TRAVEL EXPENSE STATEMENT

Name : Designation : Level :

Purpose : Official

1. Detail of journey

Sl. No. Departure from Date Time Arrived at Date Time Mode of Travel Rs
1
2
3
4
5
6
7

Sub Total -

2. Daily Allowance

@ Rs. …………. Per day for ………………. days from ……………….. to …………..

@ Rs. …………. Per day for ………………. days from ……………….. to …………..

@ Rs. …………. Per day for ………………. days from ……………….. to …………..
Sub Total

3. Incidental Expenses -

4. Hotel Charges (Details overleaf)

#NAME?
5. Local transport (Details overleaf) - No Bills attached as local taxis where hired.
#NAME?
6. Other Expenses for which prior approval was not taken. (Details overleaf) #NAME?
Grand Total (S. No. 1 to 6) #NAME?

Signature of Employee ….. ...……… Less : 1. Cost of Air/Rail ticket

Paid by Company
Date ………………
2. Hotel Expenses included
Head of deptt. ……………… above to be borne by company
(including local transport + other expenses)
Passed pf payment ………………
Net Expenses incurred
Paid/Adjusted V. No. …………….. Less : Advance Taken

Net receivable/ Net Payable #NAME?

 DETAILS OF LOCAL TRANSPORT
Date From To Mode of Transport Amount
14/08/23 KALYANI BELGHARIA TRAIN 25.00
14/08/23 BELGHARIA BIRATI AUTO 35.00
14/08/23 BIRATI SARADA PALLI TOTO 15.00
14/08/23 SARADA PALLI BIRATI TOTO 15.00
14/08/23 BIRATI BELGHARIA AUTO 35.00
14/08/23 BELGHARIA KALYANI TRAIN 25.00
Total 150.00

DETAILS OF OTHER EXPENSES

Remark/Bill/No
Sr. No. Particulars Bill No. Date Amount bill
1 COURRIER RC - 4G TO PUNE 16/08/23 200.00 BILL
2