/ Employee Reimbursement Form

This form is to be forwarded to the relevant School/Faculty/Unit for checking and coding then forwarded to Accounts Payable via ere it will be scanned into the BasWare and forwarded to your financial delegate for electronic approval.A hard copy of this form and receipts are to be kept by the faculty or division for audit purposes for a minimum of 5 years.

All information on the form, excluding signatures, should be completed electronically to assist with legibility.

Date:Invoice No (date & initial):

Employee Name:Employee Number:

Faculty/Department: Email Address:

Type of Expense: Travel (complete additional information below)or Other

Description:

(Include purpose and destination of travel, reason for other expense eg airfares to attend Finance Conference in Melbourne)

Expense Type
(please specify) / Entity / Cost Centre / Project / Natural Account / GST Code / Receipt Amount
Airfares
Meals
Taxi
Other (please specify)
Invoice Total / $0.00$ 0.00

Period of Travel: to

Number of days for: Business Purposes Private Purposes

Airfare Class (Tick): Economy Premium Economy or Business

I am entitled to Premium Economy or Business Class travel under the University Travel Policy: (Yes/No)

Name of Financial delegate who will approve in BasWare:

Travel Diary e-mailed to : Yes No

(Required for all overseas travel and domestic travel of 6 nights or more which includes a private component)

Reimbursement of any Private Travel Component Required (refer travel policy below):(Yes/No).

Applicable leave has been approved in ESS:(Yes/No).

Declaration

I certify that the above expenditure details are correct and I have checked the supporting documentation. I alsocertify that the expenditure, where applicable, complies with Grant conditions and that any travel was for official University business and complies with the Policy on Travel, Accommodation and Subsistence .

Form: ACC1Employee Reimbursement Form

Last Updated: 29/10/14 - This form is available at

Employee’s Name (Print) / Employee’s Signature and Date
Supervisor’s Name (Print) / Supervisor’s Signature and Date
Authoriser’s Name (Print) / Authoriser’s Signature and Date

Form: ACC8 Unacquitted Per Diem

Last Updated: 16/8/11

This form is available at