PROFORMA [See O.M. No.11013/7/2004-Estt.(A), dated 5-10-2004] Name : Designation : Pay : Ministry / Dept. (Specify Central / : State / PSC) Passport No. : Details of private foreign travel to : be undertaken Period of Name of the Purpose Estimated Expen. Source of Remarks Abroad Foreign (Travel / boarding Funds Countries to / lodging, visa, be visited misc., etc.) Details of previous private foreign : Travel, if any undertaken during the last one year (as under item No.6) Signature Name : Designation :
PROFORMA [See O.M. No.11013/7/2004-Estt.(A), dated 5-10-2004] Name : Designation : Pay : Ministry / Dept. (Specify Central / State / PSC) : Passport No. : Details of private foreign travel to be undertaken : Period of Abroad Name of the Foreign Countries to be visited Purpose Estimated Expen. (Travel / boarding / lodging, visa, misc., etc.) Source of Funds Remarks Details of previous private foreign Travel, if any undertaken during the last one year (as under item No.6) : Signature Name : Designation :
Proforma_Abroad280912.docx