LREDA Expense Reimbursement Form

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1	Please download this form (by clicking File, Download, Excel) and email it to finance@lreda.org.
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3	Name:
4	Position within LREDA:
5	Email:
6	Phone:
7	Make check payable to:
8	Street:
9	City:
10	State/Province:
11	ZIP/Postal Code:
12	Purpose of Expense:
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14	Itemized Expenses (please complete a new line for each receipt)				[42]
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16	DATE	VENDOR	DESCRIPTION	CATEGORY (travels, meals, etc.)	COST	ACCOUNT CODE (treasurer's use only)
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30				TOTAL	$0.00
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32	Note: Mileage reimbursement for personal car is $0.14/mile. The 14 cents a mile rate was set by Congress.
33	Neither LREDA nor the IRS has any control of this. Don't forget to attach receipts! You may
34	alternatively list the amount that you actually spent on gas to drive the miles you list.
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38	Signature			Date
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44	Approval Signature			Date
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