SAMVARDHANA MOTHERSON AUTO COMPONENT PVT.

LIMITED
EXPENSES REIMBURSEMENT
Date: 14.05.20
Name: Vishal Rajput Employee Code: S115
Designation: Sr. Engg Department: ENGG

S.No. Bill/Invoice No. Date Firm Name Particulars Amount

Sharma hardware and

1 21000074 09.04.2021 Spares of die
iron store
472

TOTAL 472

Employee Signature Approver1 Approver2

Plant Head COO

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT
Date: 26.02.20
Name: Ramkrishna Kale Employee Code: S037
Designation: Manager Department: ME

Bill/Invoice
S.No. Date Firm Name Particulars Amount
No.
Lunch with customer -HMCMM (Total 4 Members)
1 RB002443 12.12.19 Manesar Club 1229
(Arun Prajapati,Dinesh Sharma,Anup,R.S.Kale)

TOTAL 1,229

Employee Signature Approver1 Approver2

Plant Head COO

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
Local Conveyance Reimbursement

Name: Ramkrishna Kale Date 18.02.20

Designation: Manager

S.No. Date From To Purpose Mode K.M. Amount Amount

Th. Body Stepper Motor Hole

1 13.02.20 SMAC MTTL NOIDA OLA TAXI 72 1149 1149
Tool correction

Th. Body Stepper Motor Hole

2 13.02.20 MTTL NOIDA SMAC OLA TAXI 72 1110 1110
Tool correction

TOTAL 2259

Employee Signature

Recommended/Not Recommended
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT
Date: 25.09.18
Name: Ramkrishna Kale Employee Code: S037
Designation: Manager Department: ME

Bill/Invoice
S.No. Date Firm Name Particulars Amount
No.
1 9118052583 19.09.18 Sunbeam Auto Pvt.Ltd. Regulator Cover & Body Spectro/X-ray charges 2124

TOTAL 2,124

Employee Signature Approver1 Approver2

Plant Head COO

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 15.12.2016
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

1 3522 2/12/2016 HINDUSTAN CHEMICALS NITRIC ACID - 2.5 LITERS 1,000

2 3522 2/12/2016 HINDUSTAN CHEMICALS SODIUM HYDROXIDE - 500ML 189
HINDUSTAN
3 3523 3/12/2016 BEEKAR -1000ML - 1 NO 421
CHEMICALS
HINDUSTAN
4 3523 3/12/2016 THERMOMETER - 1 NO 189
CHEMICALS
5 106461 18/11/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 217

LUNCH EXPENSES ON SUNDAY

6 751 27/11/2016 RAJASTHANI HOTEL 120
WORK - 2 PERSON

7 110563 28/11/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 233

8 111996 2/12/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 217

9 29214 13/12/2016 SUBWAY LUNCH EXPENSES - 1 PERSON 161

TOTAL 2,747.7

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
MEDICAL BILLS- REIMBURSEMENT
Date 21.07.18
Employee Code No. : S037 Department: Mfg.Engg.
Name : RAMKRISHNA KALE Designation: MANAGER

S.No. Doctor/Medical Store Bill No. Date Patient Name Relationship Amount

1 Vimal Medical VMS705 05.06.17 Kalpana Wife 1403

2 Child Clinic 341 06.11.17 Gargi Daughter 1856

3 Child Clinic 337 12.12.17 Chaitanya Son 300

4 Child Clinic 449 12.12.17 Chaitanya Son 307

5 Child Clinic 355 18.12.17 Gargi Daughter 300

6 Child Clinic 496 18.12.17 Gargi Daughter 216

7 Child Clinic 533 23.12.17 Chaitanya Son 1426

8 Child Clinic 384 23.12.17 Chaitanya Son 300

9 Saksham 1273 05.02.18 Kalpana Wife 450

10 Rock Pharmacy 30 03.04.18 Kalpana Wife 387

11 Saksham 1866 02.06.18 Kalpana Wife 500

12 Saksham 1843 26.06.18 Kalpana Wife 600

13 Medicine 2025 28.06.18 Gargi Daughter 4777

14 Jijau SSM2573 24.06.18 Kalpana Wife 421

15 National Path Lab 95 06.07.18 Gargi Daughter 1200

16 balaji pharmacy 9440 04.07.18 Ramkrishna Self 90

17 Bajaj Dental 165 11.07.18 Ramkrishna Self 3500

18 Rockland 9958 03.04.18 Kalpana Wife 800

TOTAL 18,833.00

Employee Signature: _____________________

For Office Use:

Entitlement as on ______________ Rs.

