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AMERICAN UNIVERSI1Y
WASH
I
NGTO
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Missing Receipt Form
DC
EXPENSE INFORMATION
AU Employee Name
Date
Department
Transaction Date
Cost Center Account
#I.___________ _____.;
Vendor Name
Expense Report Date
L----------~
Amount
DESCRIPTION OF EXPENSE & REASON FOR MISSING RECEIPT
I certify that the transaction amount above was incurred on behalf of the company as a legitimate business expense.
The charges comply with AU's Policies. This form is submitted as a substitute to the original receipt.
AU Employee Signature
Printed Name
Date
Supervisors Signature
Printed Name
Date