KEYSTONE INFRA BUILD

TRAVEL CLAIM FORM

Employee Name Employee No.

Department Date of Departure
Project Time of Departure
Location Date of Arrival
Purpose of Visit Time of Arrival
A. Travel Expenses
Sl Mode of
From To Date Time Amount
No Travel
           

B. Stay & Boarding Expenses

No. Hotel Boarding
Sl Date Date Total
of Bill Bill
No From To Rate/Day Amount Rate/Day Amount Amount
Days No. No.

C. Local Conveyance
Sl Mode of
From To Date Bill No. Amount
No Travel
           
 A. Other Expenses
Sl
Date Expenses details Bill No. Amount Purpose
No.
1
2
3

SUMMARY STATEMENT:

Total Expenses Incurred (A+B+C+D)

Less : Tickets arranged by company
Less : Hotels Bills Paid by company
Less : Advance taken
Balance to be paid or received
Note:

 Travel Report should accompany with Travel claim form. HOD not to forward this to Finance
unless fully satisfied with the report.

 Attach bills for expenditure incurred.

Signature of the Employee: HOD PARTNER

For Use of Accounts Department

Amount Claimed :
Special Approval Required (if any) :
Passed Payment :

Verified By Approved By