expense claim form-ipms-13 mar 2013

EXPENSE CLAIM FORM Emp. Name: Mohammed Iliyaz Khan Emp. Number: IND-006 Department: IPMS Date: Sunday, May 19, 2013 S/N Expense Description Amount (SR) Remarks 1 Air Ticket ر سف ر ك ا ذ ت2 Hotel ادق ن ف9,393.28 3 Toll fees ر س ج وم س ر4 Car Parking - airport رات ا ي س ف ق وا م وم س ر5 Passport Renewal وار ج ذ ذت ج ت6 Food expenses طعام ف ي مصار1,133.00 7 Telephone Bill ف ي ها ورة ت ا ف8 Temporary Labour 0 ة0 ت ف3 و م مالة ع9 Transportation لات ق ن0 ت3,580.00 10 Medical Expense ة ت= طب ف ي مصار11 Stationary ة ترطاس ق12 Office Supplies ب ت مك م وار ل13 Fuel & Lubricants ات روف ح م14 Car Repair رات ا ي سصلاح ا15 Other Car Expenses رات ا ي سل ل رى خ3 ا ف ي مصار16 Computer Related Exp. ي ل ا ب س حا ف ي مصار17 Subscription كات را تV اش18 Iqama Charges امة ذ اف ذت ج ت19 Others - Specify Down: 20 21 22 23 24 25 26 27 28 29 30 Total 14,106.28 Submitted by Mohammed Iliyaz Khan Approved by: Mr.Prasad Amount received by: - ل سق3 لا ا ي ف رها ك د3 ا رى خ3 ا: Note: Add other "miscellenous/not mentioned" expenses in rows 19 to 30 above 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: [email protected] Website: http://www.ipms.com.sa

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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: [email protected] 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: [email protected] Website: http://www.ipms.com.sa

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