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TOWN OF HARVARD
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Expense Reimbursement Request
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NameDepartmentDate
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EXPENSE REIMBURSEMENT
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Attach proof of payment (Credit Card receipt, store receipt, cancelled check etc...)
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and the cooresponding invoice (if applicable). List each receipt separately an enter the
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purpose of the purchase. Please remember that the town is tax exempt so sales tax will
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not be reimbursed.
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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Vendor:
Purpose:
 $ -
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TOTAL REIMBURSEMENT:
 $ -
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Signature:
Approved:
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Supervisor
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