2025 Expense

	A	B	C	D	E	F	G	H
1
2	EXPENSE REIMBURSEMENT		WALLOWA COUNTY EDUCATION SERVICE DISTRICT
3	EXPENSE REIMBURSEMENT		IN DISTRICT			OUT OF DISTRICT
4	Date	Description	# of Miles	Supplies	Other	# of Miles	Meals	Other
5			0
6			0
7			0
8			0
9			0
10			0
11			0
12			0
13			0
14			0
15			0
16			0
17			0
18			0
19			0
20			0
21			0
22			0
23			0
24			0
25			0
26			0
27			0
28	IRS Rate:	Total # of Miles	0			0
29	$0.70	TOTALS	$0.00	0	0	$0.00	0	0
30		ATTACH RECEIPTS TO THE BACK OF THIS FORM
31		TOTAL EXPENSE REIMBURSEMENT CLAIMED				$0.00
32	EMPLOYEE NAME:
33	I certify that this statement, the amounts claimed and attachments are true, correct, and complete to the best of my knowledge and belief, and that payment for the amount claimed has not been received.
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37	EMPLOYEE'S SIGNATURE					DATE
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40	SUPERVISOR'S SIGNATURE					DATE
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43	SUPERINTENDENT APPROVAL
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