Expense Report Template

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NC BAR ASSOCIATION/FOUNDATION
EXPENSE REPORT
Expenses incurred in connection with official business at the following function -
in
on
(Event Name)
(Location)
(Date)
DAY OF WEEK
Mon
Tue
Wed
Thu
Fri
Sat
Sun
DATE
EXPENSE CATEGORY
Breakfast
Lunch
Dinner
Tips
Air Transportation
Hotel
#______Miles @ $ 0.535/mile
Postage
Taxi
Parking
Miscellaneous
1.
2.
3.
Daily Totals
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Some choose to contribute to the NC Bar Foundation all or part of their expense reimbursement. Such contributions are tax exempt
and will be acknowledged by a receipt.
0.00
Total Expenditures
$
Less: Amount I wish to contribute to the NC Bar Foundation
(Indicate specific program preference if any: Pro Bono,
Endowment, Bar Center Operations, CLE)
Less: Advance
0.00
Net Amount to be paid to me
$
Please print or type Name, Address & Telephone:
Name:
Address:
Phone Number:
Email Address:
SIGNATURE:
DATE:
{Expense Report.doc}Note: See reverse side for reimbursement policies

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