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Scappoose School District
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BUSINESS EXPENSE REIMBURSEMENT REQUEST FORM
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Employee Name
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Building:
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Position
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Direct Supervisor:
Dates covered by Travel and Business Expense Report:
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Charge to:From:OR
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Month of:
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Please include a Google Map when submitting mileage form
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Mileage Reimbursement:
IRS Mileage Reimbursement Amount (use most recent mileage rate from:
www.irs.gov $ 0.725
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Point ofTotal
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DateDepartureArrivalPurposeAmount
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 $ -
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Total mileage reimbursement amount
 $ -
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Business Expense Reimbursement:
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 -
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Date
Purpose (include required supporting documentation)
 Amount
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 $ -
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 $ -
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 $ -
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Total other business expense reimbursement amount
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Total mileage and other business expense reimbursement request
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Employee Signature/Date
Approving Signature/Date
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* Supporting documentation includes:
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Google Map
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Parking Receipt
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Hotel Receipt
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Flight Receipt
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