Current bill amount Rs.
Amount Payable Rs.
Balance Credit Rs.

Checked & Verified Recommended

___________________
F&A
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
CASH REIMBURSEMENT FORM
Date: 05.06.2018
Name: Varinder Pal Employee Code: S058
Designation: Engineer Department: PE

S.No. Bill No. Date Firm Name Particulars Amount

1 ….. 31.05.2018 Local M8 bolt (10*40) 4 nos. 40

2 …… 02.06.2018 Local Bolt (12*35) 6 nos. 90

TOTAL 130

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
Local Conveyance Reimbursement

Name: KANNAN Date 09.03.2017

DesignatioASST MANAGER

S.No. Date From To Purpose Mode K.M. Amount Amount

HAYATPUR
1 14.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA UBER TAXI 11.81 140 140
CHOWK

SECTOR 90
2 14.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA SHUTTLE BUS 11.81 50 50
GURGAON

SECTOR 90
3 17.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA OLA TAXI 14 230 230
GURGAON

SECTOR 90
4 17.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA OLA TAXI 14 257 257
GURGAON

TOTAL 537

Employee Signature

Recommended/Not Recommended
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date:
Name: Employee Code:
Designation: Department:

S.No. Bill No. Date Firm Name Particulars Amount

TOTAL -

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 09.03.2017
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

INDUSTRIAL
1 2987 11.01.2017 PLASTIC SEPERATOR SHEET 560
COMMERCIAL CENTER
MICRO STRUCTURE ANALYSIS
2 111079505 20.02.2017 SUNBEAM AUTO 1,380
TEST

TOTAL 1,940.0

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 29-3-2016
Name: Kannan Employee Code: T001
Designation: GET Department: Maintenance

S.No. Bill No. Date Firm Name Particulars Amount

1 2168 3/28/2016 Jai Durga Enterprises Thimble for washing machine 450
2 1268 3/17/2016 R S Traders 200mm ventilation fan 950
Balaji Building Material
3 1745 3/28/2016 dust for kaizen shop 400
supplier

4 2179 3/29/2016 Jai Durga Enterprises Harware items 2,504

5 M58129 3/22/2016 HSIIDC water meter testing fee 115

6 2462 3/22/2016 Ganesh Enterprises Water flow meter 2,300
Shri Ganpati Safety
7 1982 11/20/2015 Reflective arrow marks 1,250
Signages
Cash Voucher labour for ventilation fan 500
8 3/28/2016
Cash Voucher Labour for kaizen cement work 950
Cash Voucher electricity fuse 450
9 3/28/2016 Cash Voucher electricity fuse 500
Cash Voucher electricity fuse 300

TOTAL 10,669

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 24.04.2017
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA
TRAVEL EXPENSES OF MAKINO BANGALORE AND WABCO CHENNAI TRIP FOR VACUUM PUMP ISIR SAMPLE
PREPERATION AND ISIR SUBMISSION - FROM 08.04.2017 TO 20.04.2017 . ADVANCE AMOUNT TAKEN - RS.10000/-

S.No. Bill No. Date Firm Name Particulars Amount

TRAVEL FROM BANGALORE
1 -- 10.04.2017 UBER TAXI RAILWAYS STATION TO HOTEL CHRIS 474
- WHITEFIELD
LODGING EXPENSES - 2 PERSONS - 2
2 NFGT0513 10.04.2017 OYO ROOMS 5,498
DAYS
3 -- 10.04.2017 AUTO TRAVEL TO HOTEL TO MAKINO 30

4 KOT#2119 10.04.2017 BY THE WAY DINNER EXPENSES- 2 PERSON 423.85

5 KOT#2131 11.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 239

LODGING EXPENSES - 2 PERSONS - 1
6 KAOY9714 12.04.2017 OYO ROOMS 2,137
DAY
7 KOT#2158 12.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 263
LODGING EXPENSES - 2 PERSONS - 1
8 YKFE0217 13.04.2017 OYO ROOMS 1,987
DAY
9 KOT#2172 13.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 149

