Indian Institute of Technology Guwahati
Centre for Educational Technology
FORM 6
Expenditure Settlement of Event under TEQIP-II
(To be prepared by Event coordinators and DC's after the event. As per R&D instructions this KIC Form along with R&D 'Covering' Form - 'Settlement of
Advances' -RD-M1A both have to be submitted to KIC-TEQIP office)
1. Department /Centre:
2. Name /Title of Event:
3. Dates of the Event: From ___________________________ to _____________________________
4. Course Coordinator(s):_________________________________________________________________
5. Department Coordinator:______________________________________________________________
6. Total Number of Participants from TEQIP mapped institutions attended the TEQIP event: _________
[Please attach signature sheets of all the participants from TEQIP mapped institutions (excluding the participants who
have attended on walk-in basis) See Annexure A1]
7. Number of Registrants: ST
SC
OBC
8. Expenditure Overview:
Sl.
No.
1
2
3
4
5
6
Expenditure Head/Description under Conference,
Seminars & Workshops
Training Fee
(only for student and faculty internship programme)
Travel Cost
a) Resource Person
b) Participants (if any)
Boarding & Lodging & Food Expenses
Course Materials Cost Including Teaching & Learning
Materials and processes including ICT enable learning.
Video conferencing facilities/ corresponding ICT resources
needed etc. (Publications, Course Materials, Stationaries,
Handouts, Learning Materials, Photos/ Video Recordings)
Management Cost
a) Honorarium for External Resource Persons
b) Honorarium for In-house Resource Persons
c) Honorarium for Ancillary, Staff of IITG
d) Honorarium for Course Coordinators
e) Honorarium for Department Coordinator
Contingency & Consumables (Office Expenditure, Local
Transport etc.)
Annexure
No
A2
Attached
(Yes/No)
Amount
Paid(Rs.)(a)
Amount to be
Paid(Rs.)(b)
A3.1
A3.2
A4
A5
A6.1
A6.2
A6.3
A6.4
A6.5
A7
Grand Total(a+b)
Note: (1) Please attach Event Report, Feedback Forms, Sample copy of Material/Notes given to Participants,
Proceedings/ Photographs/Video/Discussion Recordings etc.
(2) Please attach all the bills. All bills MUST be countersigned by Course Coordinator(s) and Department
Coordinator.
9. Account Summery
A. Advance received under KIC-TEQIP through Dean R&D for the event: Rs.______________________________
B. Additional advance received for the same event, if any: Rs. ________________________________________
(On Exceptional Approval of Competent Authority)
C. Total advance received under KIC-TEQIP through Dean R&D for the event as Advance : Rs._______________
D. Total expenditure incurred: Rs._______________________________________________________________
E. Excess/unspent amount (to be refunded in the name of Registrar): Rs._______________________________
Details of refund made to the Registrar, IIT Guwahati, for the Excess/unspent amount:
a. Cheque/ Draft No :__________________________________________________________________
(Please attach a photocopy of cheque/draft)
b. Bank Name : _______________________________________________________________________
F.
Overspent amount w.r.t. the Advance as mentioned in “Point C”, if any (to be refunded to the Course Coordinator):
a. Amount: Rs.__________________________________________________
b. Course Coordinator’s Bank Details:
A/C number: ____________________________________________
Bank Name: _____________________________________________
Branch Name: ___________________________________________
G. Amount to be reimbursed to beneficiary/vendor by R&D: Rs._________________
H. Total Course expenditure (D+G): Rs.______________________________________
We hereby certify that:
(i) The Grants have been spent for the purpose for which it has been sanctioned.
(ii) All bills / vouchers / receipts are counter signed by us and attached herewith.
(iii) Form RD-M1A is attached.
(iv) A copy of approval of Temporary Advance is attached.
(v) The following are also submitted:
a) Event Reports
b) Feedback Forms
c) Copy of Notes distributed
d) Photos /Video recordings of the event.
(1)
(2)
Signature of Coordinator(s) of Event
Signature of Dept.-coordinator (DC)
Name (1): ______________________
Name: _________________________
Name (2): ______________________
Date: __________________________
Date: __________________________
Checklist
forKIC-TEQIP
KIC-TEQIPoffice
Office
For use at
Verification:
Sl. No.
List of Enclosures
1
A1: Signature sheets of all the participants
2
A2: Training Fee (only for Student/Faculty Internship programme)
3
A3.1: Travel Cost of Resource Person
4
A3.2: Travel Cost for Participants (if any)
5
A4: Boarding/Lodging & Food Expenses
6
A5: Course Materials Cost Including Teaching & Learning Materials etc.)
7
A6.1: Honorarium for External Resource Persons
8
A6.2: Honorarium for In-house Resource Persons
9
A6.3: Honorarium for Ancillary, Staff of IITG
10
A6.4: Honorarium for Course Coordinators
11
A6.5: Honorarium for Department Coordinator
12
13
A7: Contingency & Consumables (Office Expenditure, Local Transport
etc.)
Event Report
14
Feedback Forms
15
Sample copy of Material/Notes given to Participants
16
Proceedings
17
Photographs/Video/Discussion Recordings etc.
18
Form : RD-M1A
19
Copy of approval of Temporary Advance
Tick on Receipt
Checked:
Account settlement documents are checked & found in order.
Accounts have been entered in TEQIP office data base.
Acknowledgement of this submission has been given to Event Coordinator through DR.
