1 - Accumulate personally incurred expenditure receipts until $100.00 minimum is achieved. (Does not apply to students)
2 - Sort and summarize receipts by unique combination of speedcode, account and GST code.
3 - Enter appropriate speedcode.
4 - Select appropriate account number from drop down list.
5 - Enter gross amount of receipts in total expenditure column. Select the GST code. The net and GST amount will be calculated automatically.
6 - Select appropriate GST Code.
A - Receipts that include GST and are subject to a 67% rebate. Receipts must have suppliers GST registration number.
B - Only applicable to Books that are subject to a 100% ITC. Receipts must have suppliers GST registration number.
C - Receipts that include GST and were incurred for activities designated as commercial for GST purposes. Receipts
must have suppliers GST registration number.
N - Receipts for expenditures that were not subject to GST or where suppliers GST registration is not indicated on receipt.
7 - Complete personal information section and obtain appropriate approvals.
8 - Attach receipts to completed form and mail to Supply Management Services, 3rd Floor Materials Management Building.
9 - If receipts contain both taxable and non taxable items (ie. Purchases at a grocery store), enter gross amount in total expenditure column and
enter actual GST paid in the GST column, overiding the existing formula.
10 - Vendor Column is optional for department use only.
SEND FORM TO : Supply Management Services - 3rd Floor Materials Management Building - Edmonton - Alberta - T6G 2R3
UNIVERSITY OF ALBERTA
Expense Reimbursement Form
Not to be used for Travel & Hosting Related Expenses
Send to: Supply Management Services-3rd Floor Materials Management Building-Edmonton-Alberta-T6G 2R3
Name:
Person ID:
Department:
Address:
Postal Code:
Telephone:
No Entry Required
Optional *see instruction #5
Date Speedcode Account & Description Vendor Net GST Total Expense GST Code
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
Select From List - - 1
- - 1
- - 1
- - 1
- - 1
- - 1
$0.00 $0.00 $0.00
Total Net Total GST Total Expenses
I certify that this claim is correct in every particular and is in accordance with the University’s regulations and the sponsor or donor
terms and conditions (where applicable) and have been incurred with due regard to reasonable economy.
Signature Print Name Date
Claimant’s Signature___________________________ _________________ _______________
(signature)
One over one Authorization ____________________________ _________________ _______________
(signature)
Internal Control Approval: ____________________________________ _____________________ ___________________
(signature)
1. Accounting Approval (if not one of the above) _____________________ _____________________ ___________________
(signature)
2. Accounting Approval (if not one of the above) _____________________ _____________________ ___________________
(signature)
3. Accounting Approval (if not one of the above) _____________________ _____________________ ___________________
(signature)
Note: Employees will receive reimbusement through EFT (electronic funds transfer)
to the bank account on file with Staff & Student Payments for payroll deposits.
All others will receive a cheque.
PERSON ID = STAFF OR STUDENT ID #
Select From List
507201-Books
502167-Catering
503026-Cell Phone Charges
502115-Chemicals & Drugs
507021-Computer Software
502343-Computing Hdw ($1000)
502301-Computing Supplies
502306-Computing Support & Serv
503011-Courier
502341-Equipment ($1000)
502444-Freight,Express & Delivery
502347-Furniture (<$1000)
502171-Lab Supplies
502175-Lab Coats & Uniforms
502185-Memberships Individual
502188-Memberships Institutional
507215-Periodicals-Renewals
503016-Phone Long DistToll &Tel
503006-Postage
502324-Printing & Photocopy
503401-Repairs & Maint Equip
502401-Services General
502331-Stationery
502206-Subscriptions
502101-Supplies & Materials General
A
B
C
N
UNIVERSITY OF ALBERTA
Expense Reimbursement Form (Blank)
Not to be used for Travel & Hosting related expenses
Send to: Supply Management Services-3rd Floor Materials Management Building-Edmonton-Alberta-T6G 2R3
Name:
Employee ID:
Student ID:
Department:
Address:
Postal Code:
Telephone:
Optional
Date Speedcode Account & Description Vendor Net GST Total Expense GST CODE
Total Net Total GST Total Expenses
I certify that this claim is correct in every particular and is in accordance with the University’s regulations and the sponsor or donor
terms and conditions (where applicable) and have been incurred with due regard to reasonable economy.
Claimant's Signature Date One-over-one Approval Date
Internal Control Approval Title
1 - Authorized Signature(s) for Accounting Distribution
Prepared by (Please Print) Telephone
2 - Authorized Signature(s) for Accounting Distribution