ANNEXUREI PROFORMA FOR SUBMISSION OF HILL TRANSPORT SUBSIDY CLAIM. The claim Bill for transport subsidy reimbursement of Rice/Wheat/levy Sugar for the month........................................... Bill No.......... Date.......... The Government of Arunachal Pradesh A/C. The Deputy Commissioner_______________________________________________________District. Sl. No. Completed R/o No. & Date Commodity & Qnty lifted against the release order Depot from where stock lifted Depot/center/where the stock transported & taken delivery Distance Admissible/covered Qnty. For which claim lodged Rate of TPT charge of HTS claim made Total Amount Rs. P. Name of carriage contractor Remarks 1 2 3 4 5 6 7 8 9 10 11 PreReceipt Rupees____________________________________________________ ___________________________________________________________ Payment received in full Prepared by Counter signed by ( ) (District Food & Civil Supplies Officer) ( Deputy Commissioner ) 1. Certified that....................Qtls of.......................taken delivery from F. C. I. Depot......................under release order No....................have been transported as per details furnished in claim Bill No...............date.............and received at the destination Depot/Centre in good condition. 2. Certified that stock have been entered in depot register of relevant PDS rationing register for destination under PDS/TPDS Scheme. 3. Certified ..................Otls of...................taken delivery from..............under release order No.............. have been transported to ......................by road covering a distance of...............K. M. by shortest direct route and received in good condition. 4. Certified that the rate /at which the transport charge /Hill Subsidy is claimed has been fixed after assessing the market rates/ open tender, giving publicity. 5. Certified that Road transport charges claimed for transportation of stock ExF. C. I. delivery depot to destination aforesaid have not been passed on to the consumer under PDS/TPDS. 6. Certified that Hill Transport Subsidy of RS..................(Rupees..............................) only claimed in this bill has actually been incurred in transportation of.........................qtls...................from F. C. I. designated depot to the destination center as shown in the bill during the month of.................... 7. Certified that transportation of stock from ExF. C. I. depot to destination of the State Government have been made vide Truck No................................ 8. Certified that transportation charges have been paid to the transporters by Voucher No..............date...........Cheque No............Date........ for Rs................... 9. Certified that stocks were actually transported and reached to the destination of the State Government as stipulated under Government of India approved scheme. 10. It is further certified that this bill is prepared on the strength of the receipted challan(s) duly countersigned by the local administrative Officer and verification by representative of Vigilance Committee. Enclosed: 1. R/o Copy. 2. Suballocation Order............. 3. Lifting Certificate.............. ( ) () 4. D. C's Certificate.............. District Food & Civil Supplies Officer Deputy Commissioner 5. Acknowledgement 6. Approved Rate. The bill has been verified and is found to be in order Director of Food & Civil Supplies, Arunachal Pradesh, Naharlagun.
