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EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
22-Dec-08 Wife dental charges 35.00 Provider : Klinik Pergigian MH DingReceipt No 1562
Total 35.00 Less Advance Taken (if any) -
*Net Claim / Refund 35.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 6-Jan-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
14-Jul-08 Wife's maternity charges 3,000.00 Provider : Sri Manjung Specialist Centre Sdn BhdReceipt No 6072
Total 3,000.00 Less Advance Taken (if any) 1,200.00
*Net Claim / Refund 1,800.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
14-Jul-08 Daughter medical charges 265.00 Provider : Sri Manjung Specialist Centre Sdn BhdReceipt No 6074
Total 265.00 Less Advance Taken (if any) -
*Net Claim / Refund 265.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
15-Sep-08 Wife dental charges 70.00 Provider : Klinik Pergigian FairuzReceipt No 1581
Total 70.00 Less Advance Taken (if any) -
*Net Claim / Refund 70.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 13-Oct-08 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
30-Oct-08 Dental charges 140.00 Provider : Klinik Pergigian FairuzReceipt No 1642
Total 140.00 Less Advance Taken (if any) -
*Net Claim / Refund 140.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 31-Oct-08 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Shaiful Fazri Munandan Designation: Technician Dept./Faculty: Maintenance
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
31-Oct-08 63.00 Wife Dental ClaimReceipt No 1620
Total 63.00 Less Advance Taken (if any) -
*Net Claim / Refund 63.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Shaiful Fazri Munandan Name: Name:Designation: Technician Designation : Designation :Date: Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
Total - Less Advance Taken (if any) -
*Net Claim / Refund -
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)22-Dec-08 Advance payment for purchase of staff attendance card 16.00
Total Advance Required 16.00
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 22-Dec-08 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
30-Dec-08 Purchase of staff attendance card 15.00
Total 15.00 Less Advance Taken (if any) -
*Net Claim / Refund 15.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 30-Dec-08 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
23-Jan-09 Purchase of staff attendance card
Total - Less Advance Taken (if any) -
*Net Claim / Refund -
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 23-Jan-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
25-Jan-09 Medical Treatment for daughter Nur Liyana Hazirah 25.00 Provider : Klinik Sentral, SegamatReceipt No : B0456
Total 25.00 Less Advance Taken (if any) -
*Net Claim / Refund 25.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Name:Designation: Clerk Designation : Designation :Date: 1-Feb-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
24-Feb-09 Purchase of staff attendance card and polystyrene
Total - Less Advance Taken (if any) -
*Net Claim / Refund -
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 24-Feb-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
25-Feb-09 To order rubber stamp chop for official puposes 18.00
Total 18.00 Less Advance Taken (if any) -
*Net Claim / Refund 18.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 25-Feb-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
2-Mar-09 Claim for tuition fee 1,100.00 Semester Dec 08 till May 09Universiti Teknologi MARA
Total 1,100.00 Less Advance Taken (if any) -
*Net Claim / Refund 1,100.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 2-Mar-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
5-Mar-09 Medical claim for daughter Nur Liyana Hazirah 67.00 Provider : Klinik Diong Mee NeeReceipt No 06352
Total 67.00 Less Advance Taken (if any) -
*Net Claim / Refund 67.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 6-Mar-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
27-Mar-09 Purchase of staff attendance card
Total - Less Advance Taken (if any) -
*Net Claim / Refund -
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 27-Mar-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
20-Apr-09 Medical claim for wife Shahizah Mohamed Kamal 135.00 Provider : Klinik Diong Mee NeeReceipt No 06666
21-Apr-09 Medical claim for wife Shahizah Mohamed Kamal 45.00 Provider : Klinik Diong Mee NeeReceipt No 06669
Total 180.00 Less Advance Taken (if any) -
*Net Claim / Refund 180.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 22-Apr-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT
(Please attach original receipts) RM 21-Jun-09 Petrol Pick up AGR 1908 20.00
