Scribd
Upload

RER Reimbursement Expense Receipt Form

7K views1 page
Reimbursement Expense Receipt - typically used in government liquidation transactions for "small amounts" where no official receipt is available.

Uploaded by

Ian Felix Alquiros
  • Reimbursement Expense Receipt Template

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 of _________________________________________ the amount of


(Official Designation) (Official Designation)

_________________________________________ (P_________) _________________________________________ (P_________)


(in words) (in figures) (in words) (in figures)

in payment for _________________________________________ 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.)

Name/Signature ________________________________________ Name/Signature ________________________________________

Address_______________________________________________ Address_______________________________________________

Name/Signature ________________________________________ Name/Signature ________________________________________

Address_______________________________________________ Address_______________________________________________

Revised January 1, 2016 Revised January 1, 2016

REIMBURSEMENT EXPENSE RECEIPT Entity Name :______________ Date : ____________________ Fund Cluster : ______________ RER No. :

You might also like