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Mobile Phone - Reimbursement Claim Form (SNHRGPLTP2)

This document is a mobile phone reimbursement claim form for an employee of Sasken Network Engineering Limited. It summarizes a claim made by Diwakar Mishra from June 11, 2013 to November 30, 2013 for a prepaid mobile phone. The claim includes Rs. 350 for recharge coupons. The employee certifies that the reimbursement is only for official calls and the approving manager signs off on the form if the claim exceeds the eligible amount. Required enclosures include the original mobile bill for postpaid phones or recharge coupons for prepaid phones.

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1K views1 page

Mobile Phone - Reimbursement Claim Form (SNHRGPLTP2)

This document is a mobile phone reimbursement claim form for an employee of Sasken Network Engineering Limited. It summarizes a claim made by Diwakar Mishra from June 11, 2013 to November 30, 2013 for a prepaid mobile phone. The claim includes Rs. 350 for recharge coupons. The employee certifies that the reimbursement is only for official calls and the approving manager signs off on the form if the claim exceeds the eligible amount. Required enclosures include the original mobile bill for postpaid phones or recharge coupons for prepaid phones.

Uploaded by

mishradiwakar
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Mobile Phone Policy SNHRGPL4 V1.

Mobile Phone Reimbursement Claim Form (SNHRGPLTP2)


Billing Period: From____6/11/2013_____ to __30/11/2013______________ Employee ID__207604________ Mobile No: ___86553386572______________

Employee name ____DIWAKAR MISHRA______ Designation___ Engineer Band: _E1__________ Project ______ NSN/Airtel Type of Mobile: PREPAID Location____ Mumbai _________ Project ID_______03-00086____________________________

Band wise entitlement: Rs._________ per Month; Bank Account Number: __09181530003549_______ Nature of Expenses: POST PAID a) Monthly Rent : Rs _________ b) Official Call charges : (Local, STD, ISD, SMS & MMS) c) Itemized Billing d) Roaming charges Sub total e) Service Tax Total Claimed : : : : : Rs__________ Rs__________ Rs__________ Rs__________ Rs__________ Rs__________ PRE PAID: a) SIM Card charges

: Rs: _____NA___

b) Recharge coupon value: Rs: 350 c) Total Claimed : Rs: _350-00__

(Rs: In words _THREE HUNDREAD FIFTY ONLY_____ I hereby undertake that reimbursement is being claimed only for official calls. Signature of the employee: _______________________Date: ___________

Remarks/ Approval of Reporting Manager in case Claim Exceeds Limit. _____________________________________________________________________________________ Approving authority: ________________________ Signature: _______________ Note: Approval from Reporting Manager is required only in cases where the claim is over and above the eligible amount. (For Accounts use only) Amount Reimbursed : Rs ______________________________ Payment Dt: ______________

Payment No___________________

List of enclosures: Self attested original mobile bill for post paid/Original Recharge coupons for Prepaid.
Note: I. Total Reimbursement = Sub total* + service tax equivalent levied on official calls**. *(sub total = Monthly rental + Official call charges + Itemized billing charges+ Roaming charges) **service tax equivalent levied on official calls: sub total X service tax as applicable (Ex: 10.2% at present) II. Activation, security or one time charges are to be mentioned and claimed separately as per Policy.

Sasken Network Engineering Limited Confidential

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