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A HAMSON INC.

Expense Claim Form


Company Name: Employee Name: Expense Period
From:
Employee ID: Department: To:

Purpose: Suggested/Permission by:

Itemized Expenses: Employee Use for Explanation


Date Description Category Amount Paid / Cost

Subtotal:

Less Advance loan:


Administration Use Only
Total Reimbursement:
Don't forget to attach receipts!

Employee Signature: Date:

Checked by F &A Department: Approval Signature: Date:

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