FORM NO

FORM NO. 17

(See Chapter VIII, paragraph 183)

Detailed countersigned contingent bill no.——————

NOTE—Government servants whose bills are countersigned before payment by the controlling officer should use Form No. 18.

Not payable at Treasury

Sent to Controlling Officer on———————, 19 . Countersigned and sent to Accountant General on———————, 19 .

District————————Monthly detailed bill of contingent charges of—————for the month of———————, 19 .

Head of service

Details of numbers of sub-vouchers.	Description of charge and number and date of authority where special sanction is necessary			Amount
		Rs.	p.	Rs.	p.
	Carried over
	Brought forward
	Total

(1)	I certify that the expenditure charged in this bill could not, with due regard to the interest of the public service, be avoided. Certified that to the best of my knowledge and belief, the payment entered in this bill have been duly made to the parties entitled to receive them. Vouchers for all items of expenditure above Rs. 1,000 in account and all work bills are attached to the bill. I have, as far as possible, obtained vouchers for other sums and I am responsible that they have been so defaced or mutilated that they cannot be used again.	Drawn on abstract bill no—dated___ Ditto Ditto Ditto Add— Amount of this allowance from bill no. dated— refunded by deduction form contingent no. dated— and reallowed as per.
(2)	*Certified that all the articles detailed in the vouchers attached to the bill and in those retained in my office have been accounted for in the stock register.	Total of this bill
(3)	Certified that the purchases billed for have been received in good order, that their quantities are correct and their quality good, that the rates paid are not in excess of the accepted and the market rates and that suitable notes of payment have been recorded against the indents and invoices concerned to prevent double payments			Contingencies
Certified that—

*This certificate is required when proper store accounts of materials and store purchased are required to be maintained.

(a)	the expenditure on conveyance hire charged in this bill in terms of Rules 6 of Appendix X of the Financial Hand book, Volume V, Part, I, was actually incurred was unavoidable and is within the scheduled scale or charges for the conveyance used, and
(b)	the Government servant concerned is not entitled to draw travelling allowance under the ordinary rules for the journey and he is not granted any compensatory leave and does not and will not otherwise receive any special remuneration for the performance of the duty which necessary the journey.
Appropriation...for 19 —19 .		Rs.	p.
Expenditure including this bill
Amount of work bills annexed
Balance available
Signature of disbursing officer
Dated—————, 19 .

For use of Controlling Officer

		Rs.
Disallowed from sub-voucher no.
Ditto
Ditto
	Total of this bill

Passed for rupees.

I certify that in support of every charge of more than Rs. 50 made in this bill, a receipt or other voucher has been given to me and is now in my possession. The receipts and vouchers for items in excess of Rs. 1,000 are attached to the bill, and I am responsible that the receipts and vouchers for all other items of more than Rs. 50 are in proper form and order, and that they have been so cancelled that they cannot be again used to support claims gainst the Government. All work bills are also appended.

Dated—————, 19 .

Signature of the Controlling Officer.

(Correction Slip no 38 dated 19.01.1984)

[Vitta (Lekha) Anubhag-1 File No.15(5)78]