Free form template · Word

Telephone Reimbursement Form

A telephone reimbursement form covers residence landline or combined telephone and broadband bills that the company pays for senior staff or on-call roles, along with official long-distance or ISD calls itemised from a call log. It tracks year-to-date claims against the annual telephone entitlement.

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[Company Logo][Company Name]

TELEPHONE REIMBURSEMENT CLAIM

Company:: [Company Name]
Financial Year:: [FY 20XX-XX]
Claim Period:: [Quarter]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Designation
Department
Telephone Number(s)

Entitlement Tracker

Annual Entitlement (₹)	Claimed till Last Quarter (₹)	This Claim (₹)	Balance (₹)
[Amount]	[Amount]	[Amount]	[Amount]

Bill Details

Phone No.	Type (Landline / Combo)	Bill No.	Bill Period	Amount (₹)
[Phone No.]	[Landline]	[Bill No.]	[Month]	[Amount]
[Phone No.]	[Landline]	[Bill No.]	[Month]	[Amount]
[Phone No.]	[Combo]	[Bill No.]	[Month]	[Amount]

Official Long-Distance / ISD Call Log

Date	Number Called	Client / Contact	Purpose	Amount (₹)
[DD/MM/YYYY]	[Number]	[Contact]	[Purpose]	[Amount]
[DD/MM/YYYY]	[Number]	[Contact]	[Purpose]	[Amount]
[DD/MM/YYYY]	[Number]	[Contact]	[Purpose]	[Amount]

Declaration

I certify that the telephone expenses claimed relate to official use, that the bills are genuine and in my name or registered with HR, and that personal calls, where required, have been excluded.

Employee
[Employee Name]
Date: [Date]

Approved by
[Reporting Manager]
Date: [Date]

Accounts
[Name]
Paid on: [Date]

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What this template includes

Annual entitlement and year-to-date tracker
Landline or combo bill details
Official call log for ISD and long-distance calls
Split between personal and official calls where required
Bill name and address rules
Approval and payroll credit

When to use it

Senior managers entitled to a residence telephone as a perquisite
On-call staff who must be reachable on a landline
Claims for official ISD calls made from a personal phone
Salary structures with a telephone reimbursement line under flexi benefits

How to customise this template

1Enter the annual entitlement from the employee's CTC
2Remove the call log if you reimburse the full bill
3Link to your flexi benefit selection if applicable
4Set a quarterly submission rule

HR tips

For official ISD calls, ask for the purpose and client name
Use this form for landline and long-distance; use the mobile form for mobile
Reconcile year-end balance before the financial year closes
Keep original bills for audit

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Frequently asked questions

What is telephone reimbursement in salary?+

It is a component where the company repays telephone bills used for work up to an agreed limit, usually against bills.

Can I claim international calls made for work?+

Yes, if they are official. List them in the call log with purpose and attach the itemised bill.

Is a combined landline and broadband bill accepted?+

Usually yes; some companies ask you to split it if broadband is reimbursed separately.

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[Company Logo][Company Name]

MOBILE REIMBURSEMENT CLAIM

Company:: [Company Name]
Claim Month / Quarter:: [Period]
Claim No.:: [Reference Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Grade
Department
Registered Mobile Number
Monthly Limit: ₹[Amount]

Bill / Recharge Details

Mobile No.	Operator	Postpaid / Prepaid	Bill or Recharge Date	Period Covered	Amount (₹)
[Mobile No.]	[Operator]	[Postpaid]	[DD/MM/YYYY]	[Month]	[Amount]
[Mobile No.]	[Operator]	[Prepaid]	[DD/MM/YYYY]	[28 days]	[Amount]
[Mobile No.]	[Operator]	[Prepaid]	[DD/MM/YYYY]	[28 days]	[Amount]
				Total Billed	[Amount]

