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  • F-FIN-01 Expenses Claim Form

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    9 views9 pages

    F-FIN-01 Expenses Claim Form

    Uploaded by

    Pahang

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 9

    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : -


    Department: Agri Date: 17 - 18 March 2020 & 09 June 2020

    Description Currency Amount Exc. Rate Amount (IDR)


    Date
    3/17/2020 1 SENDING INV TO PT SARIMAS (JNE) IDR 19,000.00
    3/18/2020 2 SENDING INV TO PT SMART (JNE) IDR 19,000.00
    6/9/2020 3 SENDING INV TO PT SI BATAM (JNE) IDR 35,000.00
    6/9/2020 4 SENDING INV TO PT SELAMAT SEMPURNA (JNE) IDR 9,000.00
    6/9/2020 5 SENDING INV TO PT CHEIL JEDANG (JNE) IDR 9,000.00
    6/9/2020 6 SENDING INV TO PT SMART (JNE) IDR 19,000.00
    6/9/2020 7 SENDING INV TO PT ATEJA (JNE) IDR 11,000.00

    Total 121,000.00

    Requested by: Verified by:

    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    (Line Manager/date) (Employee's signature/ date)


    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 29 June 2020

    Description Currency Amount Exc. Rate Amount (IDR)


    Date
    6/15/2020 1 SENDING 30 SEALS TO SURVEYOR (BURLAN) IDR 70,000.00

    6/19/2020 2 SENDING 50 SEALS TO PT ASI IDR 57,000.00

    6/25/2020 3 SENDING INVOICE TO PT SMART IDR 19,000.00

    6/29/2020 4 SENDING SEAL (PLASTICK) TO SOPYAN IDR 38,000.00

    Total 184,000.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 29 July 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date
    7/2/2020 1 SENDING INVOICE TO PT MEGA ANDALAN KALASAN IDR 9,000.00

    7/2/2020 2 SENDING INVOICE TO PT CHEIL JEDANG INDONESIA IDR 9,000.00

    7/10/2020 3 SENDING CERTIFICATE TO LOUIS DREYFUS COMPANY IDR 9,000.00

    7/10/2020 4 SENDING INVOICE TO PT SMART IDR 19,000.00

    7/15/2020 5 SENDING INVOICE & CERTIFICATE TO PT SARI MAS IDR 19,000.00

    7/17/2020 6 SENDING INVOICE TO PT SMART IDR 19,000.00

    7/24/2020 7 SENDING INVOICE TO PT MEGA ANDALAN KALASAN IDR 22,000.00

    Medical No Description

    7/28/2020 1 MEDICAL REIMBURSE IDR 530,100.00

    Total 636,100.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 24 August 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    8/19/2020 1 SENDING INVOICE TO PT SMART IDR 19,000.00

    8/18/2020 2 SENDING INVOICE & CERTIFICATE TO PT SARI MAS IDR 19,000.00

    8/19/2020 3 SENDING INVOICE TO PT SARI MAS IDR 19,000.00

    Medical No Description

    8/6/2020 1 MEDICAL REIMBURSE IDR 408,500.00

    Total 465,500.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 10 September 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    8/25/2020 1 SENDING INVOICE/CERTIFICATE TO PT SARI MAS IDR 19,000.00

    8/25/2020 2 SENDING INVOICE/CERTIFICATE TO PT BONANZA IDR 18,000.00

    8/27/2020 3 SENDING INVOICE TO PT CHEIL JEDANG IDR 9,000.00

    8/28/2020 4 SENDING INVOICE/CERTIFICATE TO PT SARI MAS IDR 19,000.00

    9/1/2020 5 SENDING INVOICE/CERTIFICATE TO PT SARI MAS IDR 19,000.00

    9/3/2020 6 SENDING INVOICE TO PT SMART IDR 19,000.00

    9/3/2020 7 SENDING INVOICE/CERTIFICATE TO PT STC IDR 28,000.00

    9/3/2020 8 SENDING REVISED INVOICE TO PT SARI MAS IDR 19,000.00

    9/10/2020 9 SENDING INVOICE TO PT SMART IDR 19,000.00

    Medical No Description

    9/4/2020 1 MEDICAL REIMBURSE IDR 541,500.00

    Internet Credit No Description


    100,000.00
    9/9/2020 1 INTERNET CREDIT REIMBURSE

    Total 810,500.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 02 November 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    10/19/2020 1 SENDING INVOICE TO PT SMART IDR 19,000.00

    10/19/2020 2 SENDING INVOICE & CERTIFICATE TO PT BONANZA IDR 18,000.00

    10/22/2020 3 SENDING INVOICE TO PT SMART IDR 19,000.00

    10/27/2020 4 SENDING INVOICE & CERTIFICATE TO PT SARI MAS IDR 19,000.00

    10/27/2020 5 SENDING INVOICE TO PT ANTANG GUNUNG MERATUS IDR 9,000.00

    Internet Credit No Description

    10/9/2020 1 INTERNET CREDIT REIMBURSE IDR 98,000.00

    Total 182,000.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 11 November 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    11/6/2020 1 SENDING INVOICE TO PT SMART IDR 19,000.00

    11/6/2020 2 SENDING SEAL TO PAK BURLAN IDR 18,000.00

    Medical No Description

    11/4/2020 1 MEDICAL REIMBURSE IDR 771,200.00

    Internet Credit No Description

    11/8/2020 1 INTERNET CREDIT REIMBURSE IDR 100,000.00

    Total 908,200.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date: 08 December 2020

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    11/23/2020 1 SENDING COMPRO TO Mr SOPYAN IDR 19,000.00

    11/23/2020 2 SENDING INVOICE & CERTIFICATE TO PT BONANZA IDR 18,000.00

    11/23/2020 3 SENDING INVOICE TO PT SMART IDR 19,000.00

    11/23/2020 4 SENDING SEAL TO Mr BURLAN IDR 36,000.00

    11/23/2020 5 SENDING INVOICE TO PT SI BATAM IDR 35,000.00

    Internet Credit No Description

    1 INTERNET CREDIT REIMBURSE IDR 100,000.00

    Total 227,000.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)
    EXPENSE CLAIM FORM F-FIN-01

    Employee Name: Cep Ali Nurrohman Employee No. : 010-16


    Department: Agri Date:

    Courier No Description Currency Amount Exc. Rate Amount (IDR)


    Date

    12/8/2020 1 SENDING INVOICE TO PT SMART IDR 19,000.00

    12/10/2020 2 RE-SENDING INVOICE TO PT CHEIL JEDANG IDR 9,000.00

    12/11/2020 3 SENDING SEAL TO Mr. SOPYAN IDR 38,000.00

    12/14/2020 4 SENDING COPY CERTIFICATE TO LDC IDR 9,000.00

    12/14/2020 5 RE-SENDING INVOICE TO PT DUA KUDA IDR 9,000.00

    12/15/2020 6 SENDING MOU TO PT ASI IDR 19,000.00

    Internet Credit No Description

    1 INTERNET CREDIT REIMBURSE IDR

    Total 103,000.00

    Requested by: Verified by:

    Cep Ali Nurrohman


    (Employee's signature/ date) (Finance Department)/ date)

    Approved by: Received by:

    Cep Ali Nurrohman


    (Line Manager/date) (Employee's signature/ date)

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