* Lodging : (Category)
(A)
(B)
(C)
(A)
(B)
(C)
* DA :
OutsideHQ Rs
Rmk:
@HQ Rs
Rmk:
OutsideHQ Rs
Rmk:
@HQ Rs
Rmk:
* Two Wheeler :
/Km Rmk:
/Km Rmk:
* Four Wheeler :
/Km Rmk:
/Km Rmk:
* Mode of Travels OutSide HQ :
Flight:
Select
Yes
No
Cls:
Select
Economy
Business
Rmk:
Train/Bus:
Select
Yes
No
Cls:
Select
General
Sleeper
AC-III
AC-II
AC-I
AC
Rmk:
Flight:
Select
Yes
No
Cls:
Select
Economy
Business
Rmk:
Train/Bus:
Select
Yes
No
Cls:
Select
General
Sleeper
AC-III
AC-II
AC-I
AC
Rmk:
* Mobile expenses Reimbursement :
Prepaid:
Rs.:
Prd :
Month
Qtr
1/2 Yearly
Yearly
NA
Rmk:
Postpaid:
Rs.:
Prd :
Month
Qtr
1/2 Yearly
Yearly
NA
Rmk:
Prepaid:
Rs.:
Prd :
Month
Qtr
1/2 Yearly
Yearly
NA
Rmk:
Postpaid:
Rs.:
Prd :
Month
Qtr
1/2 Yearly
Yearly
NA
Rmk:
* Mobile Handset :
GPRS:
Amount:
Rmk:
GPRS:
Amount:
Rmk:
* Health Insurance(Premium Paid by Company) :
* Executive Health Check-up :
Yes
No
Amount:
Rmk:
Yes
No
Amount:
Rmk:
* Gratuity and Bonus/Exgretia(Monthly) :
* Remark :
Date :