Template Expense form.xlsx

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1											To download a copy of this expense form, click File -> Download and select "Microsoft Excel (.xslx)" Then fill out the fields and email a copy back to your staff rep or staff@mediaworkers.org
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5	Name:
6	Address:						Unit:
7							Expense Dates:
8	Phone #:						Expense Dates:
9	SSN/EIN:
10	Expense Form
11	Date	Purpose	Airfare	Car Rental / Miles Driven	Parking / Tolls / Bart	Lodging	Meals	Lost Wages	Miscellaneous	Total
12		If for lost time ($hrly rate x hours lost)						$0.00		$0.00
13										$0.00
14										$0.00
15										$0.00
16										$0.00
17										$0.00
18										$0.00
19										$0.00
20										$0.00
21										$0.00
22										$0.00
23										$0.00
24										$0.00
25										$0.00
26										$0.00
27										$0.00
28										$0.00
29										$0.00
30	Purposes:
31	Totals
32	This certifies that the amounts shown on this Expense Form were incurred by me on behalf of PMWG.						Office use only:
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34	Signature:
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36	Date:
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38	ALL expenses must be documented by a receipt or will not be paid. Lost receipts under $20 dollars may be handwritten with explanations.
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