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Expenditure reimbursement Application form - www.aletterformat.com

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									Form for claim of reimbursement of entertainment expenses for official purposes other than incurred in a club.
Name Designation Grade/Scale Employee No. : Period Certificate Basis : Voucher Basis Charges a/c Entertainment (tea, coffee & snacks) : : : Grade/Scale

I certify that Rs.

(Rupees

) was

incurred by me wholly and exclusively in the performance of my official duty on entertainment, which may please be reimbursed to me as
per my entitlement.
Date Place Official Signature of the

SANCTIONING AUTHORITY REMARKS
I have perused the above form, the declaration given by Smt./Shri ..................................... and the original bills in support of the expenditure incurred. On that basis, it is certified that the above expenditure was incurred by Smt./Shri ............................. (name of the officer) wholly and exclusively in the performance of his official duty. Passed for the payment for Rupees _________________________________________ . For ã䪶ããâ‡ãŠ Date : ¹ãƺãâ£ã‡ãŠ /Manager FOR OFFICE USE Debit Charges A/C Credit (1) Banker Cheque Rs._______________ Rupees _______________________________________________________ Bill Scrutinised and found in order

Manager

Date :

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