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NIS Checklist - Reimbursement Request No. 4101890900007
Company
Name
:
Emp. No
: 41018909
Emp Name
Grade
: Executive A1
Designation : Sr. Executive
Department
: DIVISIONAL OPERATION
Payroll Area : AE
Location
: Kalina
Sub Location : Santacruz
Request Type
: Local Conveyance Reimburs
Total Amount : Rs 500.00
Claim
4101890900007
Request No :
Adani Electricity Mumbai Ltd
Parked Number : 7600022833
Barcode
: Mr Kirankumar Ashok Patil
: 22RENL000465213732021
Details of Expenditure Incurred :
Line
No
Expenditure
Type
0001
0002
Expenditure
Bill No
Date
From
Location
Local
11/09/2021
Conveyance
Local
14/09/2021
Conveyance
Vile parle
Vile parle
To Location
Juhu
Beach
Juhu
Beach
Conveyance
Remarks
Mode
Auto
Auto
Claimed
Amount
Ganapati
imersion
Ganapati
imersion
Approved
Amount
250
250
250
250
Reimbursement Administrator Address:
F&A DCC Department
Adani Electricity Mumbai Ltd.
5th Floor, Devidas Lane office,
Off SVP Road, Near MTNL Telephone Exchange
Borivali (West), Mumbai -
400103
Employee's Signature
Employee Cell No: 7208846686
Approver
Approver1
Approver Emp. Approver Name
Approver Grade /
No.
Designation
40011327
Mr P S Tayade
UG/Assistant Vice President
Approved on
Sep 15, 2021
Approver2
Approver3
Annexure Details
Notes :
1) Employees are requested to attach necessary original supportings, wherever logical & applicable with this ESS Print before sending
it to the reimbursement administrator.