Expense Report

Report Number ExpenseReportNum

if
Confirmation
Expense report number ExpenseReportNum for FormattedTotal ReimbursementCurrencyCode was submitted for approval.

Barcode ExpenseReportId
AuditCode

Submission Instructions
1. To send required receipts to Accounts Payable, print this page and attach all required receipts.
2. Make a photocopy of this page and the receipts for your records.
3. Place this page and the receipts in an interoffice envelope, and send to Accounts Payable.

 The expense report approver will be notified and requested to approve this expense report. Upon approval, a notification will be sent to you and
Accounts Payable.
 This expense report will be paid after it has been approved, and Accounts Payable has verified the receipts.
 A warning ( ) for an expense item indicates that it contains a policy violation. end
I
F

end

Person ListName (EmployeeNumber) Submission Date ReportSubmitDate

Expense Dates ExpenseReportDate Report Status ExpenseStatusCode
Reimbursable Total FormattedTotal Currency Purpose Purpose

DisplayViolationFlag IF
Expense Items
Expense Type Expense Date Expense Source Description Receipt Receipt Required Reimbursable
Template Class Missing Amount if (     )end
For
sort IFIF
ExpenseTypeName End ExmExpe IF End FormattedAmount if
ExpenseTemp IF End IfIF
IfIF StartDate nseCateg Source Description IfIF End ReimbCurrencyCodee
lateName End If
ExpenseTypeName End ory If nd End If End For
IfIFExpenseTypeName
End If
End If IF
Mileage Expense Items

Page 1 of 4
Expense Type Expense Date Expense Distance Description Receipt Receipt Required Reimbursable
Template Class Missing Amount if (     )end
For sort IFIF
ExpenseTypeName End
ExmExpe IF End FormattedAmount if
IfIF ExpenseTemp Trip IF End IfIF
StartDate nseCateg Description IfIF End ReimbCurrencyCodee
ExpenseTypeName End lateName Distance End If
ory If nd End If End For
IfIFExpenseTypeName
End If
End If IF
Entertainment Expense Items
Expense Type Expense Date Expense Source Description Receipt Receipt Required Reimbursable
Template Class Missing Amount if (     )end
For sort IFIF
ExpenseTypeName End
ExmExpe IF End FormattedAmount if
IfIF ExpenseTemp IF End IfIF
StartDate nseCateg Source Description IfIF End ReimbCurrencyCodee
ExpenseTypeName End lateName End If
ory If nd
IfIFExpenseTypeName
End If

IF
Employees
Name Amount
For IF AttendeeName FormattedAmount
End If End For
End If IF
Non-Employees
Name Employer Amount
For If AttendeeName EmployerName FormattedAmount
EndIf End For
EndIf End If End For

End If
end

DisplayViolationFlag IF
Expense Items
Warning Expense Type Expense Date Expense Source Description Receipt Receipt Reimbursable
Template Class Missing Required Amount if
(     )end
For sort IF ExpenseTypeName End
ExmExpe IF End IF End FormattedAmount if
IfIF ExpenseTypeName ExpenseTemp
IFIF StartDate nseCateg Source Description IfIF End IfIF End ReimbCurrencyCode
End IfIFExpenseTypeName lateName
End If ory If If end End If End For
End If
End If IF
Mileage Expense Items
Warning Expense Type Expense Date Expense Distance Description Receipt Receipt Reimbursable
Template Class Missing Required Amount if
(     )end

Page 2 of 4
For sort IF ExpenseTypeName End
ExmExpe IF End IF End FormattedAmount if
IfIF ExpenseTypeName ExpenseTemp Trip
IFIF StartDate nseCateg Description IfIF End IfIF End ReimbCurrencyCode
End IfIFExpenseTypeName lateName Distance
End If ory If If end End If End For
End If
End If IF

Entertainment Expense Items

Warning Expense Type Expense Date Expense Source Description Receipt Receipt Reimbursable
Template Class Missing Required Amount if
(     )end
For sort IF ExpenseTypeName End
ExmExpe IF End IF End FormattedAmount if
IfIF ExpenseTypeName ExpenseTemp
IFIF StartDate nseCateg Source Description IfIF End IfIF End ReimbCurrencyCode
End IfIFExpenseTypeName lateName
End If ory If If end
End If

IF
Employees
Name Amount
For IF AttendeeName FormattedAmount
End If End For
End If IF
Non-Employees
Name Employer Amount
For If AttendeeName EmployerName FormattedAmount
End If End For
EndIf End If End For

End If end
Amount CurrendEnd
For sort IFAmount Due to Card Issuer (Card-Num) End IfIFAmount Due to You End IfIFAmount You Owe to Card Issuer (Card-Num) End If
For

Page 3 of 4
 For-Attach

TITLE End For

Page 4 of 4