Employee Reimbursement/Corporate Card Payment Form
Harvard University
University Financial Services
1033 Massachusetts Ave., 2nd Floor
Cambridge, MA 02138
Employee Reimbursement/
Corporate Card Payment Form
Name:*
Approved By (Print):*
Harvard ID#:*
I certify these are valid University business expenses
Phone #
Prepared by (Print):*
Phone #
Reimbursee/Card Holder Signature:*
WR #:*
Dates of
Expense(s)
Business Purpose:
Provide detailed reasons and date ranges for expenditure(s). Travel and entertainment expenses
require the person(s) and/or organization and location. ALL expenses must be itemized.
#1
#2
#3
#4
Description (date, details, etc)
Air/Rail
Travel
Ground
Trans
Lodging
Business
Meals
Other Total
#1
#2
#3
#4
Sub Total Expense from Page 2
Expense Report Total
Summary of Expenses - You may attach a Corporate Card statement in lieu of completing the description section. Cross-reference
the business purpose to each item on the statement by writing the business purpose # next to the itemized lines.
I have reviewed these expenses and they are in accordance with University and TUB policy
Total amount under $75 itemized in Expense Report Total
Out of Pocket Corporate Card
Payment Type (Check all that apply)
* Required Field
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Employee Reimbursement/Corporate Card Payment Form PDF
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