Printed by 00027280 - Tuesday, October 5, 2021

EMPLOYEE EXPENSE
CLAIM VOUCHER

ECV No : CV-20211004-0225 ECV Date : 02-10-2021

Department : SERVICE DIRECT ECV Status : CREATED
Employee SN : 00027280 Division : EAST INDONESIA
Employee Name : YEREMIA RUDOLOF KRISTIAN Branch : TERNATE
Employee Email : YEREMIA.R.KRISTIAN@TRAKINDO.CO.ID Cost Center : 10B4360HA
Claim Number :1

Cash Detail

Refer to TCAR No : TC-20210903-0058

Credit Card
: NO
Settlement
TCAR Period : 02-09-2021 - 17-09-2021

Business Travel

Actual
Date Expense Type Description TCAR Ref Cost Center WO No. Currency
Expense

Service - Daily
2021-09-02 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-03 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-04 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-05 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-06 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-07 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-08 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-09 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-10 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-11 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-12 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-13 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

2021-09-14 Service - Daily daily lumpsum - 8500135912 IDR 350,000.00

 Lumpsum

Service - Daily
2021-09-15 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Service - Daily
2021-09-16 daily lumpsum - 8500135912 IDR 350,000.00
Lumpsum

Non-Travel

Date Expense Type Description TCAR Ref Cost Center WO / IO No. LoB Currency Actual Expense

VER

Expense Type Currency Periode Actual Expense

Status Currency Cash Requested Actual Expense Total

Claim IDR 5,000,000.00 5,250,000.00 250,000.00

Claim USD 0.00 0.00 0.00

Approval Matrix

SN Employee Name Roles Email Status

- [SERVICE ACCOUNT] SERVICE ACCOUNT - WAITING FOR APPROVAL

00015815 YUSUF MUHAMAD RAMDAN SUPERIOR yusuf.m.ramdan@trakindo.co.id WAITING FOR APPROVAL

- [VERIFICATION SECTION] VERIFICATION SECTION - WAITING FOR APPROVAL

I hereby declare that all the information above is true and correct, supported by adequate evidence as required by the Company policies in filling in a claim. I
understand that filing a false claim will result in rejection from the approver and any other disciplinary actions based on Company policies.

This is a system generated document. Should there be any difference of the information and/or the amount printed on this statement and in the system, the
correct information is as stated in the system.