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Expenses claim
Personal information
First name
*
Last name
*
Department
*
Phone number
E-Mail
Name of manager
*
Itinerary
Reason for trip
*
Name of client /location
*
Point of departure
*
Departure date
*
mm/dd/yyyy
Time
*
Return date
*
mm/dd/yyyy
Time
*
Method of transportation
Your own transportation
Lease car
Train
Airplane
Travelling expenses
Rental car
usd
Taxi
usd
Airplane
usd
Additional expenses
usd
Fuel cost
usd
Milage with own car
Reimbursement $ 0.30 per mile
usd
Number of nights spent on location
Reimbursement $ 60 per night
usd
Private meals
Breakfast
meals at $ 6 reimbursement
usd
Lunch
meals at $ 12 reimbursement
usd
Diner
meals at $ 24 reimbursement
usd
Business meals
Breakfast
meals at $ 20 reimbursement
usd
Lunch
meals at $ 30 reimbursement
usd
Diner
meals at $ 80 reimbursement
usd
Additional expenses
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Gratuity
Parking
Phone
Fax
Postage
Gifts
Meals on the way
usd
Total expenses
Nights spent
usd
Travel expenses
usd
Private meals
usd
Business meals
usd
Additional expenses
usd
Already received in advance
usd
Amount payable
usd
Payment information
Transfer
with monthly salary payment
Direct
Bank account number
*
Bank account holder's name
*
*
=
Input is required