* Name : Ashish Kumar Yadav * Designation: Safety Officer Expenses Details * ( Please fill up all the below rows)

* Deputee ID # : 2373408 * Mobile No# for Contact : 9795935151

* E Mail ID: Ashish.ryadav28@gmail.com * Base Location: Allahabad-UP Reimbursement incurred during Month of May-2024
* Company Name : Siemens Ltd. * Department / Division : EHS Department/Siemens Mobility

Loding Allowance
(Telephone/Mobil

HQ/ Outstation )
(Taxi/Train/Bus)

Communication

Expenses( Per
Diem/ HQ / Ex

Totals in INR
Conveyance

Conveyance

(Pls specify)
Rate per KM

Boarding &
No. of KMs

e/ Internet)

Relocation
Beverages

Stationery
Printing &

Expenses
Bill Date *

Incidental

VAT/GST
Expense

Lodging
Bill No *

Food &
Airfare

Others
Description / Particulars

Local
(From & To) For Conveyance

01-May-24 1 Mobile Bill

-
299.00 299.00
Site Visit Cab Fare (Jhunsi To
02-May-24 2 Narayanpur Bazar-DDU
4,755.00 4,755.00
-
Jhunsi To Balson Office Taxi Fare
3 (May Month)
3,740.00 3,740.00
27-May-24 -

8,495.00 299.00 8,794.00

Total : - - - - - - - - -

Note : Fields indicated with * mark are mandatory Less: Advances Taken On
Amount Due
I hereby declare that the above given expenses are incurred for official purposes and the documents submitted are true to the best of my knowledge.

Name of the Member Signature Member ID No Approved Date

Ashish K Yadav 1602342 29--05-2024

Prepared By:*

Manager Approval:*
BH Approval:* ( Deviations)

Please submit all your claims to the respective HR person in Client Head Office who will inturn forward the bills to Randstad Head Office
All claims should reach to: Reimbursement Help Desk - SSC, Randstad India Ltd, "Randstad House", Old No. 5& 5A, New No.9, Pycrofts Garden Road, Chennai-600 006, Tamil Nadu
For Questions (or) Staus of the claims - Please E-mail: reim.quer@randstad.in
Information requested above must be complete and accurate. Please update business purpose for each receipt . Wrongly filled/Incomplete claims will be rejected and sent back to Member
Submit ORIGINAL RECEIPTS & Submit NON-CAPITAL EXPENDITURE ONLY for reimbursement. Please attach the credit/debit card slips wherever it was used for payment.
In case of Deviations from the policy; please obtaint the deviation approval from the HR Head and attach it to this Form