10 KOT#2173 13.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 297

11 NO BILL 14.04.2017 STREET SHOP DINNER EXPENSES - 2 PERSON 100

TRAVEL FROM MAKINO TO MADIWALA
12 -- 14.04.2017 UBER TAXI 383
BUS STOP
13 -- 16.04.2017 HOTEL TEMPLE CITY DINNER EXPENSES 330
TRAVEL EXPNESES - MADURAI
14 -- 16.04.2017 SRI SAKTHI TOURS & TR 1,300
( BANGALORE) TO CHENNAI
LODGING EXPENSES - 1 PERSON - 3
15 ZIWR9350 16.04.2017 OYO ROOMS 2,810
DAYS
TRAVEL FROM CHENNAI BUS STAND
16 CRN659646893 17.04.2017 OLA CABS 354
TO HOTEL
17 NO BILL 17.04.2017 Auto Rikshaw TRAVEL LODGE TO WABCO 60

18 NO BILL 17.04.2017 WABCO CANTEEN LUNCH EXPENSES - 2 PERSONS 60

18 NO BILL 17.04.2017 Auto Rikshaw TRAVEL WABCO TO LODGE 60

19 238 17.04.2017 HOTEL SAI KRISHNA DINNER EXPENSES 40

20 51 18.04.2017 HOTEL SAI KRISHNA BREAKFAST EXPENSES 89

21 NO BILL 18.04.2017 Auto Rikshaw TRAVEL LODGE TO WABCO 60

19 NO BILL 18.04.2017 WABCO CANTEEN LUNCH EXPENSES - 2 PERSONS 60

20 NO BILL 18.04.2017 Auto Rikshaw TRAVEL WABCO TO LODGE 60

21 260 18.04.2017 HOTEL SAI KRISHNA DINNER EXPENSES 40

19 NO BILL 19.04.2017 Auto Rikshaw TRAVEL LODGE TO WABCO 60

20 NO BILL 19.04.2017 Auto Rikshaw TRAVEL WABCO TO LODGE 60

HOTEL BALAJI
21 278 19.04.2017 DINNER EXPENSES 135
WOODLANDS
LODGING EXPENSES - 1 PERSON - 1
19 PMAJ2801 19.04.2017 OYO ROOMS 974
DAY
20 42 20.04.2017 HOTEL SAI KRISHNA BREAKFAST EXPENSES 134

21 -- 20.04.2017 MANAVAI COMPUTERS ISIR FILES PRINTOUT EXPENSES 311

TRAVEL FROM WABCO TO CHENNAI
19 -- 20.04.2017 UBER TAXI 431
AIRPORT
20 CC00422082 20.04.2017 KFC RESTAURANT DINNER EXPENSES 150
TRAVEL FROM DELHI AIRPORT TO
21 -- 20.04.2017 UBER TAXI 794
SECTOR 90 GURGAON
TOTAL 20,352.3

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 8/1/2017
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

1 … 12-May BY METRO SMAC TO ERAE 150

2 … 12-May BY METRO ERAE TO SMAC 150
3 … 20-May BY METRO SMAC TO ERAE 150
4 … 20-May BY METRO ERAE TO SMAC 150
5 … 24-May BY METRO SMAC TO ERAE 150
6 … 24-May BY METRO ERAE TO SMAC 150
7 … 25-May BY METRO SMAC TO ERAE 150
8 … 25-May BY METRO ERAE TO SMAC 150
9 … 26-May BY METRO SMAC TO ERAE 150
10 … 26-May BY METRO ERAE TO SMAC 150
11 … 29-May BY METRO SMAC TO ERAE 150
12 … 29-May BY METRO ERAE TO SMAC 150
13 … 30-May BY METRO SMAC TO ERAE 150
14 … 30-May BY METRO ERAE TO SMAC 150
15 … 31-May BY METRO SMAC TO ERAE 150
16 … 31-May BY METRO ERAE TO SMAC 150
17 … 1-Jun BY METRO SMAC TO ERAE 150
18 … 1-Jun BY METRO ERAE TO SMAC 150
19 … 2-Jun BY METRO SMAC TO ERAE 150
20 … 2-Jun BY METRO ERAE TO SMAC 150
21 … 13-Jul BY METRO SMAC TO ERAE 150
22 … 13-Jul BY METRO ERAE TO SMAC 150
23 … 15-Jul BY METRO SMAC TO ERAE 150
24 … 15-Jul BY METRO ERAE TO SMAC 150
25 … 17-Jul BY METRO SMAC TO ERAE 150
26 … 17-Jul BY METRO ERAE TO SMAC 150
27 40 28-Jul DK Enterprises Cylinder Key 50
1143 8/1/2017 Rajasthan Hotel Food 120
Total 4070

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES ERAE REIMBURSEMENT FORM
Date: 10.07.2017
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

1 … 3.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

2 … 3.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

3 … 4.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

4 … 4.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

5 … 5.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

6 … 5.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

7 … 6.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

8 … 6.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

9 … 7.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

10 … 7.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

11 … 8.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

12 … 8.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

13 … 9.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

14 … 9.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

15 … 10.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

16 … 10.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

17 … 11.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

18 … 11.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

19 … 12.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

20 … 12.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

21 … 13.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

22 … 13.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

23 … 14.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

24 … 14.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

25 … 15.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

26 … 15.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

By Auto(10rs)Bus
27 … 16.06.2017 (30Rs),Metro(45Rs),Auto(20) SMAC TO ERAE 150
By Auto(10rs)Bus
Bus(45)
28 … 16.06.2017 (30Rs),Metro(45Rs),Auto(20) ERAE TO SMAC 150
Bus(45)
29 … 17.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

30 … 17.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

31 … 18.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

32 … 18.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

33 … 19.06.2017 BY AUTO PG (NOIDA) TO ERAE 20

34 … 19.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
35 … 20.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
36 … 20.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
37 … 21.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
38 … 21.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
39 … 22.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
40 … 22.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
41 … 23.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
42 … 23.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
43 … 24.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
44 … 24.06.2017 BY AUTO ERAE TO PG (NOIDA) 20
3.06.2017 to
45 201 SHRRE GANPATI PG RENT(For 10 Days Prashant) 3000
12.06.2017
 By Auto(10rs)Bus
46 … 16.06.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
47 … 16.06.2017 ERAE TO SMAC
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
48 … 24.06.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
49 … 24.06.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
50 … 25.06.2017 BY AUTO PG(Jagat Farm) TO ERAE

51 … 25.06.2017 BY AUTO ERAE TO PG(Jagat Farm)

By Auto(10rs)Bus
52 … 26.06.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
53 … 26.06.2017 ERAE TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
54 … 27.06.2017 BY AUTO PG(Jagat Farm) TO ERAE

55 … 27.06.2017 BY AUTO ERAE TO PG(Jagat Farm)

56 … 28.06.2017 BY AUTO PG(Jagat Farm) TO ERAE

57 … 28.06.2017 BY AUTO ERAE TO PG(Jagat Farm)

58 … 29.06.2017 BY AUTO PG(Jagat Farm) TO ERAE

59 … 29.06.2017 BY AUTO ERAE TO PG(Jagat Farm)

60 … 30.06.2017 BY AUTO SMAC TO ERAE

61 … 30.06.2017 BY AUTO ERAE TO SMAC

By Auto(10rs)Bus
62 … 1.07.2017 PG(Jagat Farm) TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
63 … 1.07.2017 ERAE TO PG(Jagat Farm)
(30Rs),Metro(45Rs),Auto(20) Bus(45)
64 … 3.07.2017 By Auto PG(Jagat Farm) TO ERAE

65 … 3.072017 By Auto ERAE TO PG(Jagat Farm)

66 … 4.07.2017 By Auto PG(Jagat Farm) TO ERAE

67 … 4.072017 By Auto ERAE TO PG(Jagat Farm)

68 … 5.07.2017 By Auto PG(Jagat Farm) TO ERAE

69 … 5.072017 By Auto ERAE TO PG(Jagat Farm)

70 … 6.07.2017 By Auto PG(Jagat Farm) TO ERAE

71 … 6.072017 By Auto ERAE TO PG(Jagat Farm)

72 … 7.07.2017 By Auto PG(Jagat Farm) TO ERAE

73 … 7.072017 By Auto ERAE TO PG(Jagat Farm)

