EXPENSE FORM - General Expenses

Networkers International LLC

N/C (for AH
Line DATE DETAILS TOTAL use only)

01 28-Nov-10 CASETA $49.00

02 28-Nov-10 CASETA $49.00
03 28-Nov-10 CASETA $66.00
04 28-Nov-10 CASETA $49.00
05 28-Nov-10 CASETA $108.00
06 28-Nov-10 CASETA $60.00
07 28-Nov-10 CASETA $109.00
08 6-Dec-10 TAXI AEROPUERTO $292.00
09
10
11
12
13
14
15
TOTAL for GENERAL EXPENSES $782.00

Mileage
TOTAL
Line DATE DETAILS MILEAGE TOTAL
06 28-Dec-10 TRASLADO A CHIHUAHUA $305.00
07 28-Nov-10 TRASLADO A CHIHUAHUA $440.00
08 1-Dec-10 GAS PARA CALENTADOR OFICINA $89.41
09 $0.00
10 $0.00
TOTAL for MILEAGE $834.41

TOTAL CLAIM $1,616.41

Method of Payment:

Print Name: Date:

Signature:

Authorized by: Date:

Signature:
For AH use only:
PLEASE ATTACH ALL RECEIPTS. Total N/C

BREAKOUT OF EXPENSES:
NWI:
Customer:
Individual: