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Reimbursement Expense Receipt Reimbursement Expense Receipt

This document is a reimbursement expense receipt form. It collects information for reimbursing expenses, including the date, receipt number, name and designation of the person being reimbursed, the amount in words and figures, and details of what the payment is for. It requires signatures from the payee and a witness, along with their addresses, residence certificate numbers, dates and places of issue.

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Van Caz
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110 views1 page

Reimbursement Expense Receipt Reimbursement Expense Receipt

This document is a reimbursement expense receipt form. It collects information for reimbursing expenses, including the date, receipt number, name and designation of the person being reimbursed, the amount in words and figures, and details of what the payment is for. It requires signatures from the payee and a witness, along with their addresses, residence certificate numbers, dates and places of issue.

Uploaded by

Van Caz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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General Form No.

2
Revised January 1992

General Form No. 2


Revised January 1992

REIMBURSEMENT EXPENSE RECEIPT


Date

No.

REIMBURSEMENT EXPENSE RECEIPT


Date

RECEIVED from _______________________________

No.
RECEIVED from _______________________________

(Name)

(Name)

______________________________________ the amount


(Official Designation)

(Official Designation)

of _________________________________ (=P=________)
(In Word s)

______________________________________ the amount

(In Figure)

in payment for ____________________________________


(Payments for subsiste nce, services,

of _________________________________ (=P=________)
(In Word s)

(In Figure)

in payment for ____________________________________


(Payments for subsiste nce, services,

rental or transportation should show inclusive date s,

rental or transportation should show inclusive date s,

purpose, distance, inclusive points of t ravel, etc.)

purpose, distance, inclusive points of t ravel, etc.)

PAYEE

PAYEE

Name/Signature __________________________________

Name/Signature __________________________________

Address _________________________________________

Address _________________________________________

Residence Cert. No. ________________________________

Residence Cert. No. ________________________________

Date of Issue _____________________________________

Date of Issue _____________________________________

Place of Issue ____________________________________

Place of Issue ____________________________________

WITNESS

WITNESS

Name/Signature __________________________________

Name/Signature __________________________________

Address _________________________________________

Address _________________________________________

Residence Cert. No. ________________________________

Residence Cert. No. ________________________________

Date of Issue _____________________________________

Date of Issue _____________________________________

Place of Issue ____________________________________

Place of Issue ____________________________________

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