74 … 8.07.2017 By Auto PG(Jagat Farm) TO ERAE

75 … 8.072017 By Auto ERAE TO PG(Jagat Farm)

By Auto(10rs)Bus
76 … 09.07.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
77 … 09.07.2017 ERAE TO SMAC
(30Rs),Metro(45Rs),Auto(20) Bus(45) PG RENT(Prashant have
13.0617 to
78 195 Roomer house stay 10 Days+Sitanshu
7.07.2017
have stay 14 Days )
Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

150

150

300

300

40

40

150

150

40

40

40

40

40

40

40

40

150

150

40

40

40

40

40

40

40

40

40

40

40

40

150

150

7,200
14,020.0
Approved/Not Approved

Plant Head
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 30.06.2017
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

1 6786682 27.05.2017 AMAZON PENDRIVE HP -16 GB 499

X RAY TEST - LEAK PART ANALYSIS -
2 111017087 29.05.2017 SUNBEAM 575
REAR CYLINDER
ERAE VISIT - SECTOR 90 TO IFFCO
3 CRN782298820 09.06.2017 OLA CABS 436
CHOWK METROL
IFFCO CHOWK TO BOTANICAL
4 --- 09.06.2017 DELHI METRO 50
GARDEN
BOTANICAL GARDEN TO ERAE
5 CRN782693274 09.06.2017 OLA CABS 412
GREATER NOIDA
6 397 09.06.2017 BARISTA CAFÉ FOOD EXPENSES 59

7 --- 09.06.2017 UP GOVT BUS GR. NOIDA TO BOTANICAL GARDEN 45

8 --- 09.06.2017 DELHI METRO BOTANICAL GARDEN TO IFFOCHOWK 50

HIHVACCF-03- IFFCO CHOWK TO SECTOR OP
9 09.06.2017 UBER TAXI 338
140 GURGOAN
X RAY TEST - LEAK PART ANALYSIS -
10 111022093 14.06.2017 SUNBEAM 575
FRONT HEAD
ERAE VISIT - SECTOR 90 TO SECTOR
11 CRN804192366 19.06.2017 OLA TAXI 282
15 GURGAON
ERAE VISIT- SECTOR 29 TO SECTOR
12 CRN806335972 19.06.2017 OLA TAXI 255
90 GURGAON
TOTAL 3,576.2

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 05.09.2017
Name: Anup Kumar Employee Code: S008
Designation: Sr.Engineer Department: QA

S.No. Bill No. Date Firm Name Particulars Amount

1 08.07.2017 Pen Marker 100

2 03.08.2017 Ratan Singh Pen Marker 20

3 05.08.2017 Black Marker 160

4 12.08.2017 Iron And paint Store Drill 3 mm 50

5 25.08.2017 coldrink 100

6 01.09.2017 Spary Paint 250

7 05.09.2017 Pen Marker 36

8 05.09.2017 Yellow Paint & Brush 200

TOTAL 916.0

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 07.04.2018
Name: Rohit Rajan Employee Code: S028
Designation: Engineer Department: Production Engineering

S.No. Bill No. Date Firm Name Particulars Amount

1 …… 05.04.2018 Mohta Brother Collet & Drill Purchase 450

2 …….. 03.04.2018 Powder Coating Supplier Audit Total 16 km by Bike 40

3 ……… 24.03.2018 YRA Base Frame Trial Hose Clamp Purchase 50

TOTAL 540.0

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
Local Conveyance Reimbursement

Name: Rohit Rajan S028 Date 24.08.2017

Designatioengineer

S.No. Date From To Purpose Mode K.M. Amount Amount

1 13.07.2017 HOME IFFCO CHAUK VISIT TO ERAE NOIDA AUTO 10 100 100

BOTANICAL
2 13.07.2017 IFFCO VISIT TO ERAE NOIDA METRO …. 45 45
GARDEN METRO

BUTANICAL
3 13.07.2017 PARI CHAUK VISIT TO ERAE NOIDA BUS 25 45 45
GARDEN

4 13.07.2017 PARI CHAUK TO ERAE INDIA VISIT TO ERAE NOIDA AUTO 4 40 40

5 13.07.2017 ERAE PARI CHAUK VISIT TO ERAE NOIDA AUTO 4 40 40

BOTANICAL
6 13.07.2017 PARI CHAUK TO VISIT TO ERAE NOIDA BUS 25 45 45
GARDEN METRO

BUTANICAL
7 13.07.2017 IFFCO CHAUK VISIT TO ERAE NOIDA METRO …… 45 45
GARDEN

8 13.07.2017 IFFCO HOME VISIT TO ERAE NOIDA AUTO 10 100 100

9 13.07.2017 FOOD/ SNACKS VISIT TO ERAE NOIDA ……. ….. 120 120

10.07.2017/ 11.07.2017/ 12.07.2017/

10 17.07.2017/ 22.07.2017/ 24.07.2017/ SMAC UNITED HITECH WABCO PART TRIAL BIKE 123 308 308
25.07.2017/ 26.07.2017/ 27.07.2017

11 23.08.2017 SMAC BHIWADI FIRE BRICK PURCHASE BIKE 70 175 175

12 23.08.2017 SMAC BHIWADI FIRE BRICK CASH ….. 200 200

13 LUNCH EXPENCE DHABA 380 380

TOTAL 1643

Employee Signature
APPROVED BY:

Recommended/Not Recommended
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 8/1/2017
Name: Kannan Employee Code: S003
Designation: Asst
Department: QA
manager

S.No. Bill No. Date Firm Name Particulars Amount

1 … 12-May BY METRO SMAC TO ERAE 150
2 … 12-May BY METRO ERAE TO SMAC 150
3 … 20-May BY METRO SMAC TO ERAE 150
4 … 20-May BY METRO ERAE TO SMAC 150
5 … 24-May BY METRO SMAC TO ERAE 150
6 … 24-May BY METRO ERAE TO SMAC 150
7 … 25-May BY METRO SMAC TO ERAE 150
8 … 25-May BY METRO ERAE TO SMAC 150
9 … 26-May BY METRO SMAC TO ERAE 150
10 … 26-May BY METRO ERAE TO SMAC 150
11 … 29-May BY METRO SMAC TO ERAE 150
12 … 29-May BY METRO ERAE TO SMAC 150
13 … 30-May BY METRO SMAC TO ERAE 150
14 … 30-May BY METRO ERAE TO SMAC 150
15 … 31-May BY METRO SMAC TO ERAE 150
16 … 31-May BY METRO ERAE TO SMAC 150
17 … 1-Jun BY METRO SMAC TO ERAE 150
18 … 1-Jun BY METRO ERAE TO SMAC 150
19 … 2-Jun BY METRO SMAC TO ERAE 150
20 … 2-Jun BY METRO ERAE TO SMAC 150
21 … 13-Jul BY METRO SMAC TO ERAE 150
22 … 13-Jul BY METRO ERAE TO SMAC 150
23 … 15-Jul BY METRO SMAC TO ERAE 150
24 … 15-Jul BY METRO ERAE TO SMAC 150
25 … 17-Jul BY METRO SMAC TO ERAE 150
26 … 17-Jul BY METRO ERAE TO SMAC 150
27 40 28-Jul DK Enterprises Cylinder Key 50
28 1143 8/1/2017 Rajasthan Hotel Food 120
Total 4070

Employee Signature Approved/Not Approved

Recommended/Not
Plant Head
Recommended
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date:
Name: Kamran Khan Employee Code:

Designation: GET Department:

S.No. Bill No. Date Firm Name Particulars

1 … 8-Aug By Auto SMAC TO Sunbeam
2 … 8-Aug By Auto Sunbeam TO SMAC
3 … 10-Aug By Auto SMAC TO Sunbeam
4 … 10-Aug By Auto Sunbeam TO SMAC
Total

Employee Signature Approved/Not Approved

Recommended/Not
Plant Head
Recommended
MITED

8/12/2017
TRA03

QA

Amount
30
30
30
30
120

oved/Not Approved

Plant Head
 SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
EXPENSES REIMBURSEMENT FORM
Date: 31.08.18
Name: D S Rawat Employee Code: S005
Designation: Dy Manager Department: Machine shop

S.No. Bill No. Date Firm Name Particulars Amount

1 2.08.18 Drill Bit 2.0 mm 100

2 18.08.18 Drill Bit 13.0mm 362

TOTAL 462

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head