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Missing Expense Receipt Voucher
Date of Expense:
Paid to:
Amount of Expense:
Check Number:
Reason for expense, such as a meal (names of individuals attending and
purpose of meal), Equipment (list items purchased), etc.:
Account(s) to be charged:
Fund Cost Center Internal Order G/L Account $ Amount
Reason for not submitting original receipt: Lost Rec
Signature of person responsible Date
for missing receipt
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