HomeMy WebLinkAboutEmployee Expense Reimbursement FormINSTRUCTIONS: Complete the form and then obtain your supervisor's signature. Once approved, submit a copy of the form along with supporting documentation to the Accounting Division.
The reimbursement will be paid on your next paycheck, if received by the Friday before the payday.
EMPLOYEE
DESCRIPTION
0
AMOUNT
PLEASE ANSWER THE FOLLOWING QUESTIONS:
LIST REASON FOR PURCHASE
WAS THIS PURCHASE AN EMERGENCY?
DOES THE CITY OF IOWA CITY HAVE A CHARGE ACCOUNT SET UP WITH THE VENDOR?
IF SO, WHY WAS THE PURCHASE NOT PUT ON THE VENDOR ACCOUNT?
APPROVAL
Employee Signature Date
CITY OF IOWA CITY
EMPLOYEE EXPENSE REIMBURSEMENT FORM
DEPARTMENT/DIVISION
YES
NO
Supervisor Signature Date
EMPLOYEE ID#
PROJECT # OR PROJECT STRING
YES
NO
ORG CODE
OBJECT