OPEN - ESDS
OPEN - ESDS
OPEN - ESDS
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
5<br />
EXAMPLE PAGE<br />
Phase write each item on e separate line<br />
Meals, snacka and ~atcohok chinks (tncludirtg aoff drtnks) bought ●nd<br />
consumod ●way from horn.. Incfuda UPS and samlce charge.<br />
(1) Bought at w~ canteen, atatf;dfnlng room, ●tc.<br />
. . . . ..sm...~..h~3 . . . . . . . . . . . . . . . ..i . . . . . . . . . . . . . .<br />
. . . . . . . . . . . . ... . ... ..~.~...k . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . .<br />
. . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
(2) Bought at cafe, mataurant, hotel, fish andchlp shop,<br />
sandwtch bar, pubf{c house, school show tuck show<br />
cin~ etc.<br />
. . . . ...Md..d..kJ.tipQ. .. . ..........<br />
-. . . ..................<br />
......Tm5i-i- .Cke5e.%w’AIt&.Chofil<br />
( \ .......Ba.mfi..cJw5kak<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
. .<br />
Beet, wine, spirtts and other alcoholk drinks bought<br />
and consumed away from home,.<br />
. . . ...hin.d!a.lvbd)....m. . .. . ..........<br />
.......%(M...........................................<br />
Dally shopping items (other ttun.faad) G- ci~ettes, tobaccc<br />
matches, cleaning materiats, tbtJ-atrla&cosmetlca, stationery,<br />
newspapers, magazin~. bookq pastage etc.<br />
........ Mq-.-hQ3 ...... .........................................<br />
........ Td*E...,, ... ...............................<br />
..... %@-wpca .. . .... ...................................<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
Clothin~; clothlng matuials. ●ntt fuoMaaK<br />
CONSUMED<br />
ON OFF<br />
?EMISE9PREMISE:<br />
o RING<br />
1 2<br />
1 @<br />
1 2<br />
Wher*<br />
Purchasad<br />
on Other<br />
~iCOllCO(Pub, 64C]<br />
.~y<br />
. . . . . . . . . . . . . . .<br />
. . . . . . . . . . . . . . .<br />
I. . . . . . . . . . . . . .<br />
I . ...!....! . . . .<br />
........dtiGt..b~.~.. ~&W~6&> .............<br />
( -,.......%csfm.~c..sfm.. *<br />
..(O........................<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
Travel by rail, bus air, taxi, Motor vehicles (purchaee, pstrol, oil and<br />
repairs), Cycles ●tc.<br />
. . . . . . . . . . .. Hus..&f& .............................................<br />
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br />
J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...!..... . . . . . . . . . . . . . .<br />
Any other payments msdc tu-cMy, wtttr full details, e.g. fuel and Ilght (including<br />
paymonta Into meters), ●ntertainment hafrdraasln~ holidays, furniture,<br />
household goods, domestic help.<br />
. . . .kbd orck:.b&4N<br />
pmls.f?mkd .* .Ml<br />
*<br />
. . ...m*e .....................................................<br />
....... R-Qsek’-.dw- . ................... -> ........<br />
......wdm..m.c?!w..ma+ m& L...l~.:=~<br />
Amount p<br />
c<br />
. . . . . . . . . .<br />
. . . . . . . . . .<br />
. . . . . . . . . .<br />
. . . . . .<br />
. . . . . .<br />
. . . . . .<br />
.. . . . . . .<br />
5.<br />
...<br />
...<br />
...<br />
. . . . . . . b.<br />
1<br />
...........<br />
7<br />
. . . . . . . . . .<br />
. . ... . . . . . .<br />
. . . . . . . . \ .<br />
. . . . . . . . . .<br />
. . . . . . . . . . .<br />
........ &<br />
.......tl<br />
. . . . . . . . . .<br />
. . . . . . . . . .<br />
. . . . . . . . . .<br />
. . . . . . . . . .<br />
. . . . . ..\cJ<br />
\k<br />
!’”’”””’””<br />
—<br />
P<br />
Qc<br />
Cjc<br />
5C<br />
...<br />
-<br />
..<br />
OFF. USE.<br />
Pleaseleave<br />
blank<br />
I<br />
I<br />
!<br />
1<br />
.. .........<br />
...<br />
I<br />
I<br />
I<br />
1<br />
I<br />
I<br />
I<br />
I<br />
I<br />
1<br />
:<br />
I<br />
I<br />
1<br />
1<br />
I<br />
1<br />
...<br />
I<br />
...<br />
I<br />
..<br />
...<br />
I<br />
1<br />
t<br />
I<br />
1<br />
I<br />
....:. ......<br />
I<br />
t<br />
I<br />
.. .<br />
..<br />
T :<br />
““~””””””””<br />
,. ““”~:”””<br />
““”i””””””””<br />
m<br />
/<br />
. .<br />
. .<br />
. .<br />
. .<br />
. .<br />
. .<br />
M<br />
. .<br />
. .<br />
. .<br />
. .<br />
,..<br />
m<br />
,..<br />
,..<br />
m<br />
,..<br />
,..<br />
,.<br />
\<br />
,..<br />
135