Thank you for choosing to use our Travel Reimbursement Form. Please complete the following sections accurately to facilitate prompt processing of your reimbursement request. Your cooperation is greatly appreciated.
Name | [Your Name] |
Employee ID | [Your Employee ID] |
Department | Sales |
Contact Number | [Your Number] |
Trip Purpose | Sales Conference |
Destination | New York City |
Date Of Departure | September 15, 2050 |
Date Of Return | September 18, 2050 |
Please provide detailed information for each expense incurred during your trip. Attach original receipts where required.
Transportation Expenses | |
Airfare | $500.00 |
Rental Car | $200.00 |
Taxi/Uber | $75.00 |
Parking Fees | $40.00 |
Other (specify) | Subway Fare $20.00 |
Lodging Expenses | |
Hotel Name | New York Plaza Hotel |
Number Of Nights | 3 nights |
Total Hotel Expense | $600.00 |
Meals | |
Breakfast | $15.00 |
Lunch | $20.00 |
Dinner | $40.00 |
Daily Total | $75.00 |
Miscellaneous Expenses | |
Conference Registration | $150.00 |
Business Supplies | $50.00 |
Other (specify) | Miscellaneous Supplies $30.00 |
Other Expenses (if applicable) | |
Description | Entertainment for Client $100.00 |
Description | Taxi to Airport $50.00 |
Total Expenses (A) | $1,660.00 |
Advance Amount Received | $800.00 |
Total Reimbursement Request | $860.00 |
I certify that the expenses listed above were incurred during the course of my authorized business travel and are accurate and in accordance with company policies.
Traveler's Signature: [Signature] Date: September 20, 2050
I have reviewed and approved the expenses claimed by the traveler.
Supervisor's Name: Jane Smith Date: September 21, 2050
Payment Method: [X] Direct Deposit [ ] Check
Payment Amount: $860.00
Payment Date: September 25, 2050
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