Form for claiming reimbursement for travel, boarding, lodging related to meeting with Mentor Councils 1 Name Shri.Dr. Anjan Dutta 2 (i) Designation Professor Academic/Professional Institutions (ii) Organisation IIT Nominated by Indian Institute of Technology, Guwahati (iii) Pay/Pay Band (in case of Govt. Official) Dept. of Civil Engg., Indian Institute of Technology Guwahati 3 Address with District/State Guwahati 781039, Assam, India 4 Phone Number 0361-2582405 5 E-mail Address 6 Details regarding travel Departure Arrival Receipt/ Distance Amount Ticket Mode of in Kms. claimed/ attached Travel (for travel Date/Time From Date/Time To Fare Paid by road) (Yes/No) 7 Details regarding boarding/lodging Period of Stay Amount paid/to be paid Receipt Name of Hotel attached From To Boarding Lodging Total (Yes/No) Sector Construction, Construction Material and Real Estate sector (42 -48) / 279 (Signature of claimant) (27.01.2014)
Form for claiming reimbursement for travel, boarding, lodging related to meeting with Mentor Councils 1 Name Shri.Dr. Anjan Dutta 2 (i) Designation Professor (ii) Organisation Academic/Professional Institutions IIT Nominated by Indian Institute of Technology, Guwahati (iii) Pay/Pay Band (in case of Govt. Official) 3 Address with District/State Dept. of Civil Engg., Indian Institute of Technology Guwahati Guwahati 781039, Assam, India 4 Phone Number 0361-2582405 5 E-mail Address 6 Details regarding travel Departure Arrival Amount claimed/ Fare Paid Mode of Travel Distance in Kms. (for travel by road) Receipt/ Ticket attached (Yes/No) Date/Time From Date/Time To 7 Details regarding boarding/lodging Period of Stay Name of Hotel Amount paid/to be paid Receipt attached (Yes/No) From To Boarding Lodging Total Sector Construction, Construction Material and Real Estate sector (42 -48) / 279 (Signature of claimant) (27.01.2014)