HTML Preview Staff Reimbursement Form page number 1.
PAYABLE TO (FULL NAME):
EMPLOYEE #:
SCHOOL :
DEPT./ PURPOSE:
DATE:
SUPPLIER
RECEIPT
DATE
ACCOUNT NO. GST PST
RECEIPT
AMOUNT
TOTALS:
NOTES:
STAFF SIGNATURE:
AUTHORIZATION SIGNATURE:
Revised 01/17/14
STAFF REIMBURSEMENT FORM
I certify that the above expenses were paid by me in the course of my work for the Chilliwack School District during the
indicated period.