TERUMO PENPOL Limited EXPENSES STATEMENT

(SUBMIT EVERY FORTNIGHT)

Name: HQ: Month: Period:
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 stay) (Km x Taxi age . calls
rate) Y/N
16
17
18
19
20
21
22
23 Delhi Trivandrum 3036 4554 -------- ----- 150 N
24 Delhi Trivandrum 150 N

25 Delhi Trivandrum 37 150 N

26 Match Pt. Match point 150 N
27 Match Pt- Horizon Horizon- Match Pt. 150 N
28 Match Pt.-Horizon Horizon- Match Pt. 150 N
29 Match Pt.- Horizon Horizon- Match Pt. 150 N
30 Match Pt.- Kottayam- Match 225 N
Kottayam Pt.
SUBTOTAL: 1275

Other Expenses(with Bills) (B) Total (A) 5829

Telephone Printing & Stationary Others (Pl. Specify)
Rs. Parking charges
Mobile Transportation
Int / Email Sales promotion*
Fax Repair & Maint.
Xerox Rates & Taxes
Courier Service-Traded Prod Total (B) Rs.0
Postage Service-Mfg-Prod. Grand Total (A+B) Rs. 5829

(Rupees: Three thousand six hundred ninety nine only)

(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