CITY LIFE

TRAVEL EXPENSE CLAIM FORM

Name: MANTOSH KUMAR Expense Period : 1JULY TO 15 JULY
Designation : SALES EXECUTIVE Region : BIHAR
Sales &
Departmnet :
Purpose Of Travel (Please specify) marketing
Required Attachment of Voucher / Cash memos / Bills.
1. Ex / Out Station District Travelling Expenses - Ticket Fare.
Travel Ticket
Date Departure Station Arrival Destination Amount
Mode NO.
03/07/2023 SAMASTIPUR LAKHISARAI BIKE 152KM 608.00
4-Jul LAKHISARAI MUNGER, JAMALPUR BIKE 124KM 496.00
5-Jul LAKHISARAI SAMASTIPUR BIKE 142KM 568.00
6-Jul RAMNATHPUR BIRAUL BIKE 136KM 544.00
8-Jul RAMNATHPUR SAMASTIPUR DISTRIC BIKE 70KM 280.00
11-Jul RAMNATHPUR ROSERA BIKE 48KM 192.00
12-Jul RAMNATHPUR TAJPUR BIKE 58KM 232.00
14-Jul RAMNATHPUR DHOLI BIKE 74KM 296.00
15-Jul RAMNATHPUR MUZZFARPUR, TAJPUR BIKE 162KM 648.00

Total 3864.00

2. Night Stay / Food Expenses :

With Bill up to the Giv en
DURATION
Limit
District / Town
From
To Date Night Stay Accomodation FOOD Total
Date
3:JULY 3:JULY LAKHISARAI 400.00 400.00
4:JULY 4:JULY MUNGER, JMALPUR 470.00 470.00
5:JULY 5:JULY BEGUSARAI, SPJ 350.00 350.00
6:JULY 6:JULY BIRAUL 430.00 430.00
8:JULY 8:JULY SAMASTIPUR DST 290.00 290.00
11:JULY 11:JULY ROSERA 310.00 310.00
12:JULY 12:JULY TAJPUR 320.00 320.00
 14:JULY 14:JULY DHOLI 290.00 290.00
15:JULY 15:JULY MUZZFARPUR, 340.00 340.00
0.00
Total 3200.00

3. HQ District / Ex. Station Daily Allowances:

No of
KM
Date Markets Disributor Shop Amount
Covered
Covered

Total 0.00

4 . Other Expenses (Please Specify): For Employee For HO A/c - Department

Amount
Itenery Amount (Rs.) A/c Head Maximum Amount Limit
Claimed
Mobile / Internet Travelling
Night Stay &
GIFT FOR DEALER
800.00 Food Expense
 Local
Courier Conveyance+
FOOD
Others Total: 800.00
Total Amount Claimed by Employee 7864
Minimum Primary Target / Achieved Primary
M: Target:
Amount Approved by the Head of the Dept. Rs:7864

Sign. of the
Employee Verified By : Authorized By Head of the Department