Form for claiming reimbursement for travel, boarding, lodging related to meeting with Mentor Councils 1 Name Shri. Sanjay Kumar Chowdhary 2 (i) Designation Manager (Projects) Academic/Professional Institutions (ii) Organisation Advanced Plastic Processing Technology Centre Nominated by Government of Odisha (iii) Pay/Pay Band (in case of Govt. Official) Advanced Plastic Processing Technology Centre, S-1/25, 3 Address with District/State Industrial Estate, O.T.Road, Balasore -756001 (ORISSA) 4 Phone Number 06782-653213 / 9437124606 5 E-mail Address apptcbls@gmail.com 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 Plastics sector (193 -194) / 279 (Signature of claimant) (27.01.2014)
Form for claiming reimbursement for travel, boarding, lodging related to meeting with Mentor Councils 1 Name Shri. Sanjay Kumar Chowdhary 2 (i) Designation Manager (Projects) (ii) Organisation Academic/Professional Institutions Advanced Plastic Processing Technology Centre Nominated by Government of Odisha (iii) Pay/Pay Band (in case of Govt. Official) 3 Address with District/State Advanced Plastic Processing Technology Centre, S-1/25, Industrial Estate, O.T.Road, Balasore -756001 (ORISSA) 4 Phone Number 06782-653213 / 9437124606 5 E-mail Address apptcbls@gmail.com 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 Plastics sector (193 -194) / 279 (Signature of claimant) (27.01.2014)
262inviteesdetails-25sectorsAgritoTravel-TADAform-draft.docx