Reimbursement Declaration Without Car Lease FY 2026-27 Please enable JavaScript in your browser to complete this form.Employee ID *Employee Name *Employee Email *Reimbursement Declaration Driver SalaryDriver Salary (Maximum amount is ₹3000 per month) *YesNoSpecify Driver Salary for per month in words (Maximum amount ₹3000 per month) *Specify Drivers Salary for per month in figures (Maximum amount ₹3000 per month) *Fuel AllowanceFuel Allowance *YesNoPlease update your car details *Upto 1.6cc (Fuel allowance will be maximum ₹5000 per month)More than 1.6cc (Fuel allowance will be maximum ₹7000 per month)Please upload your Car RC copy. Kindly ensure that the vehicle is registered on your name. * Click or drag a file to this area to upload. Specify Fuel Allowance for per month in words (Maximum amount ₹5000 or ₹7000 per month) *Specify Fuel Allowance for per month in figures (Maximum amount ₹5000 or ₹7000 per month) *Telephone & Broadband AllowanceTelephone & Broadband Allowance (Maximum amount is ₹5000 per month) *YesNoSpecify Telephone & Broadband Allowance for per month in words (Maximum amount ₹5000 per month) *Specify Telephone & Broadband Allowance for per month in figures (Maximum amount ₹5000 per month) *Books & Periodicals Allowance (Applicable on old regime only)Books & Periodicals Allowance (Maximum amount ₹5000 per month) *YesNoSpecify Books & Periodicals Allowance for per month in words (Maximum amount ₹5000 per month) *Specify Books & Periodicals Allowance for per month in figures (Maximum amount ₹5000 per month) *I agree that the final amount of contribution will be decided by the HFS Payroll team. *YesI agree that my Annual FBP plan shall not exceed 6 lacs *YesSubmit
