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2011 Expense Report - Revised July 1

Revised for July 1 Increase in Mileage Rate


AFE/Subledger # (When Appropriate)

(Revised July 1, 2011)

Vendor Number
Name Address Period: From

Title City To

State Company Code

Zip Cost Center

Expenses must be itemized DAILY (i.e. Hotel daily rate & tax). Any receipt smaller than 1/2 sheet of standard copy paper must be securely taped to an 8 1/2" x 11" piece of white paper to allow cost effective imaging of the report. PLEASE RETAIN A COPY OF THE REPORT AND RECEIPTS UNTIL YOUR PAYMENT HAS BEEN RECEIVED.
General Ledger Account -

Date expense incurred Travel - City and Purpose


(Details must be included on page 2 and will automatically Business Meals & populate ) Entertainment

Totals

1 2

Auto Mileage Traveled

$ $

750000 750006

5 6 7 8 9 10 11 12 13 14 15

Breakfast Lunch Own Meals Dinner Refreshments/drinks Total Meals Gas Parking Auto Rental Transportation Tolls Taxi, Bus, Shuttle Total Trans. Hotel Room & Tax Only (list daily) Company Paid Airfare Associate Paid Airfare Supplies/Copies Postage Associate Gifts and Awards* Safety Shoes Subscriptions Organization/Business Dues Other Expenses

750006

Daily Totals

Monthly Telecom

Special Instructions:

Telephone/Fax Cell Phone Internet

$ $ $ $ $ $ $ $ $ $ $ $ $ $

750008 750002
n/a

750004 730050 733000 758014 758010 730004 758004

760000 768000 768002

Expense Report Subtotal


Less Company Paid Airfare Less Cash Advances Date Submitted Approver Printed Name and Title:

113002

Employee Signature:

Total Reimbursement Claimed


Date Approved: Maximum Expenses Allowable for Submitter

Approver Signature:

* Note: All Associate gifts and awards must be also reported to payroll for tax purposes.

Mileage Log

Business Meals and Entertainment Log

DATE

Business Purpose

Traveled From/To

# of Miles

Total claimed @ .555/mile Place of Meeting


0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Company Entertained or Visited

Attendees

Amount

Current Mileage Rate

0.555

Mileage Claim Total

0.00 $

Total Business Meals and Entertainment

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