Glimex Liquidation and Expense Reimbursement Form

Date
From: 10-Sep-23
ABIE To: 24-Sep-23
Name

Amount
Liquidation
Business Purpose: REIMBURSEMENT OF EXPENSES
Reimbursement

VATABLE
DATE PAYEE TIN Number PARTICULAR TOTAL VAT
SALES
10-Sep-23 MERCURY DRUG 000-388-474 Medicine 473.75 ₱ 422.99 ₱ 50.76
17-Sep-23 MERCURY DRUG 000-388-474 Medicine 1,921.50 1,715.63 205.88
24-Sep-23 MERCURY DRUG 000-388-474 Medicine 284.75 254.24 30.51
24-Sep-23 MERCURY DRUG 000-388-474 Medicine 234.25 209.15 25.10
#N/A - -
#N/A - -
#N/A - -
#N/A - -
#N/A - -
#N/A - -
#N/A - -
#N/A - - -
#N/A - -
SUBTOTAL (W/ VAT) ₱ 2,914.25 2,602.01 312.24

DATE PAYEE TIN Number PARTICULAR TOTAL NON-VAT

SUBTOTAL (NON-VAT) ₱ -
Less Cash Advance
GRAND TOTAL ₱ 2,914.25
Don't forget to attach receipts!

Employee Signature Approval Signature

Date Date