Complete this form to document and support a transaction when the receipt is lost or unattainable. Attach to University payment documentation. This form is not required for travel reimbursements. Please refer to the Employee Expense Worksheet (UM 1612) and instructions.
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Record each transaction below with merchant name, location, date and dollar amount. Provide detailed business purpose, description of transaction(s) and reason for missing receipt.
I certify that the expenses(s) outlined above are valid and accurate; I have paid the total shown and I am entitled to reimbursement. Employee Signature:
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For Questions - Call. Record each transaction below with merchant name, location, date and dollar amount. Provide detailed business purpose, description of ...
room and board accommodations. Housing. Requests for information about or assistance in securing accommodations in the residence halls or apartment complexes at UMD should be addressed to the Housing Office, 149 Lake. Superior Hall, 2404 Oakland Aven
Complete this form to document and support a transaction when the receipt is lost or unattainable. Attach to University ... reimbursement. Employee Signature:.
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