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Claim For Leave Travel Assistance (LTA) Form

This document is a claim form for Leave Travel Assistance (LTA) that requires the employee's personal and travel details, including names of persons traveled with and journey specifics. It includes a declaration of expenses incurred and requires signatures from the claimant, leave sanctioning authority, and HR department for verification. The form also has sections for financial checks by the accounts department.

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piyush.2401
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56 views2 pages

Claim For Leave Travel Assistance (LTA) Form

This document is a claim form for Leave Travel Assistance (LTA) that requires the employee's personal and travel details, including names of persons traveled with and journey specifics. It includes a declaration of expenses incurred and requires signatures from the claimant, leave sanctioning authority, and HR department for verification. The form also has sections for financial checks by the accounts department.

Uploaded by

piyush.2401
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CLAIM FOR LEAVE TRAVEL ASSISTANCE (LTA)

Name: ___________________________________
Designation:_______________________________

Department:_______________________________Employee Code:_____________
Grade:____________

Basic Salary Rs.:____________________________LTA Bill Submission


Date:______________

DETAILS OF PERSONS TRAVELED


Sl. Name of the Person Relationship
No.
1

2
3
4
5
6
DETAILS OF JOURNEY
Sl. Date Travel by Class of
of From To Rail Amount Rs.
No. Travel
Travel /Air//Bus/Tax
1
2
3
4
5
6
Total
Expenses
DECLARATION
I hereby declare that I have actually spent the claimed amount on travel by self on leave
and family for the year …………..…. / block of two years………..

……………………………. ………………………..
Signature of Claimant
Leave Sanctioning Authority
_________________________________________________________________________________________

…………………………….. ………… ………..


……
Verified by HR Deptt.
Signature of Registrar
________________________________________________________________________________________
For Accounts Use:
Checked by…………………. Passed
For Rs. ………………..

Asstt. Finance
Officer Finance Officer

Date………….
Date………

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