Company Name

Expense Claim/ Advance Adjustment Form for Employees

NAME:

SIGNATURE:

DATE:____________________

Designation:___________________

PURPOSE OF EXPENSE:

Grade:____________________

APPROVAL:

Destination :From:____________

To: _________________

Amount

Period Of traval: From__________ to _____________

Department :

Expense Description

Amount

Limit as per HR Policy

Actual claim amount

Difference / Varience

Airfare/ Train Fare/ Bus Fare

Lodging Expenses (Hotel)
Boarding Expenses (Lunch/ Dinner/ Breakfast etc)
Tips/Laundary
Telephone / Mobile Communication Expense
Business Meals
Petrol Expenses (if Co. owned Vehicle)
Printing & Stationery Expenses
Postage/ Courier Expenses
Repair & Maintenance Expenses
Business Promotiion Expenses
Other (Pls Specify)
Total
Accounting Use Only
Head

Amount

Description
Advance Taken if any :
Date

Total
Prepared By:

________________
Employee

Approved By:

________________
H.O.D.

Checked By:

Authorised by:

_____________________

_____________________

Accounts

Accounts

Amount

Less cash advance (d)

_____________________

Balance due employee

_____________________

Balance due company

_____________________