INTERVIEW / JOINING

TA CLAIM REIMBURSEMENT FORM

(PLEASE FILL IN BLOCK LETTERS)

DATE :

POST APPLIED FOR :

NAME :

PRESENT DESIGNATION : DEPARTMENT:

BANK ACCOUNT DETAILS : (For reimbursement transaction in bank account).

ACCOUNT HOLDER :
(NAME)
IFSC CODE
BANK & BRANCH

ACCOUNT NUMBER :

DETAILS OF JOURNEY

FROM TO MODE / CLASS FARE (Rs.)

ONE WAY
RETURN

Total Rupees (in words) : Total Rs.

APPLICANT'S SIGNATURE

HR DEPARTMENT
SANCTIONING AUTHORITY

ATTACH DOCUMENTS (Without supporting proof / documents , reimbursement will not be passed):

1. Copy of 'Call For Interview' mail / letter.

2. Journey Tickets (Bus / Train / Air (Economy Class with Boarding Pass) having amount mentioned.
Note: Communication made thro' interview call letter will only be reimbursed. Hotel Accommodation / Refreshment Bills will NOT be
reimbursed.