Employee Reimbursement Form

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Employee Reimbursement Form

Name: __Mrs. Cherry Ngojo ____________


Title: _Projects Abroad Coordinator____________
Employer: __Mr. Kenneth Sotto___________

Dates of Payment Method Purpose of Expenditure(s): Please give


Expense(s) (Out of Pocket ) detailed reasons for all expenditures.
#1
#2
#3
#4

Summary of Expenses
Description Air/Rail Groun Lodging Meals Other Total
(Date, Details, Travel d
Etc) Trans
#1
#2
#3
#4

Expense Total:

I certify these are valid business expenses.

Reimburse/Cardholder Signature: ______________________


Reimburse/Cardholder Name: _________________________

Prepared by (Print): __________________ Date: ________________

I have reviewed these expenses and I believe they are true and
accurate.

Approved by (Print): __________________ Date: ________________

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