Schedule LIII-Form No.72 PARTICULARS OF JOURNEY (See Rule 160 of O.T.A. Rules) (a) Name ............. (e) Journey on Tour/Transfer (g) Amount of advance drawn Rs. (b) Designation ............ (f) Pay and Special Pay Rs. For this journey. (c) Department/Office ........ (h) Particulars of family members (d) Headquarters ........... For whom T.A. is claimed ........ Departure Arrival Distance Purpose of Mode of journey Fare paid Charges, if any paid for accommodation [under Rule 65 (d)1] REMARKS (Indicate whether leave or free hospitality if any availed) Place Date Time Place Date Time journey Air/Rail/Road, etc. Type of train and class for train journey and conveyance used for road journey Conveyance & transport charges Cost of propulsion 1 2 3 4 5 6 7 8 9 10 Signature of the Controlling Officer Signature of the Claimant P.T.O. 1 2 3 4 5 6 7 8 9 10 Signature of the Controlling Officer Signature of the Claimant
