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REIMBURSEMENT FORM
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EXPENSE FORM
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XYZ COMPANY
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EXPENSE FORM
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Employee Information
Expense Form #
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NameNick ButterflyNo:A0012
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Employee ID12345678Date:4/22/2022
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DepartmentMarketing
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PositionSales Person
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DateExpense TypeLocationNotesAmountCurrency
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4/1/2022HotelNew York, NY120.00USD

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4/2/2022FuelNew York, NY50.00USD
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4/2/2022MealsLos Angeles, CA500.00USD
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4/3/2022HotelLos Angeles, CAMini bar is excluded250.00USD
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4/4/2022StationeryChicago, IL50.00USD
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4/5/2022TransportationChicago, ILAdditional flight ticket (Berlin to Oslo)150.00USD
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4/6/2022HotelChicago, IL450.00USD
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4/7/2022MealsSan Diego, CA20.00USD
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Amount Total:1,590.00USD
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Approved ByNotes
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Very important notes, do not forget to do
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Give my money
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ABD Park Industrial Systems
Tel: 1-216-1234567
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The Maieston No: 5, Ballymun Road, Liverpool / UK
www.my-company-website.com
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* Expense payments will be made in the upcoming month, after the form is declared
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Terms of Usecontact@someka.net
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