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RER Form and Receipt Template

This document is a reimbursement expense receipt form. It collects information about the entity receiving reimbursement such as the name, fund cluster, date, and receipt number. It also collects information about the payee such as their name, official designation, and the amount being reimbursed. Finally, it documents the purpose of the reimbursement and gets signatures from both the payee and a witness.

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Dee Hei
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112 views1 page

RER Form and Receipt Template

This document is a reimbursement expense receipt form. It collects information about the entity receiving reimbursement such as the name, fund cluster, date, and receipt number. It also collects information about the payee such as their name, official designation, and the amount being reimbursed. Finally, it documents the purpose of the reimbursement and gets signatures from both the payee and a witness.

Uploaded by

Dee Hei
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd

Appendix 46

Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________

Fund Cluster : ________________

Entity Name: _________________

Fund Cluster : ________________

Date : _______________________

RER No. : ___________________

Date : _______________________

RER No. : ___________________

RECEIVED from ______________________________________

RECEIVED from ______________________________________

(Name)

(Name)

_________________________________________________ the amount

_________________________________________________ the amount

(Official Designation)

(Official Designation)

of __________________________________________ (P__________)
(In Words)

of __________________________________________ (P__________)

(in Figures)

(In Words)

in payment for _______________________________________________

(in Figures)

in payment for _______________________________________________

(Payments for subsistence, services,

(Payments for subsistence, services,

_________________________________________________________

_________________________________________________________

rental or transportation should show inclusive dates,

rental or transportation should show inclusive dates,

_________________________________________________________

_________________________________________________________

purpose, distance, inclusive points of travel, etc.)

purpose, distance, inclusive points of travel, etc.)

PAYEE

PAYEE

Name/Signature __________________________________________

Name/Signature __________________________________________

Address ________________________________________________

Address ________________________________________________

WITNESS

WITNESS

Name/Signature __________________________________________

Name/Signature __________________________________________

Address ________________________________________________

Address ________________________________________________

123

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