Payment Claims Voucher

Pcv No 2026-06-032928 Settle Date June 10, 2026
Insured Name MOM SIRA Policy No PV/PPI/C-259392
Claims No CL/PV/PPI/11832-01
No Invoice No Description Exchange Rate Amount
1Payment For: OWN DAMAGEUSD 673.69
Pay To: HUANG XIANZHEN
Payment Status: Full Payment
Cheque No:
Total USD 673.69
Amount in Word USD Six Hundred Seventy Three and Sixty Nine Cents Only
Reviewed & Appr. PPI Signature Name Date
PREPARED BY vichet June 10, 2026
CHECKED BY AM KUSORL June 10, 2026
VERIFIED BY HOD SOCHEAN June 10, 2026
APPR BY PPI CEO SALY SOULEVANN June 10, 2026
Review And Approved By Group : CHAIRMAN & CEO CFO
Account Code Account Name Debit Credit
111005Claim Paid -Motor.(Othe)673.69
660020Amount due from/(TO)Reinsuranc134.74
115505Claim Rec.Cam.Re-Motor-Other134.74
Claim Rec.Out FAC-Motor-Othe
Claim Rec.Q.T Share-Motor-Oth
660216ABA - Collection Acct673.69
TOTAL 808.43808.43