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Expense Reimbursement Form

Abani Kumar Bisoi

Employees Name

Expense Period

From
To
Department

Comp. Sc. and Engg (Faculty)

13/06/2013
28/07/2013

Nodal Centre duty at IIIT-BBSR, IGIT-TALCHER, OUAT-BBSR

Purpose of Business
Expense Details:Date
13/06/2013
-To09/07/2013

Description

22/06/2013
25/07/2013
-To28/07/2013

Category

Nodal Centre duty at IIIT-BBSR


(Except 22/06/2013)

26 DAYS

Nodal Centre duty at IGIT-TALCHER


(Train ticket both side+ Auto fare both side)
Nodal Centre duty at OUAT-BBSR

1 DAY

Cost

Rs. 200.00 +

4 DAYS

Sub Total

Rs.

Less Cash Advance

Rs. 00.00 (NIL)

Total Reimbursement

Rs.

-----------------------------------------Employee signature

--------------------------------------Date

-----------------------------------------Approval signature

--------------------------------------Date

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