AVI Speaker Reimbursement Form

	A	B	C	D	E
1	AVI Speaker Expense Reimbursement Form
2	Make a copy of this sheet before starting edits.
3					Expense Period
4	Member Name:			From:
5				To:
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7	Business Purpose:
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10	Reimbursement method:		--Select one--
11	Mailing address (if check)
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13	Itemized Expenses (travel, lodging, and approved office supplies only)
14	DATE	DESCRIPTION		CATEGORY	COST
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29				TOTAL REIMBURSEMENT	$0.00
30	Add receipt images to the Receipts sheet.
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32	Member Signature (e-signature ok)			Date
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34	Approval Signature			Date
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