expense claim form-ipms-13 mar 2013

Expense Claim Form

Exp Claim (2)EXPENSE CLAIM FORMEmp. Name:Mohammed Iliyaz KhanEmp. Number:IND-006Department:IPMSDate:Sunday, May 19, 2013S/NExpense DescriptionAmount (SR)Remarks1Air Ticket 2Hotel9,393.283Toll fees 4Car Parking - airport 5Passport Renewal 6Food expenses 1,133.007Telephone Bill 8Temporary Labour 9Transportation3,580.0010Medical Expense 11Stationary12Office Supplies 13Fuel & Lubricants14Car Repair 15Other Car Expenses 16Computer Related Exp. 17Subscription18Iqama Charges 19Others - Specify Down:- :2021222324252627282930Total14,106.28Note: Add other "miscellenous/not mentioned" expenses in rows 19 to 30 aboveSubmitted by :Mohammed Iliyaz KhanApproved by:Mr.PrasadAmount received by:Disclaimer: I hereby acknowledge and confirm the correctness and completeness of above expense claim information.

P. O. Box No. 5555, Dammam 31432, Kingdom of Saudi Arabia, Tel # +966 3 837 5555, Fax # +966 3 837 3333, Email: info@ipms.com.sa Website: http://www.ipms.com.sa

Exp ClaimEXPENSE CLAIM FORMEmp. Name:Mohammed Iliyaz KhanEmp. Number:IND-006Department:IPMSDate:Sunday, May 19, 2013S/NExpense DescriptionAmount (SR)Remarks1Air Ticket 210.57Cancellation charges; Complete bills are as attached2Hotel( SR 934.80 - SR 724.23) = 210.573Toll fees 4Car Parking - airport 5Passport Renewal 6Food expenses 7Telephone Bill 8Temporary Labour 9Transportation230.00From 16-02-2013 to 19-05-201310Medical Expense 11Stationary12Office Supplies 13Fuel & Lubricants14Car Repair 15Other Car Expenses 16Computer Related Exp. 17Subscription18Iqama Charges 19Others - Specify Down:- :20213M Safety glasses(5pcs)222324252627282930Total440.57Note: Add other "miscellenous/not mentioned" expenses in rows 19 to 30 aboveSubmitted by :Mohammed Iliyaz KhanApproved by:Mr.PrasadAmount received by:Disclaimer: I hereby acknowledge and confirm the correctness and completeness of above expense claim information.

P. O. Box No. 5555, Dammam 31432, Kingdom of Saudi Arabia, Tel # +966 3 837 5555, Fax # +966 3 837 3333, Email: info@ipms.com.sa Website: http://www.ipms.com.sa