Reimbursement

This document is a reimbursement expense receipt template that includes fields for entity name, fund cluster, date, and receipt number. It requires details about the payee, the amount being reimbursed, and the purpose of the payment. Additionally, it includes sections for signatures of the payee and a witness.

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Reimbursement

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ann

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Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _ Fund Cluster :

Date : _______________________ RER No. : ___________________

RECEIVED from ______________________________________

(Name)

_________________________________________________ the amount

(Official Designation)

of __________________________________________ (P__________)
(In Words) (in Figures)

in payment for _______________________________________________

(Payments for subsistence, services,

_________________________________________________________
rental or transportation should show inclusive dates,

_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________

WITNESS
Name/Signature __________________________________________
Address ________________________________________________

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Reimbursement

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Reimbursement

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Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________

RECEIVED from ______________________________________

_________________________________________________ the amount

in payment for _______________________________________________

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Entity Name: _ Fund Cluster :