Personal Reimbursement Request

Personal reimbursements are to be used a last resort for ordering items.

Date*

Requester's name*

Requester email*

Employee ID*

Requester's Complete HOME address:*

You must enter your HOME address (DO NOT use 1840 Entrepreneur Drive)

City, State and zip code: MUST COMPLETE*

Supervisor Name (if ordering as a student or postd

Supervisor email - If student / postdoc

Account number to be charged*

Assigned Fund Manager: (Please pick one)*

Select or enter value

Amount requested for reimbursement*

Business purpose justification*

Is this a food reimbursement?*

If yes, then the AP107 Non-Travel Meals Authorization Expense form must be uploaded into this request. The form can be found at the link below:

https://controller.ofa.ncsu.edu/resources/forms/

Other items that must be included for reimbursement of meals are an itemized receipt, listing all attendees and an itinerary/agenda.

Select

Is Alcohol part of the reimbursement?*

If alcohol is part of this reimbursement, please complete the following form:

https://engr.ncsu.edu/wp-content/uploads/2016/12/COE-Request-for-Deans-Signature-Form-1.pdf

Select

If this request is for an annual membership reimbursement, then please provide the benefit to the university justification for this membership.

Location for where items are housed on NCSU campus*

Justification for not using normal ordering proces*

Please upload itemized receipts and other supporting documentation*

If this is a food purchase you must upload the AP107 and the agenda or email invitation for the meal. If these are not uploaded the request will be denied.

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