Download:: pmad.gov.

pk/rc

PAFT-1715
TA/DA CLAIM
No Rank Name Appt Unit: Fmn

Rate of Pay A/c No Specific duty under P R Rule No

Authority for move Date copy attached if unclassified)

From To *KM +Days Rail Fare/ Deduct pm Total Additional Information

Place Hour Date Place Hour Date by Halted Road Account for (for permanent duty only)
Road KM of Form ‘E’ Payment
Rupees Used Rupees
Rupees
A. Details of family.
Wife . . . . . . . . . . . .
Children residing with and wholly dependant on the indivi-
dual.
3 to 12 Over 12
years years
Moved:-
Legitimate Male From
Female To
Legally adopted . On
Step .
B. Auth motor vehs conveyed (Copy of competent authority’s
sanction attached) :-

C. Amount paid for the conveyance of :-

1. Motor vehs.
a. By rail Rs. b. By road Rs
2. Baggage :- Rupees Weight
a. By Road
b. By goods train
c. By passenger train

*Distance between residence and railway station will be shown Total

Enforced halts are also to be shown here Carried Forward Date____________ _______________________

Signature of claimant

Received Payment
Download:: pmad.gov.pk/rc

Rupees
Revenue
Stamp if
Necessary
Total brought forward
Deduction a. Accommodation
on b. Messing Date 20 Signature
account c. Transport
of d. Advance Countersigned as a correct claim

Total for payment

(in words) Date 20 Signature

CERTIFICATES
I certify that :-

1. I travelled by rail in class

or
2. I did not perform/performed the road journey(s) for which Km has been claimed at the higher rate prescribed in SR 46/PR Rule 416 as amended by a taxi, motor,
omnibus or motor lorry plying for hire/engaging a whole taxi because a seat in a taxi, motor omnibus or motor lorry plying for hire on single seat basis on the route
travelled by me was not available.
3. I was actually and not merely constructively in camp for the days whether Friday or holiday for which DA has been claimed, (For temporary duty only).
4. I was not provided with free accommodation, messing and transport facilities at government expense.

Date 20 Signature

FOR USE IN CMA’S OFFICE

TA Audit Register Page Demand Register Page Disbursement Vr no for
Passed for Rs (Rupees
in favour of Paid by Cheque no dated
Treasury/Bank PTR
DCMA on_ Treasury/Bank
DACMA

Supdt Auditor Supt DACMA