CONFIDENTIAL

BUSINESS TRAVEL FORM

(*No :043/ HRD/ TIN/ VI/ 2023)

1. Asignment Letter
We hereby assign * :
Name * : Shubham Ashok Gandhi
Position * : Principal Data Scientist
Division * : Technology
Office Based * : India
Destination * : Jakarta
Departure date * : 21 July 2023
Return date * : 5 August 2023
Type Of Transportation * : Flight
Accommodation Type * : Hotel
e-mail @tiket.com * : shubham.gandhi@tiket.com

Details of Tasks * : Data Science Offsite

Actual Cost (For

Cost Estimation (For Cash
2. Fasilitas / Facility Reimbursement or Remarks
Advance Request)
Report)
2. Transportation
2.1 Home Base
A. Air Fare * :
Economy Class * : If the booking made via
B2B Dashboard you are
B. Train Booking * : not mandatory to fill in
the amount
C. Bus Booking * :
D. Taxi / Online Transportation * :
E.Fuel * :
D. ................. * :
2.2. Hotel/Accommodation * : If the booking made via
B2B Dashboard you are
2.3. Meal Allowance not mandatory to fill in
the amount
A. Weekdays * : (₹ 40,671) 11 days
B. Hari Libur/Weekend * : (₹ 20,541) 5 days
2.4. Perjalanan Luar Negeri/International Travel
A. Laundry Expenses (Min. Stay 4 Nights) * :
B. Taxi / Online Transportation * :
C. Telephone Usage * :
D. Internet Usage * :
E. …............ * :
2.5. Others
A. Entertainment * :
B. …............................ * :
TOTAL (₹ 61,212) (₹ -) (₹ 61,212)
Bank Name: Kotak Mahindra Bank
Bank Account Number: 312697059
Bank Account Holder: Shubham Ashok Gandhi
SWIFT CODES* (for non Indonesia Bank): KKBKINBB
Jakarta, 14 Februari 2019
Assignor, Assignee, Acknowledge by,

Approved by Email Shubham Ashok Gandhi

Dimas Surya Yaputra Shubham Ashok Gandhi ( )

Approval For Reimbursement or Cash Advance Report

Manager: People Services: Finance: Director:

Approved by Slack