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Travel Reimbursement Form

User's Details:
Name : Mandipudi Srikanth Department :
Emp Code : E100013427 Level : F1
Designation : Manager Location : Chhattisgarh
Cost Center : 5S01211E01 Company : Jakson Green Private Limited

Request Number : 2023-3339 Travel Type : Domestic Travel Request Date : 22-Apr-2023
From Date : 23/04/2023 08:00 To Date : 24/04/2023 05:00 Travel Control No : 13427-8
Expenses Type : Own Arrangment DA Eligibility : 1500 DA Expense : 1500

REQUISITION DETAILS
Dep.Date Name Dep.Time Dep.From Arr.To Mode Class Remark
23/04/2023 Mandipudi Srikanth 08:00-08:15 Bilaspur Anantapur Train AC II Tier transfer

AIR/TRAIN/BUS FARE
Departure Arrival Paid Fare Travel Modes
Time From Time To KM Mode Class Remarks
Date Date By Amt Eligibility
08:00 10:00 AC II train ticket
23/04/2023 Bilaspur 24/04/2023 Anantapur 0 Train Self 2290.4
AM AM Tier charges.
Total 2290.4
LOCAL CONVEYANCE
Date From To Paid By Mode K.M. Amount Remarks
24/04/2023 ananthapur tadipatri Metered Taxi/Auto 70 1800 transfer
Total 70 1800

TOTAL

Self Total(₹) 5590.4

Company Total(₹) 0
Re-schedule Total(₹) 0
Grand Total (A+B+C+D) (₹) 5590.4
RM Approved Amount (₹) 5590.4
Paid Amount (₹)

TRAVEL SUMMARY REPORT

Date Activity
24/04/2023 site transfer

APPROVAL SECTION

RM Status (By-Dileep Kumar BS ) : Approved RM Approved Amount : 5590.4

Remarks :
Finance Status ( ) : Pending Finance Passed Amount :
Remarks :

Please send the TA bill in finance at HO after approval of your RM (Dileep Kumar BS )

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