Miscellaneous Expense Statement

NAME
EMPLOYEE ID
DATE
(dd-mmyy)

RECEIPT
(Y / N)

Sweta Gupta
S1101414
PAID BY
CORP CC

05/01/15

PROJECT CODE

IGV-QI-ASP

EXPENSE DESCRIPTION

BILLED AMOUNT

(use multiple rows if required)

(if bill not in INR)

SETTLEMENT
AMOUNT (INR)

Marriage

5,000.00

5,000.00
INR

ADVANCE
CASH / BANK TRANSFER
OTHERS
TOTAL

0.00

REFUND (INR)

REFUND TO / DUE FROM COMPANY

CASH
CORPORATE CREDIT CARD
TOTAL

DUE (INR)
5,000.00
5,000.00

0.00

COMMENTS

SIGNATURE OF EMPLOYEE

DATE

SIGNATURE AND NAME OF APPROVER

APPROVAL DATE

Nomura Research Institute Financial Technologies India Pvt. Ltd., 2012

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