EXPENSE ACCOUNT STATEMENT
Employee: _____________________________ For period ending: ______________________
Reimbursement Expense Incurred
Hotels/Lodging $_______________ Meals $_______________ Tax $_______________ Travel (air, train, bus) $_______________ Personal auto (y/n)_____miles x_____ $_______________ Parking $_______________ Phone $_______________ Other (itemize): __________ $__________ __________ $__________ __________ $__________ __________ $__________ $_______________
Total $_______________
I certify the above is a true statement of incurred expenses in accordance with company policy. Receipts are attached to this statement.
Employee______________________
Approved for payment: By:___________________________
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