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Expense Reimbursement Form (pdf)
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EXPENSE REIMBURSEMENT FORM |
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Reporter: |
Date of Report: |
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Activity: |
Activity Date: |
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Charge: |
CBA |
DBA |
Other |
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Attach All Receipts (Auditor Requires Receipts for amounts over $75) |
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Expense Description |
Personal Charges |
Association Charges |
TOTAL |
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Meals |
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Meals |
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Airfare |
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Auto Rental |
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Ground Transportation |
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Mileage: mi. x $.50/mi= |
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Lodging |
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Lodging |
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Communications |
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Miscellaneous Tips |
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Others (itemize) |
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SUB-TOTAL |
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Total Expenses |
$ |
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Less Personal Expenses |
$ |
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Less Advance Taken |
$ |
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BALANCE DUE ASSOCIATION (ATTACH CHECK): |
$ |
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BALANCE DUE REPORTER: |
$ |
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Reporter's Signature |
Treasurer’s Approval |
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