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Expense Report Missing Receipt Form
This form may be used only when a receipt is unavailable. Whenever possible receive and submit actual receipts from the vendor or merchant processing the charge to you.
Using this Form:
Save a copy of the form to your computer or device. Then you will need to fill one out for each Expense Item (not for the whole report) that you are missing a receipt for. You can then Save it and attach it to that item on your Expense Report.
1) Missing Receipt Reason
Select one from the list below:
Receipt was received but lost
2) Missing Receipt Details
Fill in the information below:
Merchant Name Firehouse Subs #11
Date of Transaction 9/23/2016
Total Amount of Transaction 223.92
3) Sign and Date
Type your first and last name below to sign:
By signing this you are stating that you did in fact incur the transaction above on behalf of The Navigators and according to Navigator Policy. You further state that this is the only time you are submitting this expense transaction, and have not nor will not submit it for other reimbursement.