Accounts Payable Forms	Accounts Payable Tel No (818) 677-3472 Fax No: (818) 677-4581 Mail Drop: 8202
	Credit Card Travel Reimbursement Form

I am hereby requesting a reimbursement for Travel Expenses incurred on my credit card. Attached, please find my credit card bank statement and individual item receipts. I understand that this is a reimbursement for the current month charges ONLY, and that upon return from my trip; I will properly submit a Travel Expense Claim form (STD262). The Reimbursed Expense should be included on the Travel Expense Claim Form. NOTE: IF YOU HAVE HAD MORE THAN ONE TRIP THIS MONTH, PLEASE INDICATE WHICH TRIP EACH EXPENSE IS TO BE CHARGED TO.

Name:		Department:
CSUN ID# :		Tel No:

Date of Trip:	Destination:	Paid To:	Amount:

Name:

Phone Ext: