MTSU Policy No IV:04:13 Purchase of Meals and Refreshments for Both on
and Off Campus provides additional information for completing this form.
AUTHORIZATION FOR PURCHASE OF MEALS & REFRESHMENTS
For Both On and Off Campus
ORIGINAL ITEMIZED RECEIPTS OR INVOICE MUST BE SUBMITTED FOR REIMBURSEMENT
Purchases greater than $500, except made through University's food service vendor, must have a purchase order.
Vendor (W-9 attached):
Location of Meal:
Payment Amount:
Date of Meal:
Specific Purpose of Event: (Explanation below)
Guest(s):
IRS rules of substantiation of business expenses require documentation of time, date, place,
specific topic of discussion, and attendees at the meal.
Should identify all persons served; however, groups need not include specific names if a roster or registration list can be provided for audit,
including number of people served. For example, "34 registered XYZ conference participants and guests."
University Personnel in Attendance:
Make Pymt or Reimbursement To:
M#
Address:
City, State, & Zip:
The claimant certifies by signature that NO charges for alcoholic beverages are included in the requested amount.
Signature:
Date
Claimant (University official requesting reimbursement must have been present when the meal was purchased or refreshments served)
Approved by:
Approved by:
Date
Department Head/Higher Authority Approval (Required for All Requests)
President/Vice President/Provost (Required if exception to Policy No IV:04:13)
Index Number
Date
Acct. Code
A Tennessee Board of Regents University
MTSU is an equal opportunity, non-racially identifiable, educational institution that does not discriminate against individuals with disabilities.
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