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Fortnightly Expense Statement Page 1 of 2

Expense statement for period: 05-12-2022 to 18-12-2022 Statement number: Date of Submission:
Employee Name: YATENDRA SINGH SBU : TSD Emp No: 3587 Zone: NZ-2
Base Location: Lucknow Designation AREA SERVICE Cadre: M01/TL
Activity Details Departure From Arrival At Details of Travel
Activity Hours in No. of Mode of Other
Day Date Location Field Customers Town Time Town Time Travel Fare Expenses** Allowance Day Total

19-Dec-22 680.00
MON LUCKNOW 10:00Hrs. 4 680.00
LUCKNOW 8:30 AM KANPUR 10:30 AM Other
20-Dec-22 1,815.00
TUE KANPUR 13:00Hrs. 4 1,815.00

21-Dec-22 2,166.00
WED KANPUR 12:00Hrs. 4 2,166.00
KANPUR 7:00 AM ETWAH 10:30 AM Other 300.00
22-Dec-22 2,228.00
THU ETWAH 14:00Hrs. 2 ETWAH 5:00 PM KANPUR 10:00 PM Bus 205.00 1,723.00
KANPUR 9:00 PM LUCKNOW 11:00 PM Other
23-Dec-22 1,114.00
FRI KANPUR 12:00Hrs. 5 1,114.00

24-Dec-22 648.00
SAT LUCKNOW 9:00Hrs. 4 648.00

25-Dec-22 0.00
SUN 0.00

26-Dec-22 730.00
MON LUCKNOW 9:00Hrs. 4 730.00
LUCKNOW 8:00 AM BEHRAICH 11:00 AM Other 1,740.00
27-Dec-22 3,444.00
TUE BEHRAICH 13:00Hrs. 3 1,704.00
BEHRICH 6:00 PM LUCKNOW 9:00 PM Other 1,740.00
28-Dec-22 2,135.00
WED BEHRAICH 14:00Hrs. 4 395.00
LUCKNOW 8:30 AM AMETHI 11:30 AM Other 1,710.00
29-Dec-22 4,107.00
THU AMETHI 15:00Hrs. 3 AMETHI 10:00 PM LUCKNOW 1:00 AM Other 1,710.00 687.00

30-Dec-22 560.00
FRI LUCKNOW 9:00Hrs. 4 560.00
LUCKNOW 8:00 AM RAIBARELI 10:00 AM Other 1,200.00
31-Dec-22 2,813.00
SAT RAIBARELI 13:00Hrs. 5 RAIBARELI 6:30 PM LUCKNOW 9:00 PM Other 1,200.00 413.00

01-Jan-23 0.00
SUN 0.00

** Details should be filled in page 2 Grand Total 9,805.00 12,635.00 0.00 22,440.00

PREPARED BY : yatendra singh SCRUTINISED BY: FOR HEAD OFFICE USE ONLY

ADVANCE AMT: ___________ REMARKS IF ANY: L/Con NET AMT APPROVED:


Tr/Exp VERIFIED BY:
EMP SIGN: ___________
DATE: ___________ SUPERVISOR'S SIGNATURE & DATE TOTAL SIGN: DATE:
Page 2 of 2 124

Details of Other Expenses 420


Statement number:

Supportin
19-Dec-22 DATE

26-Dec-22 DATE
Supporting g
DAY

DAY
Narration Narration (other) Voucher Narration Narration (other) Voucher
Amount (Yes/No) Amount (Yes/No)
Hotel Expns Hotel Expns
MONDAY

MONDAY
Food Expns 200.00 YES Food Expns 226.00
Other Misc Exps Other Misc Exps
Local conveyance 40KM 480.00 NO Local conveyance 42KM 504.00
TOTAL 680.00 TOTAL 730.00
Hotel Expns 922.00 YES Hotel Expns 1,232.00 YES
20-Dec-22

27-Dec-22
THURSDAY WEDNESDAY TUESDAY

THURSDAY WEDNESDAY TUESDAY


Food Expns 613.00 YES Food Expns 407.00 YES
Other Misc Exps Other Misc Exps TOLL TAX 65.00 YES
Local conveyance 280.00 Local conveyance
TOTAL 1,815.00 TOTAL 1,704.00
Hotel Expns 922.00 YES Hotel Expns
21-Dec-22

28-Dec-22
Food Expns 974.00 YES Food Expns 330.00 YES
Other Misc Exps Other Misc Exps TOLL TAX 65.00 YES
Local conveyance 270.00 Local conveyance
TOTAL 2,166.00 TOTAL 395.00
Hotel Expns 1,000.00 YES Hotel Expns
22-Dec-22

29-Dec-22
Food Expns 473.00 YES Food Expns 219.00
Other Misc Exps Other Misc Exps
Local conveyance 250.00 Local conveyance 39KM 468.00
TOTAL 1,723.00 TOTAL 687.00
Hotel Expns Hotel Expns
23-Dec-22

30-Dec-22
Food Expns 814.00 YES Food Expns 80.00
FRIDAY

FRIDAY
Other Misc Exps Other Misc Exps TOLL TAX
Local conveyance 300.00 Local conveyance 40KM 480.00
TOTAL 1,114.00 TOTAL 560.00
Hotel Expns Hotel Expns
SATURDAY

SATURDAY
24-Dec-22

31-Dec-22

Food Expns Food Expns 228.00 YES


Other Misc Exps Other Misc Exps TOLL TAX 185.00 YES
Local conveyance 54KM 648.00 Local conveyance
TOTAL 648.00 TOTAL 413.00
Hotel Expns Hotel Expns
25-Dec-22

01-Jan-23
SUNDAY

SUNDAY

Food Expns Food Expns


Other Misc Exps Other Misc Exps
Local conveyance Local conveyance
TOTAL 0.00 TOTAL 0.00
GRAND TOTAL ###

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