XVX

FORM
EMPLOYEE'S EXPENSES CLAIM

Company
] Global Rail Sdn Bhd
( please tick )
] Global Rail Projects Sdn Bhd
] Global Rail Infrasys Services Sdn Bhd
Employee's Name
SITI NURSAKINAH BT. ABDUL HADI
Employee ID
GR172
Designation
SHE ENGINEER
Department
QSHE - Quality, Safety, Health & Environment
Month
Year
Jul
2015
PC or PV No.
To be
Entertainment
Date
Receipt No.
Paid To
Purpose
Attendees
Amount
Total
Others/ Miscellaneous
Date
Receipt No
7/16/2015
Paid To
Purpose
Acct. Code
Amount
Digi Telecommunications Phone bill for work related
To be completed by FAD
50.00
Total
50.00
Summary of Claims
Item
Description
Total (RM)
Transport Expenses & Miileage Claims (company Car)
(page 2 / 4 )
Transport Expenses & Miileage Claims (Own Car)
258.80
(page 3 / 4 )
Transport Expenses & Miileage Claims (Own Motorbike)
(page 4 / 4 )
Entertainment
Others/Miscellaneous
50.00
GRAND TOTAL
Employee's Signature:
Attested by HOD
SITI NURSAKINAH BT.

ABDUL HADI
MOHD RAZIF BIN MOHD ALI
Date:
Date :
308.80
Validated by Accountant
Approved by FC / DOP / MD
Date:
Date:
Page 1 / 4
Notes:
(i) Itemized original receipts must be attached to support the above expenditures.
(ii) All claims must be on a calendar month basis and to be submitted on or before 5th working day of the following month.
GN/AC/F-01
Rev. 0 (01/10/2011)
(iii) Please fill up all the fields unless stated otherwise.
GN/AC/F-01
Rev. 0 (01/10/2011)
FORM
Important : Please submit mileage log book
Example
1. Atten
2. Atten
3. Atten
4. Couri
5. Trans
6. Carry
7. Perfor
8. Site v
TRANSPORT EXPENSES AND MILEAGE CLAIM (Company Car)

Company
( please tick )
Employee Name
Month
May
Employee ID
GR172
Year
2014
Designation
SHE ENGINEER
Department
Please s
(A) nam
(B) locat
(C) e.g.
(D) proje
(E) spec
demobil
Odometer Reading Record
Vehicle Reg. No
Beginning of the Month
Make / Model
End of the Month
Total usage for the Month
DETAILS OF JOURNEY MADE
Date
From
Destination
To
Mileage Purpose of Trip
Fuel
Toll
Ensure c
this mon
odomete
Parking
KM
Total
Total
Other Travelling Expenses e.g. bus fare, taxi fare, repairs of vehicles, upkeep of vehicles
Date
Receipt No
Paid To
Purpose
Amount
Total
Fuel Claim
Official Trip Mileage
Total Mileage
Entitled Fuel Claim
Other Travelling Expenses
GRAND TOTAL
Employee's Signature
Attested by HOD
FOONG MAY LING
Date:
Date :
Total Fuel Bills
Re-check Mileage
Toll & Parking Charges
(transferred to page 1)
Date:
Date:
Page 2 / 4
Notes:
GN/AC/F-01
Ensure co
month's c
Rev. 0 (01/10/2011)
FORM
TRANSPORT EXPENSES AND MILEAGE CLAIM (Own Car)
Company
( please tick )
Employee Name
Employee ID
GR172
Designation
SHE ENGINEER
Department
QSHE
Vehicle Reg. No
BMD3002
Make / Model
PERODUA / MYVI
Month
July
Year
2015
Exam
1. At
2. At
3. At
4. Co
5. Tr
6. Ca
7. Pe
8. Si
Pleas
(A) n
(B) lo
(C) e
(D) p
(E) s
dem

