Department of MathematicsReceipted Expense Reimbursements

Department of Mathematics

Receipted Expense Reimbursements

Reimburse: Last Name*

Enter last name of person seeking reimbursement.

Reimburse: First Name*

Enter first name of person seeking reimbursement.

Date of Reciept*

Please enter date shown on receipt or invoice.

Description of Reimbursement*

Use drop-down to select the description of reimbursement expense requested.

Select

Comment

Reimbursement Amount*

Please enter the total amount requested for reimbursement.

Cost Center/Speed Type*

Please enter the cost center information- 5 digit speed type for expense to be reimbursed.

Split Funded*

For split funded requests, please select 'yes' from drop-down list.

Select or enter value

Cost Center Comment

Please add the percentage or exact amount and additional cost center information.

** For example comment can read - "50% to be charged to ST 12345"

File Upload*

Please upload reimbursement form, supporting documents,and receipts.

Drag and drop files here or

Send me a copy of my responses