Reimbursement Voucher Worksheet
ADVERTISEMENT
1DePauw University Reimbursement Voucher Worksheet
For Information Purposes Only. This form is not for reimbursement purposes in Accounting
INSTRUCTIONS: Please submit ORIGINAL ITEMIZED RECEIPTS. Receipts must show that balance has
been paid in full (indicated by a credit or zero balance).
NAME:___________________________
ADDRESS: _______________________________
DEPT: __________ ACCOUNT: ____________ PURPOSE:__________________________
Code
1 Travel by Plane
7 Local (Cab, Limo, Bus)
13 Lunch-Entertainment*
19 Phone/Wires
2 Travel by Train
8 Parking/Toll
14 Dinner
20 Postage
3 Travel by Bus
9 Lodging/Hotel/Motel
15 Dinner-Entertainment*
21 Laundry/Cleaning
4 Travel by Other Way
10 Breakfast
16 Entertain-Other*
22 Other*
5 Rental Car
11 Breakfast-Entertainment*
17 Gasoline
6 Personal Auto (Mileage)*
12 Lunch
18 Tips
_______________________________________________________________________________________________________
*6 - Indicate travel starting point, destination and # of miles traveled under description (mileage from Greencastle to Indianapolis Airport is
limited to 42 miles – 84 miles roundtrip). University policy for travel expenses - $.42 cents per mile.
*11, 13, 15, 16 - Indicate who, what, where & why when entertaining.
*22 - Indicate description.
Date
Code
Description/Company
Foreign Rate
US Rate
DPU Charge
I certify this statement accurate as to actual
Total: ______________________
and necessary business expenses.
**Less Total DPU Charge: ______________________
Less Cash Advanced: ______________________
Total Due Employee: ______________________
Total Due DePauw: ______________________
Signed________________________________
Date: ______________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business