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Pansari Industries - Expenses Claim Format

Name: Month:
PRAVEEN KUMAR Oct-22
HQ : DELHI Employee Code:

Designation: SR MANAGER Reporting Manager: MR NEGI


Joint Working Particulars MODE OF TRANSPORT Courier / Night Stay
Ex. HQ TA Total
Date Day With (if any) Actual Work at (Town) HQ DA KM Ex. HQ DA TOLL (Hotel +
KM CLAIM (Fare in Rs.) Amount
(Name) From To Bus Bike Car Train Charges Food)

10/10/2022 MONDAY 10/10/2022 MALVIYA NAGAR NAHARPUR ROHINI 400 70 490 CAR

11 TUESDAY 11 MALVIYA NAGAR NARAINA AND GURUGRAM LAXMAN VIHAR 400 110 770 CAR

12 WEDNESDAY 12 MALVIYA NAGAR SAFDERJUNG ENCLAVE .SARITA VIHAR OKHLA400 70 490 CAR

13 THURSDAY 13 MALVIYA NAGAR ROHINI THEN BEGUMPUR THEN SARITA VIHAR 400 96 672 CAR

14 FRIDAY 14 MALVIYA NAGAR AEROCITY THEN LADO SARAI THE AEROCITY 400 64 448 CAR

15 SATURDAY 15 MALVIYA NAGAR SARITA VIHAR THEN BADARPUR BORDER 400 62 434 CAR

16 SUNDAY 16 SUNDAY

17 MONDAY 17 MALVIYA NAGAR LAWRENCE ROAD THEN NEHRUPLACE 400 88 616 CAR

18 TUESDAY 18 MALVIYA NAGAR ROHINI THEN KARKARDUMA COURT 400 110 770 CAR

19 WEDNESDAY 19 MALVIYA NAGAR GURUGRAM AND MANESAR 400 140 980 CAR

20 THURSDAY 20 MALVIYA NAGAR CHATTARPUR AND AEROCITY 400 44 308 CAR

21 FRIDAY MR NEGI 21 MALVIYA NAGAR AGRA UP AND DOWN VIA EXPRESSWAY 500 550 3850 CAR 860

22 SATURDAY 22 MALVIYA NAGAR ROHINI NAHARPUR AND SUBHASH NAGAR 400 70 490 CAR

23 SUNDAY 23 MALVIYA NAGAR GURUGRAM FOR GIFTING SHIVPURI 400 102 714 CAR

24 24 DEEPAWALI

25 25 HOLIDAY

26 26 HOLIDAY

27 THURSDAY 27 MALVIYA NAGAR GURUGRAM SEC37 UDYOG VIHAR 400 98 686 CAR

28 FRIDAY 28 MALVIYA NAGAR NEHRU PLACE. SARITA VIHAR. JASOLA 400 56 392 CAR

29 SATURDAY 29 MALVIYA NAGAR ROHINI ,DEFENCE COLONY , OKHLA 400 94 658 CAR

30 SUNDAY 30 SUNDAY

10/31/2022 MONDAY 10/31/2022 MALVIYA NAGAR OKHLA FARIDABAD 70 400 88 616 CAR

6900 13384

MONTHLY MOBILE
Total 6900 13384 860 21144

Total Expense Submitted Rs._____21144_______ 1st Approved / Checked By:________________

Less Advance, if any Rs._______0______ Prepared / Submitted by:__PRAVEEN KUMAR ___________ Designation:__SR MANAGER ____________ Final Approval By:______________
(Head Office)
Total Claimed, Rs.________21144_____ Date:______7 NOV ___________ Date:____________________

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