Travel/Business Expense Related
Missing Receipt Affidavit Form
Complete and submit this in lieu of missing receipt for a value greater than $25.
Guest/Employee Name:
Vendor
Description of Goods/Services
Amount
Employee's Signature: ____________________________ Date: ____/____/____
I acknowledge the above transaction(s) are valid although receipt(s) were lost or not obtained.
Please attached this form to your travel expense report in Concur if you are missing
a receipt.