For Office Use

Expense report

PURPOSE: STATEMENT NUMBER: PAY PERIOD: From 12/30/1899

To 12/30/1899

EMPLOYEE INFORMATION:

Name Position SSN

Department Manager Employee ID

Date Account Description Hotel Transport Fuel Meals Phone Entertainment Misc. Total

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ - $ - $ - $ - $ - $ - $ -

Subtotal $ -

APPROVED: NOTES: Advances

Total $ -