Claim Calculation

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[Company Logo][Company Name]
INTERNET REIMBURSEMENT CLAIM (WORK FROM HOME)
Company:
[Company Name]
Claim Period:
[Month]
Claim No.:
[Reference Number]
Date:
[Date]
Employee Details
Employee Name
Employee ID
Department
Work Arrangement: Remote / Hybrid
Registered Home Address
Connection Details
Internet Service Provider
Plan Speed (Mbps)
Billing Cycle: Monthly / Quarterly / Annual
Account Holder Name
Relationship (if not self)
Claim Details
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[Company Logo][Company Name]
FUEL / CONVEYANCE REIMBURSEMENT CLAIM
Company:
[Company Name]
Claim Month:
[Month / Year]
Claim No.:
[Reference Number]
Date:
[Date]
Employee and Vehicle
Employee Name
Employee ID
Department
Territory / Beat
Vehicle Type: Two-wheeler / Car
Registration Number
Owned by: Self / Family
Driving Licence Valid till
Vehicle Insurance Valid till
Method
- Per-km method: two-wheeler ₹[Amount]/km, car ₹[Amount]/km
- Fuel bill method: actual bills up to ₹[Amount] per month
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[Company Logo][Company Name]
EXPENSE REIMBURSEMENT CLAIM
Company:
[Company Name]
Claim No.:
[Reference Number]
Claim Period:
[Month]
Date:
[Date]
Claimant
Employee Name
Employee ID
Department
Cost Centre / Project Code
Reporting Manager
Expense Categories
- C1 Client entertainment
- C2 Courier and postage
- C3 Stationery and printing
- C4 Software and subscriptions (pre-approved)
- C5 Team supplies and refreshments
- C6 Other (specify)
Expense Details
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[Company Logo][Company Name]
EMPLOYEE BENEFITS ENROLLMENT FORM
Company:
[Company Name]
Form No.:
[Reference Number]
Date of Submission:
[Date]
Enrollment Deadline:
[DD/MM/YYYY]
Please complete all sections within the enrollment window and return this form to [HR Name], Human Resources. Benefits will be activated only after HR verification.
Section A: Employee Details
Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)
Section B: Statutory Benefits
UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No
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Internet Service Provider
Plan Speed (Mbps)
Billing Cycle: Monthly / Quarterly / Annual
Account Holder Name
Relationship (if not self)

Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)

UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No

[Company Logo][Company Name]

FLEXIBLE BENEFITS SELECTION FORM

Company:: [Company Name]
Financial Year:: [FY 20XX-XX]
Submission Date:: [Date]
Payroll Cut-off:: [DD/MM/YYYY]

Part 1: Employee Information

Employee Name
Employee ID
Designation
Department
Annual CTC: ₹[CTC]
Annual Flexi Basket: ₹[Amount]
Tax Regime Opted: Old / New

Part 2: Allocation of Flexi Basket

Component	Company Limit per Month (₹)	My Monthly Allocation (₹)	Annual Allocation (₹)	Bills Required
Meal Card / Food Coupons	[Amount]	[Amount]	[Amount]	No (card based)
Fuel and Vehicle Maintenance	[Amount]	[Amount]	[Amount]	Yes
Telephone and Internet	[Amount]	[Amount]	[Amount]	Yes
Leave Travel Allowance	[Amount]	[Amount]	[Amount]	Yes, travel proof
Books and Periodicals	[Amount]	[Amount]	[Amount]	Yes
Employer NPS Contribution	[Amount]	[Amount]	[Amount]	No
Total (must equal flexi basket)	-	[Amount]	[Amount]	-

Part 3: Terms

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[Company Logo][Company Name]

GROUP INSURANCE NOMINATION FORM

Company:: [Company Name]
Policy:: Group Term Life / Group Personal Accident
Insurer:: [Insurer Name]
Policy No.:: [Policy Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Designation
Department
Date of Birth
Date of Joining
Marital Status

Nominee Details

Nominee Name	Relationship	Date of Birth	Address and Mobile	Share (%)
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
Total				100%

Appointee (only if a nominee is a minor)

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Employee Name
Employee ID
Department
Territory / Beat
Vehicle Type: Two-wheeler / Car
Registration Number
Owned by: Self / Family
Driving Licence Valid till
Vehicle Insurance Valid till

Employee Name
Employee ID
Department
Cost Centre / Project Code
Reporting Manager

Telephone Reimbursement Form

Preview of the form

Employee Details

Entitlement Tracker

Bill Details

Official Long-Distance / ISD Call Log

Declaration

What this template includes

When to use it

How to customise this template

HR tips

Hire top talent from BetterJobs

Frequently asked questions

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