Benhard Juma Nyagaya

IF YOU ARE UNSURE OF CODING, PLEASE ASK FINANCE Expenses Claim Form All expenses must be supported by official third party receipts. Where receipts cannot be obtained, a full description of the expense must be stated on the No Receipts Claim Form. All advances must be accounted for within one week of return to the office and prior to another advance being issued. Name: Position: Asssignment: Period: Item No. Expense description Date(s) Amount in KES T3 code 1 2 3 4 5 6 Total Less cash advance paid Plus returned cash Total claimed Declaration: I confirm that to the best of my knowledge the above expenses were incurred wholly, necessarily and exclusively for Takacare business. Submitted by: Authorised by: Signature: Signature: Date: Mpesa phone #: Date: