REIMBURSEMENT COVERING SHEET

Name

Employee Code

Department

Finance

Location

Mumbai ( RCP )

Date

01-DEC-14 to 31-DEC-14

Sr. No.

Agency Name

Employee Name

Particulars

From

To

Total

Local Conveyance

5.00

Tour

150

Other Expenses

250

4
Total

405.00

Employee Name

Associate Signature :
(I hereby certify that the above claims are true and in case it is found to be false, the management can take appropriate action against me )

Checked & Approved by

HR Section

Reporting Supervisor

HOD/BM/RM/RSM/ZSM

Name

Name

Signature

: Mr. RK

Signature

Local Conveyance Log sheet

Name

Employee Code

Department

Finance

Location

Mumbai ( RCP )

Date

Claims for the month(s) of

ABC

01-DEC-14 to 31-DEC-14

Destination/Place

Date

From

Agency
Name

To

Purpose

Time

6-Dec-14

Kms

@ Rs.5 /km

Total

5.00

5.00

6-Dec-14

5.00

11-Dec-14

5.00

13-Dec-14

5.00

13-Dec-14

5.00

20-Dec-14

5.00

20-Dec-14

5.00

24-Dec-14

5.00

25-Dec-14

5.00

25-Dec-14

5.00

27-Dec-14

5.00

27-Dec-14

5.00

Total

5.00

Employee Name

Associate Signature :
(I hereby certify that the above claims are true and in case it is found to be false, the management can take appropriate action against me )

Checked & Approved by

HR Section

Reporting Supervisor

HOD/BM/RM/RSM/ZSM

Name

Name

Signature

: Mr. RK

Signature

Local Conveyance Log sheet

Destination/Place

Date

From

To

Purpose

Time

Kms

@ Rs.3.5 /km

Total

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

Total

0.00

Associate Signature :
(I hereby certify that the above claims are true and in case it is found to be false, the management can take appropriate action against me )

Checked & Approved by

HR Section

Reporting Supervisor

HOD/BM/RM/RSM/ZSM

Name

Name

Signature

Signature

TRAVEL PLAN FORM

Name

Employee Name

Employee Code

Department

Finance

Location

Mumbai ( RCP )

Date

01-DEC-14 to 31-DEC-14

Claims for the month(s) of

Destination/Place
Date

From

To

(Arr.

(Dep. Time)

Mode of Travel

COST(Rs)

Remark

Time)

50.00

Total

50.00

HOTEL RESERVATION DETAILS

Location / Place

DATE IN
[Date & Time]

DATE OUT
[Date & Time]

No. of Days

HOTEL NAME

COST(Rs)

ANY REMARKS

100.00

Total

DAILY ALLOWANCES : 75 X

Days

Total Cost of the Trip

100

150

Associate Signature :
(I hereby certify that the above claims are true and in case it is found to be false, the management can take appropriate action against me )

Checked & Approved by

HR Section

Reporting Supervisor

HOD/BM/RM/RSM/ZSM

Name

Name

Signature

Signature

Mr. RK
:

OTHER EXPENCE REIMBURSEMENT FORM

Name

Employee Name

Employee Code

Department

PMO

Location

Mumbai ( RCP )

Date

Reporting to

Sr. No.

Particulars

Bill Dated

AMOUNT

250

Total

250

Associate Signature :
(I hereby certify that the above claims are true and in case it is found to be false, the management can take appropriate action against me )

Checked & Approved by

HR Section

Reporting Supervisor

HOD/BM/RM/RSM/ZSM

Name

Name

Signature

Signature

Mr. RK
: