UNITATEA:

SC _____________
ORDIN DE DEPLASARE(DELEGATIE)

Domnul/ Doamna----------------------------------------------------------------------------------------------------------------------avand functia de------------------------------------------------------------------------------------------------------------------------este delegat pentru----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------la----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------durata deplasarii de la ---------------------------------------------------------------------------------------------------------------se legitimeaza cu----------------------------------------------------------------------------------------------------------------------Data

Stampila unitatii si semnatura

Sosit*-------------------------------------------------Plecat*-----------------------------------------------Stampila unitatii si
Cu(fara) cazare----------- semnatura

Sosit*-------------------------------------Plecat*-----------------------------------Stampila unitatii si
Cu(fara) cazare-------------------------semnatura

Sosit*---------------------------------------------------Plecat*-------------------------------------------------Stampila unitatii si
Cu(fara) cazare----------- semnatura

Sosit*-------------------------------------Plecat*-----------------------------------Stampila unitatii si
Cu(fara) cazare------------------------ semnatura

*Se va completa ziua,luna,anul si ora

Ziua si ora plecarii----------------------------------- Avans spre decontare

Ziua si ora sosirii ------------------------------------ Primit la plecare-------------------------------------------------------Data depunerii decontului------------------------- Primit in timpul deplasarii------------------------------------------Penalizarii calculate-------------------------------- TOTAL--------------------------------------------------------------------Cheltuieli efectuate conform documentelor anexate
Felul actului si emitentul
Nr. si data
Suma

TOTAL CHELTUIELI

Diferenta de restituit s-a depus cu chitanta

nr.--- din--------------Se aproba conducatorul
unitatii

control fin.
Preventiv

Verificat
decont

Diferenta de primit/restituit
Sef
compartim
ent
Titular avans

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