![]() ![]() This form is also available for the years listed below: Accessible Fillable PDF (t777-fill-23e.pdf).You must download and open fillable PDFs in Acrobat Reader 10 or higher. Download and fill out with Acrobat Reader. ![]() Use this form if you are an employee and your employer requires you to pay expenses to earn your employment income. Open the downloaded PDF in Acrobat Reader 10 or later.Download and save the PDF to your computer.Do not click the link to open it in your web browser. Use Acrobat Reader 10 or later to open the file. Submit Your Expense Report: Submit your completed report, including all receipts, to your manager or other authorizer so they can complete the authorization section and quickly issue reimbursement.You must download the accessible fillable PDF to your computer.Most templates will calculate this amount automatically. ![]() Calculate the Total Reimbursement: Subtract any advances from your total expenses.Enter Any Advances: Include any money that was advanced to the employee requesting reimbursement.Calculate the Total Expenses: Once you’ve entered each individual expense, calculate the subtotal of all expenses paid.Entertainment: Record the cost of any reimbursable entertainment purchases.Meals: Record the cost of any business meals.Fuel and Mileage Cost: Record the amount spent on gas or the total mileage at the beginning and end of expensed car trips.Lodging Cost: List any costs related to accommodations.Air and Transportation Cost: List the amount of any travel-related expenses.Description: Briefly describe the expense.Date: List the date the expense was paid.Fill in Expenditure Information: For each reimbursable expenditure, provide relevant details for each of the following categories:.Pay Period: Select a date range for the expenses.Statement Number: Assign a statement number to the report.Purpose: Provide the purpose of the expenses.Department: Identify the department issuing the reimbursement. ![]()
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