SERTAC
EXPENSE REPORT Control
Number: 5/15/06 1:49:03 PM
Print Forms as needed-DO NOT MAKE COPIES OF BLANK FORM
Employee Name
(Print): Date
Submitted
Address (if mailed) Purpose
of Trip:
Period
Beginning/Ending:
Department Position
Date:
|
|
|
|
|
|
|
|
|
|
|
Sunday |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday
|
Saturday |
Totals
for Week |
Account
Number |
|
Lodging
|
|
|
|
|
|
|
|
|
|
Telephone
|
|
|
|
|
|
|
|
|
|
Air/Rail/Bus
etc.
|
|
|
|
|
|
|
|
|
|
Parking
|
|
|
|
|
|
|
|
|
|
Car
Rental
|
|
|
|
|
|
|
|
|
|
Taxi/Bus/Tolls
|
|
|
|
|
|
|
|
|
|
Number
of Miles
|
|
|
|
|
|
|
|
|
|
Mileage
Amount*
|
|
|
|
|
|
|
|
|
|
Breakfast
|
|
|
|
|
|
|
|
|
|
Lunch
|
|
|
|
|
|
|
|
|
|
Dinner-see below
|
|
|
|
|
|
|
|
|
|
Entertainment
|
|
|
|
|
|
|
|
|
|
Miscellaneous
**
|
|
|
|
|
|
|
|
|
|
Miscellaneous
**
|
|
|
|
|
|
|
|
|
|
Totals
|
|
|
|
|
|
|
|
|
|
*Call 777-0932 for cents/per/mile for current
year
**If applicable please use below for details to
Miscellaneous
|
Business Meals & Related Expenses: |
|
Persons
Present: |
|
Business
Reason: |
|
Place: |
|
**Explanation of Miscellaneous |
Amount |
Account Number |
Totals for the Week: |
Amount |
|
|
|
|
Total Expense |
|
|
|
|
|
Cash Advance |
|
|
|
|
|
Due Company |
|
|
|
|
|
Due Employee |
|
|
|
|
|
Accounting Unit to Charge |
|
***NOTE: RECEIPTS MUST
ACCOMPANY THIS FORM FOR REIMBURSEMENT***
Employee Signature Date:
Supervisor Approval Date: