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					Figures are in rupees. DUE DRAWN STATEMENT NAME OF DEPARTMENT: ………………………………………………………………………………………….

Arrear of DA increased form ……..% to …………% w.e.f.(date) …………………………..
PERIOD S NO 1 1 Mrs A 2 Mr B 3 Mrs A 4 Mr B 5 Mrs A 6 Mr B 7 Mrs A 8 Mr B 9 Mrs A 10 Mr B NAME 2 DESIGNATION 3 Dy. Registrar Dy. Secy. Dy. Registrar Dy. Secy. Dy. Registrar Dy. Secy. Dy. Registrar Dy. Secy. Dy. Registrar Dy. Secy. FROM D1 M1 YYYY1 D2 4 5 6 7 1 1 1 7 1 13 1 19 1 25 1 31 1 37 1 43 1 49 1 55 2007 30 2006 28 2005 12 2004 23 2003 33 2002 45 2001 23 2000 44 1999 55 1998 6 TO M2 YYYY2 8 9 4 2 0 5 -6 -8 -10 -12 -14 2007 2007 2007 2007 2007 2007 2007 2007 PAY 10 9600 9600 9600 9600 9600 9600 9600 9600 9600 DP 11 4800 4800 4800 4800 4800 4800 4800 4800 4800 4800 PAY+DP 12 14400 14400 14400 14400 14400 14400 14400 14400 14400 14400 NEW OLD DA DIFF NO. OF DA DA DUE DA DRAW PER TOTAL MONTHS RATE RATE N MONTH 13 35 41 47 53 59 65 14 5040 5904 6768 7632 8496 9360 15 29 35 41 47 53 59 65 16 4176 5040 5904 6768 7632 8496 9360 17 864 864 864 864 864 864 864 864 864 864 18 19 3456 6912 2592 2592 5184 4320 4320 6912 1728 1728 39744

REMARKS 20

6797 2007

71 10224 77 11088 83 11952 89 12816

71 10224 77 11088 83 11952

2007 9600 TOTAL

4 8 3 3 6 5 5 8 2 2

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains. Signature of Drawing and Disbursing Officer

Figures are in rupees. DUE DRAWN STATEMENT NAME OF DEPARTMENT: ………………………………………………………………………………………….

Arrear of DA increased form ……..% to …………% w.e.f.(date) …………………………..
PERIOD SL. NO 1 NAME & DESIGNATION D1 2 3 1 1 1 19 1 FROM M1 YYYY1 D2 4 7 8 7 7 8 5 2005 2005 2005 2005 2005 6 18 30 18 31 30 28 31 M2 7 7 11 7 7 11 2 12 BASIC TOTAL NO. PAY DAYS OF OF PER MONTH DAYS YYYY2 MONTH 8 9 10 11 2005 2005 2005 2005 2005 2006 2006 8575 9000 8575 9000 9000 9300 4000 GRAND TOTAL 31 xx 31 31 xx xx 18 xx 18 13 xx xx PAY + DP 14 7469 NEW OLD DIFF NO. DA OF TOTAL REMARKS DA DA DUE DA PER DRAWN RATE RATE MONTH MNTS 15 16 17 17 17 17 17 17 17 21 18 1270 2295 1270 962 2295 2372 1260 19 298 540 298 227 540 558 180 20 xx 21 298 2160 298 227 2160 1674 4359 4000 2000 6000 24 1440 4320 11137 22

TO

PAY 12 4979 9000 4979 3774 9000 9300

DP 13 2490

1 Mr. A, Dy. Registrar 2 Miss B, Dy. Secy. 3 Mrs C, Dy. Director .-do.-do-

21 1568 21 2835 21 1568 21 1189 21 2835 21 2930

4500 13500 2490 7469 1887 5661 4500 13500 4650 13950

4
xx xx

.-do1 12 2005 Sub-Total for sl.no.3 (01-Jul-05 to 28-Feb-06) 4 Mr. D, LDC 1 1 2005

4 3 24

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains. Signature of Drawing and Disbursing Officer

Figures are in rupees. DUE DRAWN STATEMENT NAME OF DEPARTMENT: ………………………………………………………………………………………….

