INSTRUCTIONS : Name Job Title

1. All employees should send their Claims to their Reporting Manager only.
EXPENSE CLAIM FORM 2. Expense from 1st-25th can claim within the month Signature
and Expense from 26th-the end of month claim on first working day in next month Department
3. Claims would be reimbursed within 5-7 days of submission

Reporting Manager :
For period:
From To REMINDERS : Accounts Dept : Date:
1. Written explanations to the Reporting Manager is required for all late claims.
Page: 1 of 1 2. Late claims without valid reasons may result in the claim being cancelled. Authorized Director:
DESCRIPTION / PLACE TRAVEL EXPENSE
Give details overleaf
DATE Per diem Cab BTS Phone Own Car Total
From To PURPOSE Bus MRT Inernet Km Amount Parking + Express wayEntertainment Other

TOTALS - Total Auto Exp -