Expense Account Statement

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EXPENSE ACCOUNT STATEMENT Account of :_________________________ (employee name) From _____________ to ______________ Reimbursable Expenses Incurred Lodging $_______________________ Meals $_________________________ Travel [air/train/bus/auto] $________________ Personal automobile _____ miles x ___ cents $____________ ???????Parking _____ hours x ______ dollars $______ Others (itemize): ________________ $______________ ________________ $______________ ________________ $______________ ________________ $______________ Total: $________________________ Grand Total: $__________________ Select one [] Credit to account of _____________________ [] Send check to ____________________________ I certify the above is a true statement and that the expenses claimed were incurred by me on official business.? Receipts for each expense are attached. _______________________________ Employee Approved for payment: By:____________________________

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