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Reimbursement Expense Receipt Reimbursement Expense Receipt

The document provides a template for a reimbursement expense receipt. It includes fields for the date, amount received in words and figures, payment details including purpose and inclusive dates/locations if for transportation, and spaces for signatures of the payee and witness including their address and identification details.

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Mark Calpon Lechido
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668 views1 page

Reimbursement Expense Receipt Reimbursement Expense Receipt

The document provides a template for a reimbursement expense receipt. It includes fields for the date, amount received in words and figures, payment details including purpose and inclusive dates/locations if for transportation, and spaces for signatures of the payee and witness including their address and identification details.

Uploaded by

Mark Calpon Lechido
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Appendix 18 Appendix 18

Revised January, 2002 Revised January, 2002

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT


DATE: No. DATE: No.

Received from____________________________________ Received from____________________________________


(Name) (Name)
________________________________ the amount of ________________________________ the amount of
(official Designation) (official Designation)
___________________________ Php _____________________ ___________________________ Php _____________________
(in words) (in figure) (in words) (in figure)

In payment for _______________________________________ In payment for _______________________________________


(payment for subsistence, services, rental or (payment for subsistence, services, rental or

____________________________________________________ ____________________________________________________
Transportation should show inclusive dates, purpose, distance, Transportation should show inclusive dates, purpose, distance,

_________________________________________________________________ _________________________________________________________________
Inclusive points of travel, etc. Inclusive points of travel, etc.

PAYEE PAYEE
Name/signature: Name/signature:

Address: Address:
Residence Cert. No. Residence Cert. No.
Date Issued: Date Issued:
Place Issued: Place Issued:

WITNESS WITNESS

Name/signature: Name/signature:

Address: Address:
Residence Cert. No. Residence Cert. No.
Date issued: Date issued:
Place Issued: Place Issued:

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