Instructions for Employee Reimbursement Request Forms
Mileage & Auto Reimbursement Request Form (SHS-P004)
Using This Form
1. Use this form to request reimbursement for mileage and related automobile expenses, such as bridge tolls
and parking.
2. Submit the approved form with receipts to Accounts Payable by the 5th of each month for expenses
incurred the previous month (e.g. for July expenses, submit this form by Aug 5).
3. The approved amount will be reimbursed to you on the second paycheck of the month as a non-taxable
reimbursement.
4. DO NOT combine expenses for different months on one submission form. ONE MONTH per form.
Steps
1. Fill out all of the required information in the YELLOW fields. Please do this on your computer, as there are
formulas in place to calculate the totals. You do not need to do the math yourself. If you have questions
about using Excel, please let Accounting know.
2. Please use one sheet per Department Code. If you have expenses for more than one Department (i.e. ACT
MH and ACT General), please complete a form for each code.
3. Print the sheet – Black & White printing is fine.
4. Ask your Direct Supervisor to approve the expenses and sign the request form.
5. Submit the approved form to the Accounts Payable with receipts attached.
Employee Expense Reimbursement Form (SHS-A005)
Using This Form
1. Use this form to request reimbursement for work-related expenses other than mileage reimbursement and
related auto expenses.
2. Submit the approved form with receipts to Accounts Payable by the 5th of each month for expenses
incurred the previous month (e.g. for July expenses, submit this form by Aug 5).
3. The approved amount will be reimbursed to you on the second paycheck of the month as a non-taxable
reimbursement.
4. DO NOT combine expenses for different months on one submission form. ONE MONTH per form.
Steps
1. Fill out all of the required information in the YELLOW fields. Please do this on your computer, as there are
formulas in place to calculate the totals. You do not need to do the math yourself. If you have questions
about using Excel, please let Accounting know.
2. Please use one sheet per Department Code. If you have expenses for more than one Department (i.e. ACT
MH and ACT General), please complete a form for each code.
3. Print the sheet – Black & White printing is fine.
4. Ask your Direct Supervisor to approve the expenses and sign the request form.
5. Submit the approved form to the Accounting office with receipts attached.
SHS-M002 (Instructions for Employee Expense Reimbursements)
Rev 09-0326
1