FACULTY HOUSE

Chaudhary Charan Singh, Haryana Agril. University Hisar

Contact Ph: 01662-284325; EPBAX- 5422, Fax: 01662-284358, Email:- facultyhousehau@gmail.com

1. Name of the Visitor(s) :
Designation & Pay Scale :
Full official address :
Mobile No./Email :
2. Purpose of Visit (Please mention) :
3. Arrival Date & Time :
4. Departure Date & Time :
5. Types & No. of rooms required :

(AC/VIP room allowed only for officers in pay scale of Rs. 15600-39100 + 5400/- GP & above)

6. Details of Dining arrangement:-
Particulars of Meals From To No. of Persons
Breakfast+Lunch+Dinner
Breakfast only
Lunch only
Dinner only
7. Bill to be settled by (Please tick):

(Indenter would be responsible for settling/resolving unpaid bills/dispute, if any.)

Signature of Indenter

Full Name
Designation
Deptt/Address
Mobile No.

For Office Use Only.

Asstt. Manager (H) Officer Incharge (H) SVC/SPS