#NAME?

CLAIM FOR REIMBURSEMENT OF EXPENSES

Name : Prashant Ghodke Date :20.08.2021

Site Name with Project No.: HPCL jabalpur rule 19

Amount Mode of
Date/ Month Details of Expenses received Conveyance Expense
from (Train/Taxi Amount (Rs)
office (Rs) / Auto/Bus)

bendra to home byculla dt. 21.08.2021 taxi 280

byculla to cstm dt. 17.08.2021 taxi 150
bhopal to mumbai dt. 20.08.2021 train 700
jabalpur station to hpcl plant maneri by auto and bus auto and bus 450
hpcl maneri plant to jabalpur station auto and bus 450
jabalpur station to hpcl plant maneri by auto and bus auto and bus 450

hpcl maneri plant to jabalpur station auto and bus 450

hotel roo rent for 2 days 700x2=1400 18 & 19 aug … 1400

food allounce 2 days 350x2=700 …. 700
5030

Total:
Rupees:

Checked By : Approved By :

Signature by Claimant