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Text File  |  1991-06-08  |  1021 b   |  53 lines
  1.                       EXPENSE ACCOUNT STATEMENT
  2.  
  3.  
  4.  
  5.  
  6.  
  7.  
  8. Employee: _
  9. For period ending: _
  10.  
  11.  
  12.  
  13.  
  14.                     REIMBURSABLE EXPENSES INCURRED
  15.  
  16.  
  17. Hotel/Lodging                                       $_
  18. Meals                                               $_
  19. Tax                                                 $_
  20. Travel [air, train, bus]                            $_
  21. Personal auto _ miles x _ cents                     $_
  22. Parking                                             $_
  23. Phone                                               $_
  24. Other [itemize]:
  25.                 _                                   $_
  26.  
  27.  
  28. Total:                                              $_
  29. -------------------------
  30.  
  31.  
  32.      I certify the above is a true statement of incurred
  33. expenses in accordance with company policy.  Receipts are
  34. attached.
  35.  
  36.  
  37.  
  38.  
  39. _______________________________
  40.                                                 Employee
  41.  
  42.  
  43.  
  44.  
  45. Approved for payment:
  46.  
  47.  
  48.  
  49.  
  50. By:_____________________________
  51.  
  52.  
  53.