Days

ECS Days

Distance Driven

(Kilometers)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

# of Regular Days

X

=

FOR OFFICE USE:

# of Regular KM

X

=

GST

General Ledger Codes:

1.415.06.106.000.66

Fuel Initative Calculation

X

=

1.415.06.615.000.66

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