Signature (KIC-TEQIP office)
Signature (DR, CET)
Date:
Date:
Forwarded to Dean (R&D) with relevant attachments with recommendation for settlement.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A1: List of Registered Participants (participants from TEQIP mapped institutions, excluding the
participants who have attended on walk-in basis)
Sl. No. Name of Participant
Institution
Signature
Remarks
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
A2: Training Fees (only for Student/Faculty Internship Programme)
Sl.No
Name of Participant
Duration of Internship
Training Fees (Amount in Rs.)
Bank Details of Host Faculty
Member
Total
Note: Event report must include research outcome from the internship programme.
Signature of Host Faculty Member
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the honorarium amount Rs.______________________________________
into the bank A/c of__________________________________________________________________ (the host faculty member).
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A3.1: Travel Cost of Resource Person (both national/International)
Sl. No.
Name(s)
Mode of
Journey (Air/
Train/ Bus)
Fare
Tickets Booked by Total Travel In case amount
DTA/ Resource Amount Paid is paid to the
Person
to the
Resource
Resource
Person, please
Person(Rs.)
attach the
money receipt*
Total
*Note (1)A: Booking of the ticket for an external expert should be done through DTA by Course Coordinator. In
case ticket is booked by expert himself/herself, kindly apply additional advance to reimburse his/her
travel amount.
(1)B: Please attach receipt with this annexure.
(2): Please note that all TEQIP events held after 30/11/2015, payment to the participants will be directly
made by the institute.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs.______________________________________________
to___________________________________________________________________________________(DTA/Resource person)
as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A3.2: Travel Cost for Participants from TEQIP mapped institutions
Sl.No
Name(s)
Duly filled TA Form
(by claimant) is
scrutinized by F&A
Section, IITG.
(Yes/No)
Date
Amount of TA
as verified by
F&A Section,
IITG
Bank Details
of participants
In case
payment is
made by Course
Coordinator,
please attach
the receipt*
Total
*Note(1): Please note that all TEQIP events held after 30/11/2015, payment to the participants will be directly
made by the institute.
(2): Please attach receipt with this annexure.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs._______________________________________________
to claimants as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A4: Boarding/Lodging & Food Expenses
Sl.No.
Description of Expenditure
Name of
Service
provider
Bill/Indent No.
& Date
Amount
In case payment is made
to be paid by
by Course Coordinator,
R&D / F&A
please attach the
section directly
receipt*
to the vendor
Total
*Note (1): Please note that all TEQIP events held after 30/11/2015, payment to the vendor will be directly made by
the institute.
(2): Please attach receipt with this annexure.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs._______________________________________________
to the vendor(s)_________________________________________________________________________________________
as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A5: Course Materials Cost Including Teaching & Learning Materials etc.
(Publications, Course Materials, Stationaries, Handouts, Learning Materials, Photos/ Video Recordings)
Sl.No.
Description of Expenditure
Name of
Service
provider
Bill/Indent No.
& Date
Amount
In case payment is made
to be paid by by Course Coordinator,
R&D / F&A
please attach the
section directly
receipt*
to the vendor
Total
*Note (1): Please note that all TEQIP events held after 30/11/2015, payment to the vendor will be directly made by
the institute.
(2): Please attach receipt with this annexure.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs._______________________________________________
to the vendor(s) __________________________________________________________________________________________
as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A6.1: Honorarium Details for External Resource Persons
Sl.No Name of Expert /
Resource Person
Institution / Organisation Total Number
With address
of Hours
Engaged
Total
Money receipt attached
Honorarium (Yes/No) *
Amount paid
(Rs.)
Total
* Please attach receipt with this annexure.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved at KIC-TEQIP.
Forwarded to Dean (R&D).
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A6.2: Honorarium Details for In-House Resource Persons
Sl.No.
Name of Expert / Resource Employee
Person
ID
Department
/ Centre
Total Hours of
engagement
Total Honorarium
Amount (Rs.)
Bank A/C details
TOTAL
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount to the In-House Resource Person(s) as per the details
mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A6.3: Honorarium Details for Ancillary Staff of IITG
Sl.No.
Name of Staff
Employee ID
Department/
Centre/Section of
IITG
Total Number of
Hours of
engagement
Total
Honorarium
Amount (Rs.)
Bank A/C details
Total
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount to the Ancillary Staff(s) of IITG as per the details mentioned
above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A6.4: Honorarium Details for Course coordinators
Sl. No
Name of Faculty Member
Employee ID
Honorarium Amount (Rs.)
Bank Details
Total
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs.______________________________________________
to____________________________________________________________________________________________________
[the Course Coordinators(s)] as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A6.5: Honorarium Details for Department Coordinator
Sl.No Name of Faculty Member
Employee ID
Department
Honorarium
Amount (Rs)
10,000.00
Bank Details
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved for Payment at KIC-TEQIP.
Forwarded to Dean (R&D), with a request to disburse the amount Rs._______________________________________________
to____________________________________________________________________________________________________
(the Department Coordinator) for the present event as per the details mentioned above.
PI & Coordinator KIC-TEQIP (Head CET)
Date:
A7: Contingency
(Including consumables, payment to student assistants, daily wages etc.)
Sl.No
Amount (Rs.)
Description of Expenditure
Bill/ Voucher No./ Date/
Name of Service Provider
etc.
Money receipt attached
(Yes/No)*
Total
*
Please attach receipt with this annexure.
Signature of Course Coordinator(s)
Signature of Department Coordinator
Date:
Date:
Approved at KIC-TEQIP.
Forwarded to Dean (R&D).
PI & Coordinator KIC-TEQIP (Head CET)
Date: