Gemini Communication Ltd.

Doc No: QSP

Name Designation Purpose of Travel PART I - FOOD AND LODGING EXPENSES Sl. No 1 2 3 4 5 Date Type of Expense Amount Remarks Date

Travel Expenses Statement

Request Date:
Place of visits Number of persons Number of days PART II TRANSPORTATION EXPENSES Mode of From To Conveyance Page 1 of 1

Request No

Amount

Sub total - A PART III - LOCAL EXPENSES Sl. No 1 2 3 4 5 6 7 8 9 10 11 12 Travel Particulars Amount Remarks Date

Sub total - B PART IV MATERIAL EXPENSES Material Quantity Rate Purchased

Amount

Sub total - D Sub total - C TOTAL EXPENSE(A+B+C+D) ADVANCE RECEIVED TO BE RECEIVED BY EMPLOYEE TO BE PAID BY EMPLOYEE For Office use only Signature & Date of Submission Sanctioned expense amount: Signature of Head of the Dept: Accounts settlement details: Signature of Approving authority: Signature of Accounts Staff with date: Prepared By
Approved By