Form Ref V4 - Employee Expense Report
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1AP
Form Ref V4 150110
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Note: Original Tax Invoice/Receipts &/or documentation MUST be attached
Employee Name:
Phone No:
PAYMENT DETAILS:
Dept No or
Employee Number:
Company No:
Budget Unit:
Does this claim relate to a previously issued advance? (please indicate
)
No
Yes - please enter amount of previous advance: $
Does this claim relate to Travel on University business? (please indicate
)
No
Yes - please enter Travel Portal Requisition No.
DETAILS OF CLAIM –
Enter all amounts in AUD
Receipt
GST Amount
Purpose of Expenditure
Amount
Section
Account
Project
Group
Activity
Location
(if applicable)
(incl GST)
Total Amount of Claim
EMPLOYEE EXPENSE PAYMENT BENEFIT DECLARATION
PAYMENT APPROVAL
The above expenses I am claiming for reimbursement were incurred by me during the
I approve the above expenditure within my delegation as an Authorised Officer.
period
to
for the purposes mentioned above, on official University
I confirm that it has been incurred in accordance with University policy and procedures, and is for
business. I also declare that the percentage of those expenses incurred in earning my
legitimate University Purposes.
assessable income was __
%. Original documentation is attached.
Employee’s Signature:
Approver’s Signature:
Date:
Name (please print):
Date:
Note:
Some expenditure approved as official University business may still be
subject to Fringe Benefits Tax (eg. HECS, telephone rental, etc.)
Voucher No:
Date Entered:
E:\Web\Forms\AP\Emp_Exp_Report.doc
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Parent category: Business