PROJECT CLAIM FORM

EMPLOYEES NAME:
PROJECT NAME :

DATE: ____

ORDER STATUS :
CONFIRMED
GENERAL INQUIRY
PRODUCT DEVELOPMENT
SAMPLE PAYMENT REFUNDABLE :

YES / NO

PRE PRODUCTION SAMPLE ROUND:

DATE

BILL NO.

DESCRIPTION

PURPOSE

Sub Total
Less Advance
Employees Signature:
Checked By:

Date:

Approved By:

Date:

Mode of Payment

Net Amount Due AED

: Online Trf / Western Union/ Paypal

Shipping Details
:
Shipping Cost
:
Quality Standard Document :
Our Pre Qualification Form : YES / NO
Confidentiality Agreement : YES / NO
Supplier Status
: NEW / OLD
If New - Business Card
: YES / NO

Note: Please attach receipts for listed expenses, sign the form and send to the Ms. Sam for approval

DATE: ________________

AMOUNT
(USD/AED)

ESI/DE Scarf Breakdown of Fees

Supplier: YiWu JRS Knitting Factory
Attn: Mr. Jerry Wong
for ESI Scarf:
30% DP
70% Balance

TOTAL:
less

for DE Scarf: (ORDER CANCELLED)

30% DP
for TOTAL PAYMENT:
70% Balance (for ESI Scarf)
less
Remaining
Payables:

$5,225.00
$1,773.70
$3,451.30

$362.00 (REFUND)

$3,451.30
$362.00 (DE Scarf 30% payment)

$3,089.30

0% payment)