Reimbursement Request
Please fill this form out on your computer, then print and attach receipts
1. Input name of person being reimbursed and today's date. 2. Go through each receipt - circle the date, vendor, GST and $ total. Please submit actual receipts, not just the debit/credit slip. 3. Record each receipt on a separate line, noting which dept it should be charged to, event name, brief description of purchase, $ amounts. 4. Be very careful to record the GST amount of each receipt. The 50% GST rebate and the net expense to the department will be calculated. 5. Print off, attach receipts with a paper clip (do not staple), and have the department head sign off in approval of the expenses. 6. Submit the approved request form with the receipts to the office for reimbursement. (You may want to keep a copy for yourself too.)
Name on Cheque:
Today's Date:
Date on Receipt
Charge To: (Department/Budget category)
Description & Vendor
GST
Total Amount
Totals Comments:
0.00
0.00
GST Net Rebate Expense 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
GL Number (Office only)
Reviewed by: Submitted by:____________________________________________ Approved by:____________________________________________ Cheque # Cheque Amount