Submit Claims Page 1 of 2

Claim Statement

Employee ID : 11595300 Employee Name : R, BALAKUMARI.

Claim Submission
Today's Date : 03/12/2020 : 03/12/2020
Date

* For Additional Work Pay claim type, read the contents in this column as minutes
Sl.
Date Claim Type Scope Taxable Claim Status Amount / Minutes * Payroll Processed Date
No.
Full Night
Shift(starting
1 30/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
2 24/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
3 23/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
4 20/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
5 19/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
6 18/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
7 17/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
8 16/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
9 13/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
10 12/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
11 11/11/2020 Night Shift Allowances (FNS/HNS) Full Night Y Pending ₹ 350.00 -
Shift(starting
between

https://hrfreedom.itcs.houston.dxccorp.net/Ebens/Claim/CreateClaim.aspx 12/4/2020
Submit Claims Page 2 of 2

5:00PM and
3:59AM)
Full Night
Shift(starting
12 10/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
13 09/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
14 06/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
15 05/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
16 04/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
17 03/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)
Full Night
Shift(starting
18 02/11/2020 Night Shift Allowances (FNS/HNS) between Y Pending ₹ 350.00 -
5:00PM and
3:59AM)

Total Amount ₹ 6,300.00

The payment would be processed either in the same month or the following month based on the date of approval and payroll cut
off date. Any false claim will be treated as violation of SBC policy and appropriate action will be taken which may even result in
termination of employment.

Back

https://hrfreedom.itcs.houston.dxccorp.net/Ebens/Claim/CreateClaim.aspx 12/4/2020