Unisys Global Services - India

RELOCATION EXPENSES REIMBURSEMENT FORM

EMPLOYEE NAME: EMP ID:
M.YUVARAJ 307978
DEPARTMENT/PROJECT: JOINED DATE (dd-mmm-yy):
ADM 25-Jun-15
Cost Center: PROCESSING MONTH :
July
Contact Number office and Mobile:
Office : Mobile : 8608849554

DATE DESCRIPTION FROM TO AMOUNT

(dd-mmm-yy)

AIR FARE

TRAIN FARE

24-Jun-15 BUS FARE Kanchipuram Bangalore INR 335.00

TAXI FARE

AUTO FARE
RELOCATION CHARGES
(HOUSE HOLD GOODS)
OTHER
Specify :
OTHER
Specify :
TOTAL INR 335.00

Relocation reimbursement details received on or before the 15th of the month will be processed
in the same month along with salary. Received on or after the 16th of the month will be
processed in the subsequent month along with salary.

This amount will be deducted from your full & final settlement if you decide to leave us without
completing six months of employment.

EMPLOYEE SIGNATURE: DATE: 14-Jul-15

PRIMARY APPROVAL: DATE:

SECONDARY APPROVAL: DATE:

Version: 2.1 Effective Date:15/September/2010

Unisys Confidential 1 UGSI-I-RERF-SF-2_0-002