GOVT GIRLS HR SEC SCHOOL, KEELMANAMBEDU

PAYABLE AT SUB-TREASURY POONAMALLEE

D.O CODE SB5H3
TAMILNADU TREASURY CODE FORM NO.40-A
(See instruction 4 (i) to (iii) under Treasury Rule 17)

BILL NO:

/ 15-16

Under Rs.347001- Three

Lakh Forty Seven Thousand and One Only

BILL FOR WITHDRAWAL FROM GENERAL AND OTHER PROVIDENT FUNDS (TAMILNADU)
District-TIRUVALLUR
Sub- Account SA15A Vourcher No
Of
State Provident Fund
Provident Fund
Branch Bill for withdrawing Temporary Advance
withdrawals from the Provident Fund of Tmt MARY EMILDA N. A. P.G. ASST
The establishment of the office of HM, GGHSS,KEELMANAMBEDU for the month of APR.2015
S.N

Name of Subscriber and

designation

Pay

MARY EMILDA N A
P.G. ASST.

Rs.25470+
GP 4800/-

Fund
Account
Number

Number and date of Sanction

letter of authority

141943
EDN

K. Dis. No. 15 /2015, Dt.

16.04.2015 of the Headmaster,
G.G.H.S.S, Keelmanambedu
Total
Deduct amount short drawn in
this bill
Net amount

S.N

Name of subscriber and Designation

Fund
account
Number

Date of
Drawal

Particulars
of Amount
Drawn

Amount now
refunded

8009 General Provident Fund

Temporary Advance SA-15A
D.P.Code 8009-01-101-AA 0108
Nature of withdrawal
Part
TemporaryA
Final
Others
dvance Rs.
Payment

Remarks

347000
347000

347000
Net Amount required for payment Rs.34700/Rupees Three Lakh Forty Seven Thousand
Only
Signature of Drawing Officer
Designation

Station : KEELMANAMBEDU
Contents Received

Acquitt
ance

Please Pay to

ECS

Date:

17.04.2015

Signature of Messenger

Signature

1. Certified that I have satisfied myself that all sums included in bill (Form No.40A, drawn one month/two month/ three months, previous to this date in favour of
G KANAGASELVI Account No 159475/GA With the exception of those detailed (of which the total has been refunded by deduction n this ) excess of .
2. Certified that the balance in the fund at my credit/ the credit of the subscriber on the date of withdrawal covers the sum drawn in the bill.
3. Certified that the policy/ policies detiled below has/ have already been assigned in favour of the Government of Tamil Nadu and forwarded to the Accounts
Office for safe custody/ the details of the policy/ policies proposed to be taken up have been communicated to and accepted by the office in his letter No
.dated.
S.No.
Name of the subscriber with Provident Fund account number
Number of
Name of
Amount of
Due date of
(1)
(2)
Policy
company
Premium
Premium
(3)
(4)
(5)
(6)

1.Certified that the bill was not drawn and paid before
2.certified that no part final withdrawal has been allowed
to the individual during the last one year
3. Certified that no Temporary Advance has been allowed
to the individual during the last six months.

---

---

---

---

Stock
Number
(7)

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1.

Certified that in respect of withdrawals made in bills (Form No.4-A,) one month / two months / three months / previous to this date towards payment of
Insurance premia the original premia receipt have been forwarded within one months of the date of withdrawal to the Accountant General, Chennai/ duly
Produced to me for scrutiny with the exception of those relating to..for Rsand the necessary endorsement haave been made
On the receipts ot the effect that on abatement for income-tax admissible.
2. (a) Certified that the number of policies financed from the provident Fund does not exceed four b) or Certified that the number of policies financed from
The Provident Fund which exceed four, were already accepted prior to 21 st October 1953.
3 (a) Certified that the amount drawn in this bill is for payment for the first premium to take up a fresh policy. B) Certified that the policy/ polcies are in full
Force and free from encumbrance, Examined and entered.

Accountant for use in Audit Office

Rs.
Item--------------------- of------------------Details of objection if any
Admitted ..
Objected
-------------------TOTAL.
Auditor
Accountant.
---------------------

NOTE;

Signature.----------------------------------------------Pay Rs. -----------------------------------------------Rupees ------------------------------------------------

Treasury / Accounts Office

The bill for withdraw; pf advances / final withdrawal should be suppored by a duly certified copy of the sanction in the proper form the letter of authority
Issued by the Audit Office. In the case of non-gazetted Government servants. The copy should be attested by the Head of the Office. In the case of bill for
Withdrawal of payment insurance premia reference to the letter of authority issued by the Audit officer permitting the withdrawal should be quoted as
This reference to this stock number allotted in the policy assigned in favour of the Government of Tamil Nadu and sent to the Audit Officer for safe
Custody. Certified 5 (a) or(b) may be retained according as the number of policies do not exceed or exceed four in each individual case. The drawing
Officers should not present and Treasury officers should not honour the bills in respect of claims made after the expiry of the period of grace allowed
From the due date of the payment of premium specified in the statement below the certificate (2) The period of grace should invariably be mentioned in the bill.