Total 20.00 Less Advance Taken (if any) -
*Net Claim / Refund 20.00
FOR ADVANCE REQUISITION ONLY
DATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 23-Jun-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT
(Please attach original receipts) RM 21-Jun-09 Petrol Pick up AGR 1908 20.00
Total 20.00 Less Advance Taken (if any) -
*Net Claim / Refund 20.00
FOR ADVANCE REQUISITION ONLY
DATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 23-Jun-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
17-Jun-09 Medical claim for daughter Nur Liyana Hazirah 59.00 Provider : Klinik Diong Mee NeeReceipt No 07085
Total 59.00 Less Advance Taken (if any) -
*Net Claim / Refund 59.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 15-Jul-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
5-Aug-09 Claim for tuition fee 1,200.00 Semester July till December 09Universiti Teknologi MARA
Total 1,200.00 Less Advance Taken (if any) -
*Net Claim / Refund 1,200.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Clerk Designation : Admin Executive Designation :Date: 5-Aug-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Sr. Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
29-Jun-09 Purchase of staff attendance card 15.00 Receipt no : 48450Provider : LingBros Sports
Total 15.00 Less Advance Taken (if any) -
*Net Claim / Refund 15.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Sr. Clerk Designation : Admin Executive Designation :Date: 1-Sep-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Sr. Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
12-Oct-09 Medical claim for wife Shahizah 101.00 Provider : Klinik Diong Mee NeeReceipt No 08035
17-Oct-09 Medical claim for daughter Nur Liyana Hazirah 20.00 Provider : Klinik Diong Mee NeeReceipt No 08088
Total 121.00 Less Advance Taken (if any) -
*Net Claim / Refund 121.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Sr. Clerk Designation : Admin Executive Designation :Date: 19-Oct-09 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Sr. Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT (Please attach original receipts) RM
21-Jul-10 Purchase of staff attendance card 15.00 Receipt no : 49241Provider : LingBros Sports
Total 15.00 Less Advance Taken (if any) -
*Net Claim / Refund 15.00
FOR ADVANCE REQUISITION ONLYDATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Sr. Clerk Designation : Admin Executive Designation :Date: 18-Aug-10 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
EAC
EXPENSE / ADVANCE CLAIM FORM
Name: Farid Syarizal Abdul Rani Designation: Sr. Clerk Dept./Faculty: HR Unit
DATE PARTICULARS AMOUNT
(Please attach original receipts) RM 23-Sep-10 Mileage claim MIMET - Ipoh - MIMET 140.00
Immigration Department for cancellation of expartriate working pass100 km x RM0.70 x 2
Total 140.00 Less Advance Taken (if any) -
*Net Claim / Refund 140.00
FOR ADVANCE REQUISITION ONLY
DATE PARTICULARS
(Please attach copy of Purchase Requisition)
Total Advance Required
BUDGET ALLOCATION (For non-PR item e.g. medical)Account Description Budgetted Committed Amount Budget Remarks
Code Amount to Date Required Balance
(RM) (RM) (RM) (RM)
Claimant / Applicant: Verified / Recommended by: Approved by:
Name: Farid Syarizal Abdul Rani Name: Mohd Zawawi Mat Tahar Name:Designation: Sr. Clerk Designation : Admin Executive Designation :Date: 8-Oct-10 Date: Date:
pFOR FINANCE USE FOR HRD USE RECEIVED BY:
(Advance Requisition Only) (Medical / Maternity Only)Approved by: Approved by:
Name: Name: Name:Designation: Designation: Designation:Date: Date: Date:
OJT
WEEKLY WORK REPORT FOR NEW STAFF
Name: Id No : Designation: Date of Joined Sect./Unit : Dept./Faculty:
No. Description of activity, task, duty or responsibility
Observed
List one thing that went particularly well this week (area of improvement, new task , etc.)
List one thing that was the most challenging this week (issue, problem, difficulty, etc.).
List one way you can improve your job performance
Day Date Hours
MondayTuesday
WednesdayThursday
Friday
Reported by : Verified by: Checked by: Approved by:
Name: Name: Name: Name: Designation: Designation : Designation : Designation : Date: Date: Date: Date:
Activities, tasks, duties, responsibilities:List four major activities, tasks, duties, etc. you were involved in during the week. For each item, check the appropriate level of participation (you may check more than one level for each item). In the last column, record an ESTIMATE of the amount of time (hours, minutes) you spent on each activity during the week.
Performedwith
supervision
Performedalone
Time Spent
Supervisor Initial
Time In (available in office/ lab )
Time Out (from office/ lab)
please ( x )
