You are on page 1of 3

Travel Expense Reimbursement request form

Sales. Off: 5/613, Mukhathala, Kaniyanthode, Kollam, Kerala, India, PIN 691 577

NAME : EXPENSES FOR THE WEEK FROM: 18/02/2019 TO 23/02/2019/ DATE: 01/032019
DESIGNATION :

Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount
18/2/19
Sl Customer Name/ New/Follow Up Customer Type of Feedback
No Address Customer Phone No Vehicle Enquiry
1
2
3
4
5
6

Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount

19/2/19
Sl Customer Name/ New/Follow Up Customer Type of Feedback
No Address Customer Phone No Vehicle Enquiry

1
2
3
4
5
6

Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount
20/2/19
Sl Customer Name New/Follow Up Customer Type of Feedback
No Customer Phone No Vehicle Enquiry
1
2
3
4
5
6
Date ODO Meter Staring ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount
21/2/19
Sl Customer Name/ New/Follow Up Customer Type of Feedback
No Address Customer Phone No Vehicle Enquiry

1
2
3
4
5

Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount
22/2/19
Sl Customer Name/ New/Follow Up Customer Type of Feedback
No Address Customer Phone No Vehicle Enquiry
1
2
3
4
5
6

Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount

23/2/19
Sl Customer Name New/Follow Up Customer Type of Feedback
No Customer Phone No Vehicle Enquiry

6
Date ODO Meter Starting ODO Meter End Total KM Total Exp: DA Total
Opening KM Time Closing KM Time Covered KM*2.5 Amount

24/2/19
Sl Customer Name/ New/Follow Up Customer Type of Feedback
No Address Customer Phone No Vehicle Enquiry

4
5
6

Total number of Customer Met

Number of New Customer


Number of Follow up Customer
Total Conversion
Total lost
Number of Retail

Signature of the Employee :

Verified By DSM : Name & Signature :………………………………………………………………..

Verified By GM : Name & Signature :……………………………………………………………….

Verified By Accounts : Name & Signature :………………………………………………………………..

Payable Amount :…………………..

Approved By

(Authorized Signatory)

You might also like