Zax Expense Report: Odometer in Odometer Out Mileage

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ZAX EXPENSE REPORT

Account
Name:Bill Thomas Employee ID Charged

Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total


Date: 11/16/2009 11/17/2009 11/18/2009 11/19/2009 11/20/2009 11/21/2209 11/22/2009
Destination
Purpose
Odometer In 41023 41075 41136 41222 41255 41317 41362
Odometer Out 41075 41136 41222 41255 41317 41362 41393
Mileage 52 61 59 33 62 45 31 343
Amount (@.38/mi)* $ 19.76 $ 23.18 $ 22.42 $ 12.54 $ 23.56 $ 17.10 $ 11.78 $ 130.34
Transportation:
Airfare/Train $ -
Tolls $ -
Gas $ -
Taxi $ -
Car rental $ -
Parking $ -
Meals:
Breakfast $ -
Lunch $ -
Dinner $ -
Snack $ -
Hotel $ -
Tips $ -
Registration Fees $ -
Misc Expense (1) $ -
Misc Expense (2) $ -
Misc Expense (3) $ -

EXPLANATION OF BUSINESS MEALS AND OTHER (1) Grand Total $ 130.34

Less Cash Advance $ 130.34

Due to (from) employee $ 130.34

Approvals Reimburesement requested

Check No.
Employee signature Date
Date Issued

Account director signature Date Date Sent

Check Issuer Date

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