Employee Static Information by njg52012

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									                                       d514cb7c-c037-4a0c-9398-053cd129ad67.xls


                                  REIMBURSEMENT TOTAL BREAKOUT
The first two lines are examples. Please type your information over the examples and continue entering until
all of your receipts are listed. Copy the sheet total from the bottom of this sheet to the Amount to be paid field
on the front of the Employee Reimbursement Form.

Fund DAC Charge Code            Date         Reason for Purchase                     Amount Spent Sheet Total
010    221242410000000610          11/01/09 school supplies-Art Class                          $5.00                  $5.00
010    451110030000000610          12/01/09 books-special price                               $37.50                 $42.50
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                                                                                     Sheet Total                     $42.50



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