Form for claiming reimbursement for travel, boarding, lodging related to meeting with Mentor Councils 1 Name Shri.Dr. Vinod Kumar 2 (i) Designation Professor Academic/Professional Institutions (ii) Organisation IIT Nominated by Indian Institute of Technology, Roorkee (iii) Pay/Pay Band (in case of Govt. Official) D/o Elect Engg., Indian Institute of Technology Roorkee 3 Address with District/State Roorkee, Uttarakhand India - 247667 4 Phone Number 9412074172 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 Industrial Automation & Instrumentation sector (142 -147) / 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. Vinod Kumar 2 (i) Designation Professor (ii) Organisation Academic/Professional Institutions IIT Nominated by Indian Institute of Technology, Roorkee (iii) Pay/Pay Band (in case of Govt. Official) 3 Address with District/State D/o Elect Engg., Indian Institute of Technology Roorkee Roorkee, Uttarakhand India - 247667 4 Phone Number 9412074172 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 Industrial Automation & Instrumentation sector (142 -147) / 279 (Signature of claimant) (27.01.2014)
262inviteesdetails-25sectorsAgritoTravel-TADAform-draft.docx