Date
Destination
Toll
Parking
From
To
6/1/2015
Balakong Office
BEST WESTERN HOTEL
22 Environmental Quality Air Act
6/2/2015
Balakong Office
BEST WESTERN HOTEL
22 Environmental Quality Air Act
6/3/2015
Balakong Office
KAJD
30 PDP Weekly Systems Meeting
6/4/2015
Balakong Office
SUBD
90 Safety Committee Meeting
6/4/2015
Balakong Office
KAJD
30 TSR Bina meeting with system wpc
6/5/2015
Balakong Office
KAJD
30 Inspections,meetings
6/8/2015
Balakong Office
KAJD
30 Toolbox TSR Bina
6/9/2015
Balakong Office
KAJD
30 Inspections with PDP
6/9/2015
Balakong Office
KAJD
30 Meeting for inspection findings
6/10/2015
Balakong Office
KAJD
30 Inspections,meetings
6/11/2015
Balakong Office
Gamuda HQ Tower
31 Safety Practitioner meeting of MRT
6/11/2015
Gamuda HQ Tower
SUBD
22 Document checking for audit
6/11/2015
SUBD
Balakong Office
45 Send PR to Saleza
6/11/2015
Balakong Office
KAJD
30 Inspection site office(mosquito breed
6/12/2015
Balakong Office
KAJD
30 Housekeeping for (mosquito breed)
KM
Total
1.00
4.10
2.90
502
Total
8.00
Date
Receipt No
Paid To
Purpose
Amount
Total
First 500 km
500
@ RM0.50 per km
250.00
@ RM0.40 per km
0.80
Balance
Total
502
Total Mileage Claim
250.80
8.00
258.80
GRAND TOTAL
Attested by HOD
SITI NURSAKINAH BT. ABDUL

HADI
MOHD RAZIF BIN MOHD ALI
Date:
Date :
Date:
Date:
Page 3 / 4
Notes:
GN/AC/F-01
Rev. 0 (01/10/2011)
FORM
TRANSPORT EXPENSES AND MILEAGE CLAIM (Own Motorcycle)
Company
( please tick )
Employee Name
Employee ID
GR172
Designation
SHE ENGINEER
Department
Month
Jul
Year
2015
Ex
1.
2.
3.
4.
5.
6.
7.
8.
Ple
(A)
(B)
(C)
(D
(E)
de
Vehicle Reg. No
Make / Model
Date
Destination
From
To
Toll
Parking
KM
Total
Total
Date
Receipt No
Paid To
Purpose
Amount
Total
First 300 km
@ RM0.30 per km
Balance
@ RM0.20 per km
Total
Total Mileage Claim
GRAND TOTAL
Attested by HOD
Date :
Date:
Date:

Date:
Notes:
GN/AC/F-01
Page 4 / 4
Rev. 0 (01/10/2011)

XVX

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FORM

EMPLOYEE'S EXPENSES CLAIM

] Global Rail Sdn Bhd

] Global Rail Projects Sdn Bhd

] Global Rail Infrasys Services Sdn Bhd

SITI NURSAKINAH BT. ABDUL HADI

QSHE - Quality, Safety, Health & Environment

Digi Telecommunications Phone bill for work related

Transport Expenses & Miileage Claims (company Car)

Transport Expenses & Miileage Claims (Own Car)

Transport Expenses & Miileage Claims (Own Motorbike)

SITI NURSAKINAH BT.

MOHD RAZIF BIN MOHD ALI

(iii) Please fill up all the fields unless stated otherwise.

TRANSPORT EXPENSES AND MILEAGE CLAIM (Company Car)

] Global Rail Sdn Bhd

] Global Rail Projects Sdn Bhd

] Global Rail Infrasys Services Sdn Bhd

SITI NURSAKINAH BT. ABDUL HADI

QSHE - Quality, Safety, Health & Environment

Odometer Reading Record

Beginning of the Month

End of the Month

Total usage for the Month

DETAILS OF JOURNEY MADE

Mileage Purpose of Trip

Official Trip Mileage

Other Travelling Expenses

SITI NURSAKINAH BT. ABDUL HADI

FOONG MAY LING

Total Fuel Bills

Toll & Parking Charges

] Global Rail Sdn Bhd

] Global Rail Projects Sdn Bhd

] Global Rail Infrasys Services Sdn Bhd

SITI NURSAKINAH BT. ABDUL HADI

DETAILS OF JOURNEY MADE

Mileage Purpose of Trip

BEST WESTERN HOTEL

22 Environmental Quality Air Act

BEST WESTERN HOTEL

22 Environmental Quality Air Act

30 PDP Weekly Systems Meeting

90 Safety Committee Meeting

30 TSR Bina meeting with system wpc

30 Toolbox TSR Bina

30 Inspections with PDP

30 Meeting for inspection findings

31 Safety Practitioner meeting of MRT

22 Document checking for audit

30 Inspection site office(mosquito breed

30 Housekeeping for (mosquito breed)

Total Mileage Claim

Toll & Parking Charges

Other Travelling Expenses

SITI NURSAKINAH BT. ABDUL

MOHD RAZIF BIN MOHD ALI

] Global Rail Sdn Bhd

] Global Rail Projects Sdn Bhd

] Global Rail Infrasys Services Sdn Bhd

SITI NURSAKINAH BT. ABDUL HADI

QSHE - Quality, Safety, Health & Environment