CLAIM FORM

NAME: MUHAMMAD AIMANHAFIZ BIN MOHD YUSOF STAFF NO : 10018467

DEPOT/SECTOR/DEPARTMENT : MRT PYL / STATION OPERATION GRADE : JG3

DESIGNATION : STATION OFFICER BANK / ACCOUNT NO : MAYBANK 162067634383

TEL. NO: 012-9046811 PAYMENT FOR THE MONTH OF : NOVEMBER2022

Travelling/Fare
Hotel Accommodation Subsistence Allowance Medical Hand phone Other claim
Date Details Mileage/Petrol
KM RM RM RM RM RM RM
11/11/2022 RELIEF KEBS-BATS-KEBS 10.5 0.30
11/16/2022 RELIEF KEBS-BATS-KEBS 10.5 0.70
11/22/2022 RELIEF KEBS-BATS-KEBS 10.5 0.30
11/23/2022 RELIEF KEBS-BATS-KEBS 10.5 0.30
11/28/2022 RELIEF KEBS-BATS-KEBS 10.5 0.30
11/29/2022 RELIEF KEBS-BATS-KEBS 10.5 0.30

GRAND TOTAL
DEDUCT : Advance taken
STAFF'S DECLARATION : (Payment/Cash Voucher No : ......................... )
ACTUAL CLAIM
I hereby confirm that all the above said claims are true. If it is found that I have made a false claim, the Company reserves the right to take disciplinary action against me.

Claimed by : Recommended by : Approved by :

_____________________ _____________________ _____________________

Date :30/11/2022
Name : Name :
Date : Date :

NOTE : 1) Claim form must be completed. Any amendment/error must be initialed/signed. Original receipts/bills must be attached with claim form.
2) Completed claims form must be submitted to HR by 7th of the month to ensure payment is made at the end of the month.

PRA/SOP/HCD/HCS-005-FO-001, Ver. 02, 7/12/2020

CLAIM FORM

TOTAL

RM
3.15
7.35
3.15
3.15
3.15
3.15

23.10

PRA/SOP/HCD/HCS-005-FO-001, Ver. 02, 7/12/2020