Sheet1Expense Claim Form ( ECF )NAME*Pavnish Kumar SharmaECN
No.*8710LOCATION* (Please tick)JAICCN No.*ANALYSIS AND
JUSTIFICATION OF EXPENDITURE(A) Give details of expenditure on the
reverse of this claimPAYMENT(Please tick)& these expenses need
authorisationDateLine Ref.Nature and Business Purpose Required for
all ExpenditurekmsAmount(+) Supports be attachedCHEQUE PAY TO
-----------------------------( Including names of
customers/suppliers/employees if applicable)Rs.For further
information on completion see
page-2-------------------------------SL.COMPUTERRS.1-FebHome
toSanaganer, Tonk Road, M.I.Road, C-Scheme, Raja
ParkNO.EXPENDITURECODEPl round off to nearest Re4-FebHome
toSanaganer, Gopalpura, Indira Bazar, Station Road1MEDICAL- Monthly
Reimbursement for self & dependents(+)5-FebHome toTonk Road,
M.I.Road, Station Road2PETROL - Montly Reimbursment(+)6-FebHome
toAjmer Road, M.I.Road, Ajmeri Gate3DRIVER - Monthly
Reimbersment(+)7-FebHome toAjmeri Gate, Film Colony, Ajmeri Gate,
Raja Park4TAXI HIRE CHARGES(A)+8-FebHome toFilm Colony, Raja Park,
Jawahar Nagar, Tonk Road, Subhash Nagar5VEHICLE MAINT - for Co.
Vehicles(A)+11-FebHome toSanganer, Ajmer Road, Tonk Road, Station
Road6CONVEYANCE - Monthly Reimbursement(A)+537112-FebHome
toSanaganer, Tonk Road, C-Scheme, M.I.Road7LOCAL CONVEYANCE /
TRANSPORTATION / FREIGHT/ OCTROI(A)+13-FebHome toVidyadhar Nagar,
M.I.Road, Ambabari, Chandpole8STAFF WELFARE - Refreshment &
Goods for staff only(A)+14-FebHome toM.I.Road, Station
Road,9PRINTING & STATIONARY For office use only(A)+15-FebHome
toChandpole, Janta Bazar, Johri Bazar, C-Scheme10PURCHASE SERVICES
/ CASUAL LABOUR(A)+16-FebHome toSanaganer, Prithwiraj Marg,
C-Scheme, M.I.Road, Raja Park11GIFT & PRESENTATION (Please
provide name of giftees)(A)+19-FebHome toBani Park, Station
Road12BUSINESS PROMOTION / ENTERTAINMENT (Pls. provide
Entertainment Expenditure Declaration Form)(A)+20-FebHome
toSanaganer, Tonk Road, M.I.Road, Malviya Nagar21-FebHome
toVidyadhar Nagar, Sikar
Nagar13MEETING/CONFERENCE/SEMINAR(A)+22-FebHome toSanaganer,
Amabari, Vidyadhar Nagar, Station Road, M.I.Road14BOOKS &
PERIODICALS FOR OFFICE(A)+23-FebHome toAjmeri Gate, Film Colony,
Ajmeri Gate, Raja Park15MEMBERSHIP & SUBSCRIPTION(A)+26-FebHome
toVidyadhar Nagar, Tonk Road,
C-Scheme16TELEPHONE/MOBILE(A)+93328-FebHome toSanganer, Ajmer Road,
Tonk Road, Station Road17REPAIRS & MAINT. - Renovation &
Repairs(A)+18COURIER CHARGES - Local courier/cases delivery person
etc.(A)+19POSTAGE & TELEGRAM(A)+20LEGAL/PROFESSIONAL
CHARGES(A)+21DEVELOPMENT CHARGES(A)+22PHOTOCOPYING
CHARGES(A)+23AUDITORS OUT OF POCKET
EXPENSES(A)+24IMPREST(A)+25OTHERS PLS SPECIFYParking(A)+AActual
mobile bill amt958TOTAL AMOUNT CLAIMED6304.0Bless part of
salary0LESS: IMPREST / ADVANCE TAKEN0Cless personal calls25BALANCE
DUE ( TO ) FROM COMPANY0DBalance:(A-B-C)933AMOUNT IN WORDSSix
thousand three hundred four rupees only.Eeg:-as per dsgnt USAGE
LIMIT1500Balance:(D-E)AMOUNT PASSED BY ACCOUNTSTotal Claim933Please
ensure that approval signatories are confirming compliance to
approval authority policy.Claimant's Signature*Approval
Signature*Special ApprovalChecked by Accounts DeptName: Pavnish K.
SharmaNameNameCash Received byDate: 1 Mar 2013DateDateSignature
Kindly affix Revenue Stamp, if payment exceeds Rs. 500/-
Sheet2
Sheet32-DecHome to AirportSanganer, Malviya Nagar, Indira
Bazar3-DecHome to AirportSanganer, Station Road, Bani Park4-DecHome
toC-Scheme, M.I.Road, Murlipura5-DecHome tosubhash Nagar &
Back7-DecHome to AirportSanganer, Tonk Road, M.I.Road8-DecHome to
AirportSanaganer, Station Road, Civil Lines, C-Scheme9-DecHome to
AirportSanganer. Tonk Road, C-Scheme10-DecHome to AirportSanganer,
M.I. Road11-DecHome to AirportSanganer, Tonk Road,
M.I.Road12-DecRiya TravelM.I.Road, Nehru Bazar, Jawahar
Nagar14-DecHome to AirportSanganer, Durgapura, Devi nagar, Nirman
nagar15-DecHome to AirportSanganer, S.C.Road, M.I.Road16-DecHome to
AirportSanganer, station road, chandpole, C-scheme17-DecHome to
AirportSanganer, hawa sarak, Ajmer Road18-DecHome to
AirportSanganer, C-scheme, Tonk Road, Subhash nagar19-Dec21-DecSri
Balaji AssociatesSikar Road, Murlipura, V.K.I, Vidyadhar22-DecShiv
EnterprisesChand Pole Gate, Indira Bazar, S.C.Road23-DecHome to
AirportSanganer, M.I.Road,24-DecHome to AirportTonk Road, Bapu
nagar28-DecDiana TravelStation Road, M.I.Road, Bani Park29-DecHome
to AirportSanaganer, Raja Park, Tilak Nagar30-DecRiya
TravelM.I.Road, Johri Bazar31-DecON LEAVE