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains. Signature of Drawing and Disbursing Officer

DUE DRAWN STATEMENT NAME OF DEPARTMENT: …………………………………………………………………………………………. Name of govt. servant: Office Order No. & Date: Scale of Pay:
PERIOD FROM TO DA D1 M1 YYYY1 D2 M2 YYYY2 RATE
1 2 3 4 5 6 7

Figures are in rupees.

Designation:

DUE BP
8

DRAWN SBCA HRA (10%) (15%)
12 13

DP
9

BP+DP
10

DA
11

TOTAL DA DUE RATE (10+…+13) 15 14 19170 19170 17 17

BP
16

DP
17

BP+DP
18

DA
19

SBCA HRA (10%) (15%)
20 21

TOTAL DIFF. TOTAL DRAWN PER DAYS (18+…+21) MONTH OF 22 23 24 18265 18265 905 905 31 xx

NO. OF DAYS
25

PAYABLE NET NO. OF TOTAL IT TOT. IT REMARKS MONTHS DIFF. DIFF (25x28) PAYABLE (24 X (PM) OR (28) (27-29) 26 27 28 29 30 31 xx 380 905 27 64 27 64 353 841

19 1

7 2005 31 8 2005 31

7 2005 8 2005

17 17

9000 4500 13500 2295 1350 2025 9000 4500 13500 2295 1350 2025

8575 4288 12863 2187 1286 1929 8575 4288 12863 2187 1286 1929

13 xx

1

GRAND TOTAL

1285

91

1194

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains.

Signature of Drawing and Disbursing Officer

DUE DRAWN STATEMENT NAME OF DEPARTMENT: ………………………………………………………………………………………….

Figures are in rupees.

S NO 1 1 2 3 4 5 6

NAME & DESIGNATION 2 Mrs A Mr B Mrs A Mr B Mrs A Mr B D1 3 19 1 12 13 23 12

PERIOD FROM M1 YYYY1 D2 4 5 6 7 2005 31 8 9 10 11 12 2005 31 2005 31 2005 31 2005 31 2005 31

DUE DRAWN PAYABLE TO TOTAL NET DIFF. PER NO. OF TOTAL DA SBCA HRA TOTAL DA SBCA HRA TOT. IT BP DP DA BP DP DA DUE RATE PAYABLE MONTH MONTHS DIFF. M2 YYYY2 RATE (10%) (15%) (10%) (15%) DRAWN (27-29) (14-22) 7 8 9 10 11 12 13 14 (10+…+1 16 15 17 18 19 20 21 (16+…+21) 22 23 24 25 26 27 7 2005 54 9000 4500 7290 1350 2025 24165 17 8575 4288 2187 1286 1929 18265 5900 1 5900 0 5900 8 9 8 11 8 2005 2005 2005 2005 2005 54 54 54 54 54 9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350 GRAND TOTAL 2025 2025 2025 2025 2025 24165 24165 24165 24165 24165 17 17 17 17 17 8575 4288 2187 8575 4288 2187 8575 4288 2187 8575 4288 2187 8575 4288 2187 1286 1929 1286 1929 1286 1929 1286 1929 1286 1929 18265 18265 18265 18265 18265 5900 5900 5900 5900 5900

REMARKS 28

1
2

5900 11800 5900 17700 11800 59000

0 0 0 0 0 0

5900 11800 5900 17700 11800 59000

1
3

2

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains. Signature of Drawing and Disbursing Officer

DUE DRAWN STATEMENT NAME OF DEPARTMENT: …………………………………………………………………………………………. PERIOD FROM M1 YYYY1 D2 4 5 6 7 8 9 10 11 12 2005 31 2005 31 2005 31 2005 31 2005 31 2005 31 DUE TO DA M2 YYYY2 RATE 7 8 9 7 8 9 8 11 8 2005 2005 2005 2005 2005 2005 54 54 54 54 54 54 BP 10 DP 11 DA 12 SBCA (10%) 13 HRA TOTAL DA DUE RATE (15%) 14 (10+…+1 16 15 2025 2025 2025 2025 2025 24165 24165 24165 24165 24165 17 17 17 17 17 17 BP 17 DP 18 DRAWN TOTAL DIFF. PER SBCA HRA DA MONTH (10%) (15%) DRAWN (14-22) 19 20 21 (18+…+21) 22 23 1286 1929 1286 1929 1286 1929 1286 1929 1286 1929 1286 1929 18265 18265 18265 18265 18265 18265 5900 5900 5900 5900 5900 5900

Figures are in rupees.

