sample EXPENSES CLAIM FORM

Month: Nov-19

Mileage
No Date DETAILS Parking Hotel Material Others Subtotal
KM RM
1 01/11/19 IPOH- SHAH ALAM ( WEEKLY MEETING SHAH ALAM) 205.00 164.00 164.00

2 0.00

3 0.00

4 0.00

5 0.00

6 0.00

7 0.00

8 0.00

9 0.00

10 0.00

11 0.00

12 0.00

13 0.00

14 0.00

15 0.00

16 0.00

17 0.00
Total 0.00 0.00 0.00 0.00 0.00 164.00
**Milage = rm0.80 perkm w/o toll claim

Request by Verify by Approved by

Name Name Name
ADMIN

Signature Signature Signature

Date Date Date

Berapi Engineering Sdn Bhd (1345250-M)