Expense Report

This should be completed ONCE PER WEEK. Not each time an expense is incurred. Meal reimbursements are limited to $20 per day, per policy updated dated November 22, 2019.

Employee Name*

First Name

Last Name

Phone*

Email*

Date of expense*

Total amount of expense* $

Note reimbursements for meals cannot exceed $20 per day

Type of Expense*

Meals Gas Tolls Parking

Other:

Check all that apply

Comments

Upload a receipts scan 1*

No File Chosen

File uploads may not work on some mobile devices.

You may scan multiple receipts at one time (in one photo) however each receipt must be legible.

Upload a receipts scan 2*

No File Chosen

File uploads may not work on some mobile devices.

You may scan multiple receipts at one time (in one photo) however each receipt must be legible.

Expense Reimbursement Request