        |        |        |          |   
             |       |        |        |        |          |
             |       |        |        |        |          |     
        _____|_______|________|________|________|__________|_____________
        
        Certified that I have actually spent the amount narrated above 
        and the claim was not proffered previously.
        
        
        				            Signature
        					Name & Designation
                              
                              For Office Use Only
        
        Certified that Mr./Ms. _____________________________ was directed
        to travel from ___________________________ by bus/scooter/taxi in 
        connection with the work. He/She travelled in the public interest
        
        
        
            Signature of                                  Signature of 
        Controlling Officer                              Head of Office 
               
        Passed for Rs. _________  (Rupees _____________________________)
        
        Signature of D.D.O. _____________________________________
        
        
        Signature of Receiving Officer: _________________________