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INSTITUTUL CULTURAL ROMAN

ROMANIAN CULTURAL INSTITUTE

DECONT DE CHELTUIELI aferent contract nr. ...... / .........


DEDUCTION OF EXPENSES for the contract no. ..... / .........

Inregistrat la nr. ......... / data .................


Registered with no. …….. / date ………………

Scopul deplasării / Travel purpose...........................................................................................................


Locul deplasării / Travel place ....................................................................................................
Perioada de deplasare / Travel period ..................................................................................................

1. Avans primit la plecare: USD/EUR/RON Total =


1. Advance money received before departure: USD/EURO/RON Total =

BORDEROUL ACTELOR JUSTIFICATIVE DE CHELTUIELI


LIST OF SUPPORTING DOCUMENTS OF THE EXPENSES

Nr. Valoarea
crt./ DENUMIRE Felul Numar/data Tipul de Value
Crt. EMITENT actului Number/Date chletuiala
no. Issuer’s name Document Expense
type type

1
Total
Total

2. Total cheltuieli / Total amount of expenses

3. Sume de restituit / de primit ( 1 – 2 ) / Amounts to be


refunded/received :

 Ma oblig ca in termen de 3 (trei) zile de la incheierea proiectului sa depun diferenta dintre


sumele primite si cele justificate conform documentelor depuse, depasirea termenului implicand
aplicarea de penalizari in cuantum de 0.1%/zi la suma avansata sau la diferenta de restituit.
 I commit that within three (3) days from the completion of the project I will return the difference
between the amount received and the one justified according to the documents submitted,
exceeding this period involving the application of penalties in the amount of 0.1% / day at the
advanced amount or at the refunded amount.

Semnatura titularului,
Holder signature,

Se certifica indeplinirea obiectivului Verificat si gasit in regula pentru Vizat, /Stamp


delegatiei / Certification for the suma de / Verified and found okay
completion of the purpose of the fo the amount of .................... Director Directie
trip .............................................. Financiar Contabilizate,
.............................................. Salarizare,/ CFO Director
Majorari /
Sef compartiment Increments ...............................
Head of department .............................................
Serv. Financiar/ Financial service

Viza CFP Se aproba,


PRESEDINTE
Preventive financial control stamp Approved,
President

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