Sasol Chemicals (USA) LLC

2201 Old Spanish Trail

Westlake, Louisiana 70669

LAKE CHARLES CHEMICAL COMPLEX

TRAVEL EXPENSE REIMBURSEMENT FOR PROSPECTIVE EMPLOYEE

Date:______________

Name and Mailing Address of Prospective Employee:

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

TOTALS

Parking: _____________ $_____________

Personal Mileage _____________miles @ .535 cents/Mile $_____________

Meals: Number ________$_______________ $_____________

TOTAL EXPENSE $_____________

Signature: ______________________________________________
Prospective Employee

Approval: _______________________________________________

Department to be charged:_________________Account to be charged 8500154 (Recruitment)

Treasury / A/P Department:

Check number:___________________________ Issue Date:___________________________

Acct. Signatory: __________________________ Date: _______________________________