Employee:_________________________________________________________ For period ending:________________________________________________
REIMBURSABLE EXPENSES INCURRED
Hotel/Lodging $_________________________ Meals $_________________________ Tax $_________________________ Travel (air, train, bus) $_________________________ Personal auto _____ miles x ___ cents $_________________________ Parking $_________________________ Phone $_________________________ Other (itemize): _____________________ $_________________________ _____________________ $_________________________ _____________________ $_________________________ _____________________ $_________________________ Total: $_________________________ ————————-
I certify the above is a true statement of …

Employee: _ For period ending: _
REIMBURSABLE EXPENSES INCURRED
Hotel/Lodging $_ Meals $_ Tax $_ Travel (air, train, bus) $_ Personal auto _ miles x _ cents $_ Parking $_ Phone $_ Other (itemize): _ $_
Total: $_ ————————-
I certify the above is a true statement of incurred expenses in accordance with company policy. Receipts are attached.
_______________________________ …