Name:

Itemize all Reimbursable Expenses in Appropriate Blanks

Day & Date City and State Lodging Air, Rail, Etc. Rental Car, Limo, Etc. Taxi, Tolls Public Transit

Customer: Acclaim Systems

Auto Expenses Itemize Below Business Meals Itemize Below Breakfast Lunch Dinner

Period Ending:
Entertainment Itemize Below Misc. Expenses Itemize Below

Daily Total

Weekly Category Totals

0.00

0.00

Itemized Entertainment and Business Meals

Date Name of Person(s) Entertained Time & Place Nature & Purpose Amount

Project Information
Customer/Dept. Project # Amount

0.00

Itemized Miscellaneous Expenses

Date Item Description Store where Purchased Reason for Purchase Amount

Weekly Category Totals Total 0.00 Total Miles Daily Normal Reimbursable Total $ Amount Traveled Mileage Mileage Reimbursable Itemized Ent. and Business Meals Itemized Miscellaneous Expenses Itemized Automobile Expenses Other:

0.00 0.00 0.00 0.00 0.00

Itemized Automobile Expenses

Date Mileage - Location

Total on this expense report

$0.00

Completed By:______________________________________

Total

0.00 32 cents/mile

Approved By:_______________________________________