Champion X de Colombia Ltda. PLEASE PRINT IN INK OR TYPE EXPENSE REPORT R2.

0
NAME (FIRST M.I. LAST) SOCIAL SECURITY NUMBER
GROUP & DIST./DEPT. CHARGE NUMBER SPECIAL VEHICLE NUMBER PERIOD dic.2023
EXP. CODE FROM TO
Andrés Augusto Carvajal Andrade 1075260840 LHR 761-JVK 654-LHT 103 1/12/2023 31/12/2023
EMP. PAID CAR OWN MEALS HOTELS TAXI/TOLL TEL. & POSTAGE MISCELLANEOUS DAILY
DATE CITY BUSINESS PURPOSE AIRFARE RENTAL NO. AMOUNT AMOUNT PARKING FAX & SUPPLY DESCRIPTION TOTALS
EXPENSE CODES - - - - - - 14,69
---------------- 467 468 464 502 464 464
01-dic-2023 Pto. Gaitan Cepsa 0,00
02-dic-2023 Pto. Gaitan Cepsa 30000,00 30000,00
03-dic-2023 Pto. Gaitan Cepsa 0,00
04-dic-2023 Pto. Gaitan Cepsa 0,00
05-dic-2023 Pto. Gaitan Cepsa 0,00
06-dic-2023 Pto. Gaitan Cepsa 33000,00 33000,00
07-dic-2023 Pto. Gaitan Cepsa 78000,00 Hidratación 70000,00 148000,00
08-dic-2023 Pto. Gaitan Cepsa 0,00
09-dic-2023 Pto. Gaitan Cepsa 0,00
10-dic-2023 Pto. Gaitan Cepsa 0,00
11-dic-2023 Pto. Gaitan Cepsa 0,00
12-dic-2023 Pto. Gaitan Cepsa 37300,00 37300,00
13-dic-2023 Pto. Gaitan Cepsa 45000,00 100000,00 260000,00 405000,00
14-dic-2023 Pto. Gaitan Cepsa 0,00
15-dic-2023 Pto. Gaitan Cepsa 0,00
16-dic-2023 Pto. Gaitan Cepsa 0,00
17-dic-2023 Pto. Gaitan Cepsa 0,00
18-dic-2023 Pto. Gaitan Cepsa 0,00
19-dic-2023 Pto. Gaitan Cepsa 0,00
20-dic-2023 Pto. Gaitan Cepsa 0,00
21-dic-2023 Pto. Gaitan Cepsa 0,00
22-dic-2023 Pto. Gaitan Cepsa 0,00
23-dic-2023 Pto. Gaitan Cepsa 0,00
24-dic-2023 Pto. Gaitan Cepsa 0,00
25-dic-2023 Pto. Gaitan Cepsa 0,00
26-dic-2023 Pto. Gaitan Cepsa Café operadores 38000,00 38000,00
27-dic-2023 Pto. Gaitan Cepsa 15000,00 260000,00 Cafetería 5000,00 280000,00
28-dic-2023 Pto. Gaitan Cepsa 0,00
29-dic-2023 Pto. Gaitan Cepsa 95000,00 Hidratación 70000,00 165000,00
30-dic-2023 Pto. Gaitan Cepsa 0,00
31-dic-2023 Pto. Gaitan Cepsa 0,00
7 0,00 0 333300,00 100000,00 520000,00 0,00 0,00 183000,00 1136300,00
0 Enter Amount of Permanent Advance Company Paid Airfare Amount A. BUSINESS MEALS 466 0,00
05/01/2023 RECONCILIATION OF ADVANCES AND EXPENSES B. ENTERTAINMENT 441 0,00
Employee Signature Date 1. Total of Expenses from Line H 1191310,00 C. AUTO EXPENSE 675 55010,00
I HAVE REVIEWED THIS EXPENSE REPORT AND ALL EXPENSES ARE
ORDINARY AND NECESSARY BUSINESS EXPENSES. 2. Temporary Advance(s) 0,00 D. CONVENTIONS 451
3. Company Paid Airfare 0,00 E. DISTRICT EXPENSES 691
4. Total Advances (2+3) 0,00 F. DISTRICT RENT 583
Approved By Date 5. Net Due Employee 1191310,00 G. TOTAL COMPANY PAID AIRFARE 0,00
6. Net Due Company (Enclose Check) 0,00 H. TOTAL EXPENSES 1191310,00
Approved By Date EXPENSE HOTLINE: NAPERVILLE 708-305-1433 SUGARLAND 713-263-7439
AUTO EXPENSE REPORT (FOR COMPANY CARS ONLY)
NAME PERIOD CAR NUMBER
Andrés Augusto Carvajal Andrade FROM 1/12/2023 TO 31/12/2023 LHR 761-JVK 654-LHT 103
GASOLINE OIL & OIL CHANGES MAINT. TIRES & PARKING
DATE TOTAL TOTAL BUS COST & TIRE WASHING MISC. TOTAL
GALS. LITERS ONLY QTS. COST REPAIR REPAIRS TOLLS
2/12/2023 5,6 55010,00 55010,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
0,00
TOTAL DOLLARS 55010,00 0,00 0,00 0,00 0,00 0,00 55010,00
TOTAL QUANTITY 5,6 0,0 0 TOTAL $
01 02 03 04 05 06 07 08 Report in C
ENDING ODOMETER READING 1 21 - IMPORTANT -
DO NOT INCLUDE ANY COSTS PAID FOR DIRECTLY BY NALCO
BEGINNING ODOMETER READING 2 (LIST REDEEMABLE EXPENSES ONLY) ENCLOSE RECEIPTS FOR ITEMS $25.00 AND OVER

TOTAL MILES THIS PERIOD 3 0 A. Is the car used for commuting? Distance (if yes): Yes No
BUSINESS MILES 4 B. Is another vehicle available for personal use? Yes No
PERSONAL MILES (3 MINUS 4) 0 C. Do you have records for sufficient evidence to support the business claims? Yes No