INSTITUTUL CULTURAL ROMAN

ROMANIAN CULTURAL INSTITUTE

DECONT DE CHELTUIELI aferent contract nr. ...... / .........

DEDUCTION OF EXPENSES for the contract no. ..... / .........

Inregistrat la nr. ......... / data .................

Registered with no. …….. / date ………………

Scopul deplasării / Travel purpose...........................................................................................................

Locul deplasării / Travel place ....................................................................................................
Perioada de deplasare / Travel period ..................................................................................................

1. Avans primit la plecare: USD/EUR/RON Total =

1. Advance money received before departure: USD/EURO/RON Total =

BORDEROUL ACTELOR JUSTIFICATIVE DE CHELTUIELI

LIST OF SUPPORTING DOCUMENTS OF THE EXPENSES

Nr. Valoarea
crt./ DENUMIRE Felul Numar/data Tipul de Value
Crt. EMITENT actului Number/Date chletuiala
no. Issuer’s name Document Expense
type type

1
 Total
Total

2. Total cheltuieli / Total amount of expenses

3. Sume de restituit / de primit ( 1 – 2 ) / Amounts to be

refunded/received :

 Ma oblig ca in termen de 3 (trei) zile de la incheierea proiectului sa depun diferenta dintre

sumele primite si cele justificate conform documentelor depuse, depasirea termenului implicand
aplicarea de penalizari in cuantum de 0.1%/zi la suma avansata sau la diferenta de restituit.
 I commit that within three (3) days from the completion of the project I will return the difference
between the amount received and the one justified according to the documents submitted,
exceeding this period involving the application of penalties in the amount of 0.1% / day at the
advanced amount or at the refunded amount.

Semnatura titularului,
Holder signature,

Se certifica indeplinirea obiectivului Verificat si gasit in regula pentru Vizat, /Stamp

delegatiei / Certification for the
completion of the purpose of the
trip
Sef compartiment
Head of department
suma de / Verified and found okay
fo the amount of .................... Director Directie
.............................................. Financiar Contabilizate,
.............................................. Salarizare,/ CFO Director
Majorari /
Increments ...............................
.............................................
Serv. Financiar/ Financial service

Viza CFP Se aproba,

PRESEDINTE
Preventive financial control stamp Approved,
President