Statement No.

Expense Statement

Employee Pay Period

Name Abdul Rahim Emp # 0001 From 9/1/2006

SSN Position Clerk
Department Accounts Manager Satish Shukla To 9/30/2006

Date Account Description Lodging Transport Fuel Meals Phone Entertainment Other TOTAL
9/1/2006 Lunch $15.00 $15.00
9/2/2006 Lunch $12.00 $12.00
9/7/2006 Hotel $80.00 $80.00
9/15/2006 Call Charges $9.00 $9.00
9/21/2006 Movies $25.00 $25.00
9/30/2006 Misc $14.00 $14.00

$107.00 $9.00 $25.00 $14.00

Sub Total $155.00
Approved Notes Advances $46.00
TOTAL $109.00

Reimbursement

Office Use Only

AOE