Exempt Staff Expense Account Voucher
Date of Charge:
Amount charged
Charge Card Used:
Mastercard
AmEx
Staples
Vendor Purchased/Ordered from:
Purpose of Expense:
Name on Card:
Select Name
Wayne Yost
Erin Cox-Holmes
Charged by:
Select Name
Wayne Yost
Erin Cox-Holmes
Method of Item Purchase:
Select method
Physical Location
Over the Phone
Ordered Online
Staff Expense Accounts
Select Account name and number
81104 Exec Pres Medical Self Ins
81106 Exec Pres Conntinuing Ed
81107 Exec Pres Prof Exp Reimbursement
81108 Exec Pres Travel
81109 Exec Pres GA Attendance
84204 Assoc Med Self Insurance
84206 Assoc Continuing Ed
84207 Assoc Prof exp Reimbursement
84208 Assoc Travel
84209 Assoc GA Expense
84210 Assoc Administrative Expense
Receipt:
Receipt Information
Print Receipt
Electronic Receipt
See Explanation below
Signature of Person Submitting Expense:
Date
Verifying Signature
Date
Other Information Related to Charge