CLAIM FORM FOR TRAVEL EXPENSES
Dated: ……………
Company: Project
Department Site
Employee’s Name: Designation
Grade:
Travel Period: From: To
Purpose of Tour:
Whether Assigned job completed (Yes/No)
I. Details of Traveling Expenses:
Departure Arrivals Claimed Sanctioned
Mode Amount Amount
S. No. (Air/Train/ Date Time Place Date Time Place Class (Rs.) (Rs.)
Bus/Taxi/
Auto)
Sub Total
II. Boarding and Lodging Expenses
Date Boarding Lodging Claimed Amount Sanctioned
(Rs.) (Rs.) (Rs.) Amount (Rs.)
Sub Total
III.Misc. Expensses
Heads Claimed Amount Sanctioned Amount
(Rs.) (Rs.)
Internet
Agent Charges for Ticket Booking
Others Expenses (Specify)
Sub Total:
Total Claimed Amount (Rs.
Less: Advance Rs…………………. Net Payable/Refundable Rs…………
This is to certify that the traveling allowance claimed by me in this statement is entirely spent by
me during my stay mentioned in this statement.
Claimant’s Signatures
Comments of HOD:-
1.
2.
H.O.D Signature
SANCTION MEMO
Travel Claim passed for Rs. As under:
1. Travelling Expenses: Rs……………..
2. Boarding Expenses (Food): Rs.……………
3. Lodging Expenses: Rs……………..
4. Misc. Expenses (Tel. /Internet, Tickets booking, Etc.): Rs.…………….
5. Other non-traveling Exp.: Rs.…………….
TOTAL: Rs…………….
Less: Advance: Rs……………..
Net Payable/Refundable: Rs………………
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