ACCOUNTS PAYABLE | Phone: (818) 677-3472 | Fax:
(818) 677-4581 | Mail Code: 8202
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American
Express Travel Reimbursement Form |
ACCOUNTS PAYABLE | Phone: (818) 677-3472 | Fax:
(818) 677-4581 | Mail Code: 8202
|
|
|
American
Express Travel Reimbursement Form |
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I am hereby requesting a reimbursement for Travel Expenses incurred on my American Express card.
Attached, please find my American Express 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.
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NAME:
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CSUN ID:
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DEPT:
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PHONE:
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DATE:
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DESTINATION:
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PAID TO:
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AMOUNT:
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DATE:
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DESTINATION:
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PAID TO:
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AMOUNT:
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DATE:
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DESTINATION:
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PAID TO:
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AMOUNT:
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DATE:
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DESTINATION:
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PAID TO:
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AMOUNT:
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Name:
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Phone Ext:
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