FORM No.

Ref :
Title : Form :
PERMOHONAN PERSETUJUAN PERJALANAN DINAS Revision :-
(APPLICATION FOR TRAVELLING EXPENSES) Page : : Page 1 of 1

Nama : Andi Route : JAKARTA - BANDUNG

Level & Division / Dept. : KAM / SALES Period : 28 - 29 April 2021
Area (Home Base) : Jakarta Total Estimate Expenses :
Purpose Travelling : Interview spl project bandung & market visit

ITINERARY :
Date Time Route & Agenda Address & Contact Person
11/25/2019 Listing and Business Review with Yogya Bp Hernawan
Listing and Business Review with Yomart Ibu Rima
Listing and Business Review with Borma
11/26/2019 Business Review DC SAT Bandung Ibu Reni
Business Review DC IDM Bandung Bp. Nandang
Business Review DC Circle K Ibu Galih

Travelling Expenses Budget :

Item Expenses (Rp) Exchange Rate :
Hotel 500,000 x 1 Night 500,000 THB 1 = Rp
Taxi/Rent a Car 750,000 x 1 Frequent 750,000 USD 1 = Rp
Intercity Transport 80,000 x 1 Frequent 80,000 YEN 1 = Rp
Train Ticket 200,000 x 1 Exc Argo Parahyangan 200,000
200,000 x 1 Exc Argo Parahyangan 200,000
Meal x Frequent 0
Daily Allowance (gross) 85,000 x 2 Days 170,000
Laundry x Days 0
Meeting Expenses 0
Others (Gasoline) PP x Days 0
Total Biaya 1,900,000
Cash Advance 1,000,000

Apply by : Verify By : Aqknowledge By :

( Andi ) TAF Dept ( )

Date :20/11/2019 Date :20/11/2019 Date :20/11/2019
 FORM No. Ref :
Title : Form :
LAPORAN PERJALANAN DINAS Revision :-
(TRAVELLING EXPENSES SETTLEMENT) Page : Page 1 of 1

Employee Name : ANDI City (area) Destination Jakarta - Bandung

Level & Department : SALES Travelling Period : 28 - 29 April 2021

Date 28/4/2021 29/04/2021

City Bandung Bandung
Transportation
Travelling Expenses : Total (Rp) Meeting Expenses :
Hotel 299,989 299,989 Date Members (Rp)
Breakfast -
Lunch -
Dinner -
Daily allowance (gross) 75,000 75,000 150,000
Taxi/Rent a Car -
Itercity Trans. -
Travel Ticket -
Laundry -
Reschedule Ticket -
Tol/Parking -
Others (gasoline) -
Total Expenses / day 374,989 75,000 - - - - 449,989 -

Total Travelling Expenses Rp 449,989 Exchange Rate :

Total Meeting Expenses Rp - THB 1 = Rp
Total Expenses Rp 449,989 USD 1 = Rp
Payment via Credit Card Rp 299,989 (Paid By Company) YEN 1 = Rp
Voucher Hotel / Taxi Rp (Paid By Company)
Cash Advance Rp (Paid By Company)
Payment to Company (Traveller) Rp (150,000) refund

Prepared by Traveller : Verify / Aqknowledge by :

: Andi Manager Dept (Superior) TAF Dept

Date : 11/18/2019 Date : Date :