TERUMO PENPOL Limited EXPENSES STATEMENT

(SUBMIT EVERY FORTNIGHT)

Name: Utkarsh Kumar Singh HQ: Delhi Month: November Period:01 November- 15 November
Date Station Train/Bus DCR Total
From To Km (Specify) Amount Auto/ Post DWA Subm No. of
I II Arrv/dep time(if stay) Arrv/ dep time(if (Km x Taxi age . calls
stay) rate) Y/N
1 A.N.-Tughlakabad Saket- A.N. 25+15+30 105 -------- ---- 150 Y 03
2 A.N.-E,Vinod Ngr. Gurgaon-A.N. 15+25+25+45+ 193 ------- ----- 225 Y 04
55
3 A.N.- Faridabad Faridabad-A.N. 25+15+10+35 103 -------- ----- 225 Y 04
4 LEAVE
5 HOLIDAY
6 HOLIDAY
7 SUNDAY
8 A.N.- K.puri Pachkuiyan 15+30+25 105 ----- ---- 150 Y 03
Rd-A.N.
9 A.N.- K.Puri Green Park- 15+25+10+35 108 ----- ---- 150 Y 04
A.N.

10 A.N.- Vaishali Old Gzb.- A.N. 20+15+ 15+35 103 ------ ----- 225 Y 03
11 A.N.-Saket K.Bagh- A.N. 25+20+15+10+ 123 ------ ----- 150 Y 05
35
12 A.N.- ITO Vasant Kunj- 25+5+30+15+2 143 ------ ----- 150 Y 04
A.N. 0
13 A.N.- J.walan J.walan- A.N. 25+25 75 ------- ----- 150 Y 01
14 SUNDAY
15 A.N.- Farudabad Faridabad- 25+15+10+35 103 ------ ----- 225 Y 04
A.N.

Other Expenses(with Bills) (B) Total (A) 2961 1161 1800

Telephone ----- Printing & Stationary -------- Others (Pl. Specify)
Rs. 44 Parking charges
Mobile ----- Transportation -------
Int / Email ----- Sales promotion* --------
Fax ------ Repair & Maint. --------
Xerox ------ Rates & Taxes --------
Courier ------ Service-Traded Prod ------- Total (B) Rs.44
Postage ------ Service-Mfg-Prod. -------- Grand Total (A+B) Rs. 3005

(Rupees: )
(Certify that the DCR s are received as per Company
policy & activities are done as per plan approved)

Signature & Date Approval & date

Detail of Gift / Guest / M & SP expenses

Date Amount Gift/ Guest Name of the guest with Name of the Organisation Expected revenue & when
M& Sp designation