EXPENSE REIMBURSEMENT STATEMENT

Date: 17 Mei 2021 Period From : 1 Mei - 30 Mei 2021

Employee Name: Nandi Yuliandi Employee code: MGS-C-09084398

TI Project : HCPT/NOKIA/RO/SS/NS
Supportings
SN Details of Expenses Amount Total Amount
Bill Voucher
1 Daily Allowance

2 Telephone calls / Fax

3 Internet Services (Rp 200.000) (Rp 200.000)
4 Courier/Postage/Telegram:
5 Travel Expenses :
(a) GASOLINE
(b) TAXI
(c) AIRFARE
GOJEK
tool rigger
OPS DT
Other
Parking
Total travel expenses
6 Miscellaneous Expenses:

Total Miscellaneous Expenses

Grand Total 200.000 No of Supp

Advance Taken : Less This Statement: Balance left/claim:

I certify that all the expenses and bills attahced are true as per my knowledge Employee's Signature and date:

Verification

Supervisor's Signature Name and Date Finance's Signature Name and Date