Request Reimbursement for Expense

Requestor Name

Description of Expense

Total Amount to be Reimbursed

Address to Mail Reimbursement Check

If you will pick up the check from the Columbus Office, just indicate "pick-up Columbus"

Check any that apply:

If the expenses is billable to a client, please write client name in the "Additional Notes" box below.

This expense is billiable to the client and I have created an invoice in Freshbooks for the same amount that can be sent to the client

This expenses is not billable to a client

Additional Notes: