Company Name

For Office Use Only

Expense Report
STATEMENT
PURPOSE: NUMBER: PAY PERIOD: From

To
EMPLOYEE INFORMATION:

Name Position SSN

Department Manager Employee ID

Date Account Description Hotel Transport Fuel Meals Phone Entertainment Misc Total
$ -
Total $ - $ - $ - $ - $ - $ - $ - $ -
Subtotal $ -
Cash Advances
APPROVED: NOTES: Total $ -

Page 1 of 1