REIMBURSEMENT CLAIM FORM (RCF)

(Travelling, Training, Misc, etc.)

Month DECEMBER Document No.

MRS PREMIER SDN BHD (1400888-A) Staff name DATUK AGIL Staff No.
No 10 -1 Lot 336 Jalan 1/82B
Bangsar Utama 59200 Kuala Lumpur
NRIC Grade

Department project Charge Code

Location Tel / Ext. no.

REASONS / DESCRIPTION FOR CLAIM : FOR TRAVELLING CLAIM: DATE TIME

1. Travel from Office / Home To Destination

2. Arrival, return to Office / from Offical business

1) TRAVELLING DESCRIPTION FROM - TO (INDICATE FLIGHT / SHIP / ALLOWANCE /

D NAME OF TOWN OR PLACE FOR OVERNIGHT) MILEAGE COUNT TRAIN / TAXI HOTEL SUBSISTENCE OTHER MISCELLANEAOUS
a 2)NOT TRAVELLING CLAIM / TnGO EXPENSES EXPENSES ALLOWANCES EXPENSES
No. t (ALLOWANCES, TRAINING, PPE, ETC)
e KM MYR MYR MYR MYR MYR
(A) (B) (C) (D) (E) (F) (G)
1 29/Dec/22 RESTORAN FATHIMA MYR - MYR - MYR 46 MYR -
2 30/Dec/22 HOTEL GREEN PARK MYR 310
3 31/Dec/22 TNG 20.00
4 31/Dec/22 PETRON 50.00
5 30/Dec/22 HOTEL IMPERIAL MYR 100
6 31/Dec/22 MAHADI NIAGA ENTERPRISE MYR 295
7 01/Jan/23 KUANTAN TYRE SDN.BHD MYR 250
8 02/Jan/23 MIDTOWN KUALA TERENGGANU MYR 149
9 02/Jan/23 TNG 20.00
10 02/Jan/23 PETRON 80.00
11 05/Jan/23 TNG 20.00
12 06/Jan/23 RESTORAN RASMEENA MYR 39
13 07/Jan/23 RESTORAN RASMEENA MYR 93
14 08/Jan/23 RESTORAN SALAI SALAI-KG BARU MYR 113
15 8//1/2023 CHANTEQ NIAGA IT SDN BHD MYR 2,750
TOTAL 190 MYR - MYR 559 MYR 291 MYR - MYR 3,295
DESCRIPTIONS OF CURRENCY EXCHANGE RATE
DATE TYPE OF CURRENCY RATE SELLING / TT / OD TOTAL MYR (C + D + E + F + G) MYR 4,144.62
1 ADD MILEAGE CLAIM (B) 190.00
2 TOTAL CLAIM 0

I declare that all the particulars of the claims described above are true and VERIFIED BY APPROVED BY

accurate in line with the policies, terms & conditions whereby stated. SIGNATURE

POSITION

Signature: ……………………………………… Date: ……………………………………… DATE