Examples of Expense Report Forms

EXPENSE REIMBURSEMENT REQUEST FORM

Policy Statement: All expenses must be supported by original receipts and submitted in accordance with the corporate travel and expense policy. Reimbursement is subject to management approval.

---

I. EMPLOYEE INFORMATION

Employee Name: [___________________________]
Employee ID: [___________________________]
Department: [___________________________]
Manager Name: [___________________________]
Reporting Period: From [___________] to [___________]

---

II. EXPENSE SUMMARY

Subtotal: [__________________]
Less: Company Paid/Advanced: [__________________]
TOTAL REIMBURSEMENT DUE: [__________________]

---

III. ITEMIZED BREAKDOWN (OPTIONAL FOR AUDIT PURPOSES)

Please categorize expenses for accounting allocation:

• Travel (Air/Rail/Taxi): [__________________]
• Lodging: [__________________]
• Meals & Entertainment: [__________________]
• Supplies/Miscellaneous: [__________________]
• Mileage: [___________] miles @ [___________] per mile = [__________________]

---

IV. CERTIFICATION AND AUTHORIZATION

Employee Certification: I hereby certify that the expenses listed above were incurred for legitimate business purposes and that all supporting documentation is attached in accordance with corporate policy. I certify that I have not been, and will not be, reimbursed for these expenses from any other source.

Employee Signature: ___________________________ Date: [___________]

---

Manager Approval: I have reviewed the expenses submitted above and confirm that they are accurate, reasonable, and within the budgetary constraints of the department.

Approving Manager Name: [___________________________]
Manager Signature: ___________________________ Date: [___________]

---

V. INTERNAL OFFICE USE ONLY (ACCOUNTING DEPT)

Account Code: [___________________________]
Date Processed: [___________]
Authorized by: [___________________________]
Payment Reference Number: [___________________________]

Template Document: Examples of Expense Report Forms

• Scope: This procedure covers all corporate expense reimbursement requests submitted by employees for business travel and operational purchases.
• Document owner: [Role or team]
• Effective date: [Date]
• Version: [Version number]
• Applies to: [Team, department or process]

Roles and responsibilities

Procedure

1. Gather all original itemized receipts corresponding to the business expenses incurred during the reporting period. (Responsible: Employee)
2. Complete the employee information section by entering your [Employee Name], [Employee ID], and [Department]. (Responsible: Employee)
3. Populate the expense summary table with the transaction date, description, category, and payment method for each purchase. (Responsible: Employee)
4. Calculate the total expense amount in [Currency] and enter the final sum into the expense report form. (Responsible: Employee)
5. Sign and date the certification and authorization section to verify that all reported expenses comply with corporate policy. (Responsible: Employee)
6. Submit the completed reimbursement form and attached physical or digital receipts to your direct manager by [Date]. (Responsible: Employee)
7. Review the business justification and verify budget availability before approving the expense report. (Responsible: Manager)
8. Forward the approved expense documentation to the accounting department for final review and payment processing. (Responsible: Manager)
9. Audit the itemized breakdown against company spending limits and flag any discrepancies or missing documentation. (Responsible: Accountant)
10. Process the verified reimbursement amount for inclusion in the upcoming payroll or accounts payable disbursement cycle. (Responsible: Accountant)

Records and revision

• Prepared by: [Full name]
• Reviewed by: [Full name]
• Date completed: [Date]
• Signature: ______________________
• Date signed: [Date]