ABCDFGHJKLMNQRSTUVWXYZ
1
 Expense Claim Form F 3-08
2
 Revised September 22, 2025
3
4
 NAME:
LOCATION:
5
6
 TRAVEL PER KM RATE MEALS SELECT MEALS MISC EXPENSES EXPENSE TOTAL
7
 DATE DD-MON-YR PLACE OF ORIGIN PLACE OF VISIT FUNCTION AUTH INITIALS DISTANCE (KM) $ 0.57 Breakfast Lunch or Supper B-15.00 L-20.00 S-30.00 DESCRIPTION (Accommodation, Taxi, Parking, etc.) AMOUNT
8
Travel
9
placeplace $ - $ - $ - $ -
10
 placeplace $ - $ - $ - $ -
11
 placeplace $ - $ - $ - $ -
12
 placeplace $ - $ - $ - $ -
13
 placeplace $ - $ - $ - $ -
14
 placeplace $ - $ - $ - $ -
15
 placeplace $ - $ - $ - $ -
16
 placeplace $ - $ - $ - $ -
17
 placeplace $ - $ - $ - $ -
18
 placeplace $ - $ - $ - $ -
19
 placeplace $ - $ - $ - $ -
20
 placeplace $ - $ - $ - $ -
21
 placeplace $ - $ - $ - $ -
22
 placeplace $ - $ - $ - $ -
23
 placeplace $ - $ - $ - $ -
24
Enter Other Travel Here (to wrap text in the large field below, enter data, hit enter, return to field, then go to menu bar above where your data shows, and hit enter at the end of your entry)Enter Other Meals, Hotels etc. here (to wrap text in the large field below, enter data, hit enter, return to field, then go to menu bar above where your data shows, and hit enter at the end of your entry)
25
 TRAVEL PER KM RATE
26
 DATE DD-MON-YR PLACE OF ORIGIN PLACE OF VISIT FUNCTION AUTH INITIALS DISTANCE (KM) 0.285Breakfast Lunch or Supper B-15.00 L-20.00 S-30.00 DESCRIPTION (Accommodation, Taxi, Parking, etc.) AMOUNT EXPENSE TOTAL
27
 $ - $ - $ - $ -
28
 - $ - $ - $ - $ -
29
 - $ - $ - $ - $ -
30
 - $ - $ - $ - $ -
31
 - $ - $ - $ - $ -
32
 - $ - $ - $ - $ -
33
 - $ - $ - $ - $ -
34
 - $ - $ - $ - $ -
35
 - $ - $ - $ - $ -
36
 - $ - $ - $ - $ -
37
 Total $ - $ - $ - $ - $ -
38
39
 DEDUCTIONS: (Please specify) Amount
40
41
 Budget Code: $ -
42
 $ -
43
Total for ACCT Pay
$ -
87
 TOTAL DEDUCTIONS: $ -
88
 TOTAL EXPENSE CLAIM: $ -
89
99
100
Employee Signature: ________________________________________
Supervisor Signature: _______________________________________
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152