Basic Information

Form Date:

[MM/DD/YYYY]

Prepared By:

Department/Project Name:

Approval Manager:

Expense Details

Expense Category:

[e.g., Utilities, Rent, Supplies]

Expense Description:

Total Expense Amount:

Invoice/Receipt No.:

Allocation Basis

Allocation Criteria:

[e.g., by department headcount, floor space, usage]

Justification for Allocation Basis:

Cost Distribution

Distributed to Department/Project:

[List departments or projects]

Department/Project Name

Allocation Percentage

Amount Allocated

Marketing Department

30%

$1,500.00

[Department 2]

[Department 3]

[Department 4]

[Department 5]

Total Allocation:

Authorization and Signatures

Preparer’s Signature:

[Signature]

Date:

[MM/DD/YYYY]

Approving Manager's Signature:

[Signature]

Date:

[MM/DD/YYYY]