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GA 76 New Form No. GA 36 F
GFAR 189 Rule 150(1)
Government of Rajasthan
Leave Encashment Bill (Inner Sheet)
Reference No:16227631 Month/Year:Dec/2017
Detailed Leave Encashment Bill of Permanent establishment of : GSSS, BARMER OfficeID:13902

Name of DDO:GSSS, BARMER DDO Code:13902

Bill No & Date:77-26/12/2017 Demand No:15 TAN No::JDHG05076B Object Head:84
Budget Head:2071-01-115-01-01/SF/V SF:0.00 Non Plan:0.00 CA: 0.00 NA: 0.00
Gpf No/PRAN Employee Name No of Basic -------{Pay Allowance}------ Gross --{Pay Net Amount
Belt No. Designation Name of Bank/ leaves to Pay Amount Deduction}----
SR No. St. Ins. NO. Employee ID Name of Branch/ be
Pay Scale Sanction No./Date Account No. enchased

r
Grade Pay/DP
Nominee Name (days)

e
Basic Pay

g
1 258779 HAUA ACHARYA 195 27360 Basic 100 177840.00 425038.00 425038.00
\ڙȡ”€

a
0 STATE BANK OF
DA 104 247198.00

n
427373 INDIA
RJBM197805007696

a
9300-34800 PANGHAT ROAD,
5400 BARMER

M
21960 51012023481

Date of Retirement:/Death
Payable on or after (01/09/2017)
Gross Amount: 425038.00

Amount in words:FOUR LAKH TWENTY FIVE THOUSAND AND THIRTY EIGHT ONLY
P ay IF M S
Deduction Amount: 0.00 Net Amount: 425038.00

Certificates:
1. Certified that I Personally examined and satisfied myself about the genuineness of the claim that the Leave Encashment Bill of the employee(s) included in this
bill are strictly in accordance with rules and that the said employee are entitled to such Leave Encashment Bill. It is further certified that I have personally ensured observance of
all formalities regarding necessary entries in the relevant record/register(s)/service book as the case may be,before presenting the claim.
2. All Required information including bank account details in this bill has been checked and verified.
3. It is certify that I have carefully examined and verified the master data of the said claim
Enclosures (System generated/ Scanned)^:

0
Sign(With Seal)/e-Sign/Digital Sign of DDO
Enclosures marked(^) are to be printed in the bill as per selection from dropdown menu according to the requirements defined under relevant rules

Disclaimer : All contents related to this bill are provided by Head of Office/DDO and he/ she is solely responsible for it.
S/W Courtsey National informatics centre, Rajasthan State Unit (http://paymanager.raj.nic.in) Group Name: STATE FUND 1 Print Date & Time : 26/12/2017
13:12 PM