Expense Claim Form ( ECF )

NAME*

Pavnish Kumar Sharma

LOCATION* (Please tick)

ECN No.*

JAI

8710

CCN No.*

ANALYSIS AND JUSTIFICATION OF EXPENDITURE

PAYMENT

(A) Give details of expenditure on the reverse of this claim

(Please tick)

Date

& these expenses need authorisation

( Including names of customers/suppliers/employees if applicable)

SL.

COMPUTER
EXPENDITURE

CODE

RS.

1-Aug

Pl round off to nearest Re

3-Aug

1 MEDICAL- Monthly Reimbursement for self & dependents

(+)

6-Aug

2 PETROL - Montly Reimbursment

7-Aug

3 DRIVER - Monthly Reimbersment

(+)
(+)

4 TAXI HIRE CHARGES

(A)+

9-Aug

5 VEHICLE MAINT - for Co. Vehicles

(A)+

13-Aug

6 CONVEYANCE - Monthly Reimbursement

(A)+

7 LOCAL CONVEYANCE / TRANSPORTATION / FREIGHT/ OCTROI

(A)+

16-Aug

8 STAFF WELFARE - Refreshment & Goods for staff only

(A)+

17-Aug

9 PRINTING & STATIONARY For office use only

(A)+

20-Aug

10 PURCHASE SERVICES / CASUAL LABOUR

(A)+

21-Aug

11 GIFT & PRESENTATION (Please provide name of giftees)

(A)+

22-Aug

12 BUSINESS PROMOTION / ENTERTAINMENT (Pls. provide Entertainment

Expenditure Declaration Form)

(A)+

23-Aug

13 MEETING/CONFERENCE/SEMINAR

(A)+

27-Aug

14 BOOKS & PERIODICALS FOR OFFICE

(A)+

28-Aug

15 MEMBERSHIP & SUBSCRIPTION

(A)+

29-Aug

16 TELEPHONE/MOBILE

(A)+

17 REPAIRS & MAINT. - Renovation & Repairs

(A)+

18 COURIER CHARGES - Local courier/cases delivery person etc.

(A)+

19 POSTAGE & TELEGRAM

(A)+

20 LEGAL/PROFESSIONAL CHARGES

(A)+

21 DEVELOPMENT CHARGES

(A)+

22 PHOTOCOPYING CHARGES

(A)+

23 AUDITORS OUT OF POCKET EXPENSES

(A)+

24 IMPREST

(A)+

25 OTHERS PLS SPECIFY

Parking

8-Aug

5609

14-Aug

24-Aug

1049

30-Aug
31-Aug

Rs.

Home to
Home to
Home to
Home to
Home to

Sanaganer, Tonk Road, M.I.Road, C-Scheme, Raja Park

Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to
Home to

Film Colony, Raja Park, Jawahar Nagar, Tonk Road, Subhash Nagar

Sanaganer, Gopalpura, Indira Bazar, Station Road

Tonk Road, M.I.Road, Station Road
Ajmer Road, M.I.Road, Ajmeri Gate
Ajmeri Gate, Film Colony, Ajmeri Gate, Raja Park

Sanganer, Ajmer Road, Tonk Road, Station Road

Sanaganer, Tonk Road, C-Scheme, M.I.Road
Vidyadhar Nagar, M.I.Road, Ambabari, Chandpole
M.I.Road, Station Road,
Chandpole, Janta Bazar, Johri Bazar, C-Scheme
Sanaganer, Prithwiraj Marg, C-Scheme, M.I.Road, Raja Park
Bani Park, Station Road
Sanaganer, Tonk Road, M.I.Road, Malviya Nagar
Vidyadhar Nagar, Sikar Nagar
Sanaganer, Amabari, Vidyadhar Nagar, Station Road, M.I.Road
Ajmeri Gate, Film Colony, Ajmeri Gate, Raja Park
Vidyadhar Nagar, Tonk Road, C-Scheme
M.I.Road, Tilak Nagar
Sanganer, Ajmer Road, Tonk Road, Station Road

(A)+

6658.0

TOTAL AMOUNT CLAIMED

0
0

LESS: IMPREST / ADVANCE TAKEN

BALANCE DUE ( TO ) FROM COMPANY

Six thousand four hundred thirty eight only.

AMOUNT IN WORDS

Amount

-------------------------------

For further information on completion see page-2

NO.

Line Ref. Nature and Business Purpose Required for all Expenditure kms

CHEQUE PAY TO -----------------------------

(+) Supports be attached

Actual mobile bill amt

less part of salary

1094
0

less personal calls

45

Balance:(A-B-C)

1049

eg:-as per dsgnt USAGE LIMIT

1500

Balance:(D-E)
Total Claim

AMOUNT PASSED BY ACCOUNTS

Please ensure that approval signatories are confirming compliance to approval authority policy.
Claimant's Signature*

Approval Signature*

Special Approval

Checked by Accounts Dept

Kindly affix Revenue
Stamp, if payment
exceeds Rs. 500/-

Name: Rahul Anand

Name

Name

Cash Received by

1049

Stamp, if payment
exceeds Rs. 500/-

Date: 1 Jul 2012

Date

Date

Signature

2-Dec
3-Dec
4-Dec
5-Dec
7-Dec
8-Dec
9-Dec
10-Dec
11-Dec
12-Dec
14-Dec
15-Dec
16-Dec
17-Dec
18-Dec
19-Dec
21-Dec
22-Dec
23-Dec
24-Dec
28-Dec
29-Dec
30-Dec
31-Dec

Home to Airport
Home to Airport
Home to
Home to
Home to Airport
Home to Airport
Home to Airport
Home to Airport
Home to Airport
Riya Travel
Home to Airport
Home to Airport
Home to Airport
Home to Airport
Home to Airport

Sanganer, Malviya Nagar, Indira Bazar

Sanganer, Station Road, Bani Park
C-Scheme, M.I.Road, Murlipura
subhash Nagar & Back
Sanganer, Tonk Road, M.I.Road
Sanaganer, Station Road, Civil Lines, C-Scheme
Sanganer. Tonk Road, C-Scheme
Sanganer, M.I. Road
Sanganer, Tonk Road, M.I.Road
M.I.Road, Nehru Bazar, Jawahar Nagar
Sanganer, Durgapura, Devi nagar, Nirman nagar
Sanganer, S.C.Road, M.I.Road
Sanganer, station road, chandpole, C-scheme
Sanganer, hawa sarak, Ajmer Road
Sanganer, C-scheme, Tonk Road, Subhash nagar

Sri Balaji Associates

Shiv Enterprises
Home to Airport
Home to Airport
Diana Travel
Home to Airport
Riya Travel
ON LEAVE

Sikar Road, Murlipura, V.K.I, Vidyadhar

Chand Pole Gate, Indira Bazar, S.C.Road
Sanganer, M.I.Road,
Tonk Road, Bapu nagar
Station Road, M.I.Road, Bani Park
Sanaganer, Raja Park, Tilak Nagar
M.I.Road, Johri Bazar