Appendix 46 Appendix 46
REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT
Entity Name: _________________ Fund Cluster : ________________ Entity Name: _________________ Fund Cluster : ________________
Date : _______________________ RER No. : ___________________ Date : _______________________ RER No. : ___________________
RECEIVED from ______________________________________ RECEIVED from ______________________________________
(Name) (Name)
_________________________________________________ the amount _________________________________________________ the amount
(Official Designation) (Official Designation)
of of
(In Words) (in Figures) (In Words) (in Figures)
in payment for in payment for
PAYEE PAYEE
Name/Signature __________________________________________ Name/Signature __________________________________________
Address ________________________________________________ Address ________________________________________________
WITNESS WITNESS
Name/Signature __________________________________________ Name/Signature __________________________________________
Address ________________________________________________ Address ________________________________________________
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