Version 1

IDS Medical Systems Philippines, Inc. Appendix A

Expense Claim/Liquidation Form

Name: Leo Paul Delos Santos Date: 30-Apr-21

Position: Customer Support Engineer Department: CSD

Company Paid
Expense
Employee Paid Expense
Reimbursed
No Date Chargeable To*: (PHP)
Airfares**
Accommodation Meals Transportation Others Expenses Description & Remarks
PHP
1 4/26/2021 LCTI Sales 2600 Antigen Test(Engr. And Driver) 2,600.00
2
3 1/27/2021 LCTI Sales 3600 800 Hotel(Engr. And Driver),Meals(Engr. And Driver) 4,400.00
4 2000 Toll Fee Load(Company Car Plate #NBF-114) 2,000.00

5 4/28/2021 LCTI Sales 4000 800 Hotel(Engr. And Driver),Meals(Engr. And Driver) 4,800.00
6
7 4/29/2021 LCTI Sales 800 Meals(Engr. And Driver) 800.00
8 1717.6 Gasoline 1,717.60
9
10
11
12
13
14
25
26 TOTAL 16,317.60
Less: Cash Advance
* Please fill in the project name where applicable TOTAL CLAIM AMOUNT 16,317.60
** If airfare is billed directly to the Company, it should not be reimbursable to the Staff.
The purpose for inclusion of airfare in this form is to ensure the Staff is aware of the airfare price and fully responsible to go bottom-fishing for the cheapest price available.
Notes:
1 Cut-off date 20th of the month
2 To be submitted not later than 25th the month following that in which the expenses were incurred.
3 Attach all vouchers, receipts and credit card vouchers and travel authorization form, where applicable.
4 Travel related expenses includes airport tax, taxi, train, bus etc.

Claimed by: Leo Paul Delos Santos Checked by: Approved by:

Date: 30-Apr-21 Date: Date:

Updated 30 Aug 2014

 Version 1

Appendix A-2

Name: Position: Period covered:

Paid by: Business Unit: Charge to:

Entertainment:
No. Date Place Client / Company Receipt Attend by Purpose / Project Name PhP
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Total -
Notes:
(1) To be submitted monthly, not later than the end of the month following that in which the expenses were incurred.
(2) Attach all vouchers, receipts and credit card vouchers.

Claimed by: Checked by: Approved by:

Date: Date: Date:

Updated 30 Aug 2014