Document No.

I-FM-HR-HRO-030-1

Expense Claim Form Date 13-Jul-18

Rev. 1

Name of Employee: Afzaal Moin Khan Car/Motorcycle Reg.# LEB-10-252/LEM-12-88

Department: Maintenance Designation: AM E&I Claim Submission Date: 26-02-21 Month: Jan-21

Distance Allowances Amount

Date Purpose Remarks
From To Car Fuel Maintenance Mobile Travel Others

28-Dec-20 Official and Personal Use - - - 2980 - - - -

5-Jan-21 Official and Personal Use - - - 3380 - - - -

12-Jan-21 Official and Personal Use - - - 3270 - - - -

19-Jan-21 Official and Personal Use - - - 3150 - - - -

22-Jan-21 Official and Personal Use - - - 3100 - - - -

26-Jan-21 Official and Personal Use - - - 3420 - - - -

Total Amount in words : Nineteen Thousand Three Hundred Rupees Only Total Amount In Figures: Rs. 19,300/-

Employee Name Facilities & Securities Department Human Resources Department

 MONTHLY EXPENSE CLAIM FO
NAME OF EMPLOYEE: CAR / MOTORCYCLE REG.NO. :
DEPARTMENT / DESIGNATION: PERIOD / MONTH :

Monthly Allowances
Date Purpose Fuel Expense
(If any)

Prepared by Checked by
NTHLY EXPENSE CLAIM FORM
RCYCLE REG.NO. :
Jan-18

Mobile Transport
Vehicle
Maintenance Others
Allowance Allowance
Allowance

Taimoor Chaudhry
ked by Approved by
 Remarks

Taimoor Chaudhry
Approved by