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EAC

EXPENSE / ADVANCE CLAIM FORM


Name:
Designation:
Dept./Faculty:

DATE

PARTICULARS

AMOUNT

(Please attach original receipts)

RM

Total

*Net Claim / Refund

FOR ADVANCE REQUISITION ONLY

(Please attach copy of Purchase Requisition)

Total Advance Required

BUDGET ALLOCATION (For non-PR item e.g. medical)


Account

Description

Code

Budgetted

Committed

Amount

Budget

Amount

to Date

Required

Balance

(RM)

(RM)

(RM)

(RM)

Remarks

Claimant / Applicant:

Verified / Recommended by:

Approved by:

Name:

Name:

Name:

Designation:

Designation :

Designation :

Date:

Date:

Date:

FOR FINANCE USE

FOR HRD USE

(Advance Requisition Only)

(Medical / Maternity Only)

Less Advance Taken (if any)

RECEIVED BY:

Approved by:

Approved by:

Name:

Name:

Name:

Designation:

Designation:

Designation:

Date:

Date:

Date:

Claim Form
Name

Laporan Berkala
No.

No.

Subject

Task Description

TOTAL

Claimant

Verification

Name :
Date :

Name :
Date :

Recommendation

Approval

Name :
Date :

Name :
Date :

IC No.

Subject

Hours / %

Amount

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