Reimbursement Expense Receipt Reimbursement Expense Receipt

This document is a reimbursement expense receipt form. It contains fields for the date, names and designations of the payee and witness, the amount received in words and figures, and details of what the payment was for such as inclusive dates and purpose of travel. Spaces are also included for signatures, addresses, and tax identification information of the payee and witness.

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Reimbursement Expense Receipt Reimbursement Expense Receipt

Uploaded by

Mark San Andres

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Download as DOC, PDF, TXT or read online on Scribd

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GENERAL FORM NO.

02
REVISED JANUARY 1998

GENERAL FORM NO. 02

REVISED JANUARY 1998

REIMBURSEMENT EXPENSE RECEIPT

_________________________________________________________

REIMBURSEMENT EXPENSE RECEIPT

_____________________________________________________________

Date
No.
___________________________________________________________________

Date
No.
________________________________________________________________________

RECEIVED from__________________________________
(Name)
_______________________________________________________ in the amount
(Official Designation)
_________________________________________________(P ________________)
(In words)
in payment for ______________________________________________________
(Payments for subsistence, services, rental,
___________________________________________________________________
or transportation should show inclusive dates, purpose, distance,
___________________________________________________________________
inclusive
points
of
travel
etc.)

RECEIVED from ______________________________________

(Name)
___________________________________________________________ in the amount
(Official Designation)
___________________________________________________ (P _________________)
(In words)
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 ____________________________________________________________
Comm. Tax Cert. No. _________________________________________________
Date of Issue ________________________________________________________
Place of Issue ________________________________________________________
WITNESS
Name/Signature _____________________________________________________
Address ____________________________________________________________
Comm. Tax Cert. No. _________________________________________________
Date of Issue ________________________________________________________
Place of Issue ________________________________________________________

PAYEE
Name/Signature __________________________________________________________
Address ________________________________________________________________
Comm. Tax Cert. No. _____________________________________________________
Date of Issue ____________________________________________________________
Place of Issue ____________________________________________________________
WITNESS
Name/Signature __________________________________________________________
Address ________________________________________________________________
Comm. Tax Cert. No. ______________________________________________________
Date of Issue ____________________________________________________________
Place of Issue ____________________________________________________________

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Reimbursement Expense Receipt Reimbursement Expense Receipt

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Reimbursement Expense Receipt Reimbursement Expense Receipt

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GENERAL FORM NO.

GENERAL FORM NO. 02

REIMBURSEMENT EXPENSE RECEIPT

REIMBURSEMENT EXPENSE RECEIPT

RECEIVED from ______________________________________

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