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Contact Us
Domotex Reimbursement
Domotex Reimbursement
Company Name
*
IEC No.
*
Email
*
Contact No.
*
Do you have Export in FY 2022-23
*
Yes
No
F.O.B Value of Exports in 2022-23
*
Domestic Sales in FY 2022-23 (FOB Value)
*
Claim For:
*
Air Fare
Freight
Click on both checkboxes if you wish to Claim both reimbursement i.e Airfare & Freight
Travel Details for Air fare reimbursement
Name of the Person who Traveled
*
Designation
*
Date of departure
*
Date of arrival
*
Passport No.
*
Place of Issue
*
Date of Issue
*
Date of Expiry
*
Expenditure Incurred
*
Amount Claimed:
*
Freight Details
Invoice Value
*
Expenditure Incurred (Freight)
*
Shipping Bill No.
*
Shipping Bill Date
*
Bank Details
Company Name in Bank
*
Bank Name
*
Current Account No.
*
IFSC Code
*
DECLARATION
*
I Accept
I/We hereby solemnly undertake and declare that the particulars stated above are true and correct to the best of my/our knowledge and belief.
No other application for travel cost has been made or will be made in future against this bill.
Any information, if found to be incorrect, wrong or misleading, will render/us liable to rejection of our claim without prejudice to any other action that may be taken against us in this behalf.
If as a result of scrutiny any excess payment is found to have been made to me/us, the same may be adjusted against any of the subsequent claims to be made by me/our firm or in the event no claim is preferred the amount overpaid will be refunded by me/us to the extent of the excess amount paid.
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