S NO NAME & DESIGNATION 1 1 2 3 4 5 6 2 Mrs A Mr B Mrs A Mr B Mrs A Mr B D1 3 19 1 12 13 23 12

PAYABLE NET TOTAL NO. OF NO. OF TOTAL IT DIFF TOT. IT DAYS DAYS MONTHS DIFF. (PM) (25x28) PAYABLE (24 2725) X OR29 (28) (27-29) OF 24 25 26 28 30 31 xx 30 xx 30 xx 13 xx 1 xx 1 xx xx 2474 5900 197 5900 197 11800 26468 27 64 2 64 2 64 27 64 2 64 2 128 287 2447 5836 195 5836 195 11672 26181

REMARKS 31

9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350 9000 4500 7290 1350

8575 4288 2187 8575 4288 2187 8575 4288 2187 8575 4288 2187 8575 4288 2187 8575 4288 2187

1
xx

1
xx

9000 4500 7290 1350 2025 24165 GRAND TOTAL

2

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains. Signature of Drawing and Disbursing Officer

DUE DRAWN STATEMENT NAME OF DEPARTMENT: …………………………………………………………………………………………. Name of govt. servant: Office Order No. & Date: Scale of Pay:
PERIOD FROM TO DA RATE
7

Figures are in rupees.

Designation:

DUE BP
8

DRAWN SBCA HRA (10%) (15%)
12 13

D1 M1 YYYY1 D2 M2 YYYY2
1 2 3 4 5 6

DP
9

BP+DP
10

DA
11

TOTAL DA DUE RATE (10+…+13)
14 15

BP
16

DP
17

BP+DP
18

DA
19

PAYABLE DIFF. TOTAL IT SBCA HRA PER NO. OF TOTAL NET DRAWN DIFF REMARKS PAYABLE (10%) (15%) MONTH MONTHS DIFF. (18+…+21) (PM) (14-22)
20 21 22 23 24 25 26 27 28

1 1

8 2009 31 9 2009 30

8 2009 9 2009

64 54

3100 1550

4650 2976

465

698

8789 24165

64 17

3015 1508

4523 2895

452

678

8548 18265

241 5900

2

482 5900 0 0 0 0 6382

13 64 0 0 0 0 77

469 5836 0 0 0 0 6305

9000 4500 13500 7290 1350 2025

8575 4288 12863 2187 1286 1929

1

GRAND TOTAL

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains.

Signature of Drawing and Disbursing Officer

DUE DRAWN STATEMENT NAME OF DEPARTMENT: …………………………………………………………………………………………. Name of govt. servant: Office Order No. & Date: Scale of Pay:
PERIOD FROM TO DA D1 M1 YYYY1 D2 M2 YYYY2 RATE
1 2 3 4 5 6 7

Figures are in rupees.

Designation:

DUE BP
8

DRAWN SBCA HRA (10%) (15%)
12 13

DP
9

BP+DP
10

DA
11

TOTAL DA DUE RATE (10+…+13) 15 14 8789 24165 64 17

BP
16

DP
17

BP+DP
18

DA
19

SBCA HRA (10%) (15%)
20 21

TOTAL DIFF. TOTAL DRAWN PER DAYS (18+…+21) MONTH OF 22 23 24 8548 18265 241 5900 31 xx

NO. OF DAYS
25

PAYABLE NET NO. OF TOTAL IT TOT. IT REMARKS MONTHS DIFF. DIFF (25x28) PAYABLE (24 X (PM) OR (28) (27-29) 26 27 28 29 30 31 xx 241 5900 13 64 13 64 228 5836

1 1

8 2009 31 9 2009 30

8 2009 9 2009

64 54

3100 1550

4650 2976

465

698

3015 1508

4523 2895

452

678

31 xx

9000 4500 13500 7290 1350 2025

8575 4288 12863 2187 1286 1929

1

GRAND TOTAL

6141

77

6064

Certified that (i) No part of the amount claimed has been drawn previously; and (ii) A note of the arrear claimed has been made in the office copy of the bills for the period to which the claim pertains.

Signature of Drawing and Disbursing Officer


				
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