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General Form No

This reimbursement expense receipt document records the receipt of funds from an individual for expenses. It notes the date, name and designation of the payer, and the amount received in words and figures. The purposes, dates, and details of the expenses are to be included. The payee and a witness must provide their names, signatures, addresses, residence certificates, dates and places of issue.

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0% found this document useful (0 votes)

28 views

General Form No

Uploaded by

joseph dante

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Available Formats

Download as DOCX, PDF, TXT or read online on Scribd

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General Form No.

2
Revised January 1992

REIMBURSEMENT EXPENSE RECEIPT

DATE: No.

RECEIVED from
(Name)
(Official Designation) the amount of

(In Words) (In Figure)

(Payment for substance,sevices,rental or transportation should show

inclusive dates.

Purposes, distance, inclusive points of travel, etc.

___________________________________________________________________________
PAYEE

Name/Signature_____________________________________________________________
Address _____________________________________________________________
Residence Cert.______________________________________________________________
Date of Issue _____________________________________________________________
Place of Issue _____________________________________________________________
__________________________________________________________________________
WITNESS

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General Form No.

REIMBURSEMENT EXPENSE RECEIPT

(In Words) (In Figure)

(Payment for substance,sevices,rental or transportation should show

Purposes, distance, inclusive points of travel, etc.

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