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Employee Expenses Form

Name

1. Fill in all details per receipt

Rohit Saxena
Month and Year

2. Attach all original receipts

Aug-15
Entity

3. Have your linemanager sign the declarationform

IBAN number

4. Scan the form and the receipts according to exmple and send them to:

NL41 ABNA 0561 2174 75


BIC code

Expenses@treatwell.com

Nr.

Date/Period

Description

8/11/2015

Programming Scala, Ebook

8/6/2015

Advanced Scala with Scalaz and Essential Interpreters, Eboo

ABNANL2A

Currency rate

VAT

Amount

$39.99

0.00

36.00

$107.69

16,82

96,94

Total

132.94

To be paid

132.94

3
17
18

Signature employee

Signature linemanager

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