Instructions for the Declaration of Missing Receipt Form
Complete and attach the Declaration of Missing Receipt Form to any
reimbursement missing a required original or itemized original receipt
as required per University of California policies BFB-G-28 (Travel
Regulations) and BUS-79 (Expenditures for Business Meetings,
Entertainment, and Other Occasions)
1. Enter the name of the payee. (The entered name is automatically
populated in the “Name of Payee” field below the signature line.)
2. Select the appropriate section(s):
• Complete section A for missing original receipts
• Complete section B for missing itemized original receipts
• Complete sections A and B if missing multiple receipts –
both original and itemized original
*See reverse for more information on filling out this section
3. Enter payee’s title
4. Enter the date signed in MM/DD/YY format
If you do not know when the payee will sign, leave this
field blank and have the payee enter the date.
5. This form must be physically signed or approved via DocuSign
For manual signatures:
• Click the print icon in the lower left corner of the form to print the
completed document
• Obtain payee’s signature
• Attach scanned form to the MyExpense Expense Report, BearBuy
Payment Request Form, or Travel Expense Voucher
For DocuSign:
• See UCSF IT’s Electronic Signature page for more information
• Print the digitally signed copy then attach to the MyExpense
Expense Report, BearBuy Meeting & Entertainment Payment
Request Form, or Travel Expense Voucher
For attachment help, see:
• Attaching or Faxing Receipts MyExpense Job Aid
(controller.ucsf.edu/travel/myexpense/ )
• BearBuy Meeting & Entertainment Payment Request
(controller.ucsf.edu/travel/files/BBM&EAttach.pdf)
• Travel Expense Voucher (TEV form)
(controller.ucsf.edu/travel/forms.asp)
Choose from Foreign or Domestic as required
Rev. 5/1/2015
Travel & Entertainment
Page 1 of 1
Instructions for the Declaration of Missing Receipt Form
Complete Section A for missing original receipts.
Original receipts are required for:
• Extraordinary items such as repair of accidental car damage,
supported by justification
• Gifts provided to a host costing $25 or more
• Local transportation costing $75 or more
• Miscellaneous expenses or any other reimbursable items not
specified above costing $75 or more
1. Select the large radio button. Additional check boxes will display.
2. Select one option from the first group
3. Select one option from the second group
a. If alcohol was purchased and is being deducted, enter the
total of all alcohol from all missing original receipts in this
field
Complete Section B for missing itemized original receipts.
Itemized original receipts are required for:
• Airline expenses
• Car rental expenses
• Lodging Expenses
• Registration fees (confirmation of registration showing dollar
amount also accepted)
• Meal expenses for meetings and entertainment of $75 or more
1. Select the large radio button. Additional checkboxes will display.
2. Select one option
a. If alcohol was purchased and is being deducted, enter the
total of all alcohol from all missing itemized original
receipts in this field
Complete both Sections A and B if missing multiple
receipts – both original and itemized original
Rev. 5/1/2015
Travel & Entertainment
Page 2 of 2