Expense Report
PURPOSE: STATEMENT #: PAY PERIOD: From: To:
Name: Employee ID:
Department: Manager: [42] Fuel / Mileage
Date
Description
Hotel
Transport
Meals
Phone
Entertainment
Misc
TOTAL -
0.00
0.00
0.00
0.00
0.00
0.00 0.00 SUBTOTAL $ ADVANCES TOTAL REIMBURSEMENT $
-
APPROVED BY: DATE:
NOTES: Mileage reinbursement = $0.XX/mile