NANC Pvt. LTd.

Fuel Claim Form

Year and Month: 2080‐Jestha Type of Vehicle: Bike
Identification: Ba 80 Pa 2031 Fuel Consumption Rate:

Km Reading Distance Travelled

Date Travel Detail User
Start End Total Personal Site
2/1
2/2
2/3
2/4
2/5
2/6
2/7
2/8
2/9
2/10
2/11
2/12
2/13
2/14
2/15
2/16
2/17 IME Site 34744 34776 32 32
2/18 '' 34776 34808 32 32
2/19 '' 34808 34840 32 32
2/20 '' 34840 34872 32 32
2/21 '' 34872 34904 32 32
2/22 '' 34904 34936 32 32
2/23 '' 34936 34968 32 32
2/24 '' 34968 35000 32 32
2/25 '' 35000 35032 32 32
2/26 '' 35032 35064 32 32
2/27 '' 35064 35096 32 32
2/28 '' 35096 35128 32 32
2/29 '' 35128 35160 32 32
2/30 '' 35160 35192 32 32
2/31 '' 35192 35224 32 32

Total KMs 480

Total Official Trip: 480 KM Claimed fuel (Ltrs): 13.71429

Fuel Consumption Rate: 35 KM/L Rate of Fuel: 178
Claimed Amount: 2441.143

Submitted By: Approved By:

Name: Saroj Prajapati