भारतीय प्रौद्योगिकी संस्थान रोपड़INDIAN INSTITUTE OF TECHNOLOGY

भारतीय प्रौद्योगिकी संस्थान रोपड़

INDIAN INSTITUTE OF TECHNOLOGY

आकस्मिक/प्रतिपूर्ति/अग्रिम समायोजन बिल

CONTINGENT / REIMBURSEMENT / ADVANCE ADJUSTMENT BILL

Note : - If there are multiple bills, The entries may be made in single form.

Name & Designation / नाम एवं पदनाम*

Employee ID / Entry No.*

Mobile No.

Phone

Department / विभाग*

Select

Budget Head*

(Deptt, ISIRD, CPDA, Project(R&D), Admin, etc.

Vendor's Name / विक्रेता का नाम*

Particulars of Expenditure & QTY*

INVOICE NO. & INVOICE Date*

Note: - Invoice should be submitted with in one month from invoice date, otherwise approval of competent authority may kindly be attached for processing the claim.

INVOICE AMOUNT*

File Upload*

Note : - Max. 05 invoice(s) separate bills can be uploaded

Drag and drop files here or

GEM/ NON-GEM*

Note : - In case of Non-GEM, please attach approval of competent authority.

GEM

NON-GEM

Location of item*

STOCK REG. (DEPT.)*

Stock Entry should in the format i.e.: Consumables-2 - 59/6 dated Day.Month.Year

Gate Entry. /Date (If any)

Gate Entry Format i.e.: 1258(Gate Entry No.) - 12.03.2025

Amount of Advance / अग्रिम राशि

Date of Advance / अग्रिम तिथि

Total Claim Amount*

Certified that I am personally satisfied that these goods purchased are of the requisite quality and specifications and have been purchased from a reliable supplier at a reasonable price. It is also certified that the items have been entered in the respective stock registers.

Please release the Payment in the favor of*

Vendor

मांगकर्ता के हस्ताक्षर/Signature of Indenter

विभाग के प्रमुख./Head of the Deptt.

Registrar/रजिस्ट्रार

(In Case of Committee Chairman, Registrar is the competent authority)

Dean(FA&A)

(In Case HOD is the Indenter, Dean (FA&A) is the competent authority)

To Be Filled by Store and Purchase Section

DRR No. ______________________ DRR Date___________________

To Be Filled by Accounts Section

Passed for Payment Rs.___________ Debitable to the Account Head______________

Less Deduction ___________________ Cost Center________________________________

Less TDS __________________________

Less GST ___________________________

Other Deduction ____________________ Payable to _________________________________

Net Payable Amount__________________

JAA/SAA JAO/AO AR/DR/JR Audit Section Registrar

*Guidelines for Filling Out the Form:

Please complete every required column.
Take a printout of the form before submitting it.
Submit the form and forward a hard copy to the Purchase and Store Section for further processing.

Send me a copy of my responses

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