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Request For Reimbursement Form Template

Easily Manage Expense Claims with Our Reimbursement Form

When tracking reimbursable expenses gets complicated, clear processes can save you time and stress. This template is designed for organizations and nonprofits looking to streamline the reimbursement process for their members. With our form, you can collect detailed requests, allow for easy receipt uploads, ensure every claim is properly documented, and simplify your approval workflow. Embrace a more organized approach to expense management-try the live template today.

Use this Template (FREE) Live Preview
Claimant full name
Employee ID
Department
Job title
Work email
Phone number
Mailing address
Purpose of reimbursement
Reimbursement category
Travel
Meals
Supplies
Training & education
Software & subscriptions
Office equipment
Home office stipend
Client entertainment
Other
Please Specify:
Is this related to company travel?
Yes
No
Project or client code (if applicable)
Expense start date
Expense end date
Currency
USD - US Dollar
EUR - Euro
GBP - British Pound
CAD - Canadian Dollar
AUD - Australian Dollar
Other
Please Specify:
Total amount requested (in selected currency)
If yes, enter the personal amount to deduct
Does this request include any personal/non-reimbursable expenses?
Yes
No
Item 1 date
Item 1 type
Please Specify:
Item 1 merchant or vendor
Item 1 amount
Item 1 business purpose
Do you have a receipt for item 1?
Yes
No
Receipt reference or URL for item 1 (if available)
Item 2 date
Item 2 type
Please Specify:
Item 2 merchant or vendor
Item 2 amount
Item 2 business purpose
Receipt reference or URL for item 2 (if available)
Additional itemized details (if more than 2 items, list date, type, merchant, amount, and purpose for each)
Do you have a receipt for item 2?
Yes
No
Preferred reimbursement method
Payroll add-on
Bank transfer
Check
PayPal
Other
Please Specify:
Bank name (if bank transfer)
Account holder name (if bank transfer)
Account number or IBAN (if bank transfer)
Routing number or SWIFT/BIC (if bank transfer)
Alternate mailing address for check (if different)
Use mailing address above for check delivery?
Yes
No
I confirm the information provided is accurate and the expenses comply with company policy
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I confirm these expenses have not been previously reimbursed
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Is manager approval required for this request?
Yes
No
Manager full name
Manager email
Approver notes
Manager decision
Pending
Approved
Denied
Type your full name to certify this request
Signature date
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Paper art illustration featuring a reimbursement form template with various fields and icons for an article on FormCreatorAI

When to use this form

Use this form when you or a team member paid a business cost out of pocket and need repayment. Typical cases include airfare, mileage, lodging, client meals, software, or small equipment. If the request is only for trip costs, the Travel expense reimbursement form keeps entries consistent. Have several purchases from the same period? Consolidate with an Expense report form to speed review and reduce back-and-forth. For training or degree fees, route education costs through the Tuition reimbursement form. Finance and HR get complete data for audit and budgeting; managers see who spent what and why. You get paid back faster, with a clean paper trail.

Must Ask Request For Reimbursement Questions

  1. What is the business purpose of this expense?

    This ties the spend to a goal, client, or event so approvers see the value. Clear purpose accelerates approval and reduces rework.

  2. When did you incur the expense, and where?

    Dates confirm the claim is within your policy window and the correct accounting period. Location helps apply per diem rules and local tax treatment.

  3. What total amount are you requesting, with an itemized breakdown and currency?

    Itemizing fares, taxes, tips, and fees makes review fast and catches non-reimbursable items. Including the currency avoids conversion errors and short-pays.

  4. Which cost center or project should be charged, who approved it, and does this fall under your accountable plan?

    Proper coding routes the request to the right manager and ledger. If it is under your policy, the Accountable plan reimbursement form helps you collect IRS-ready details.

  5. Do you have the original receipt(s) and any supporting files?

    Proof of purchase verifies the amount, vendor, and method of payment. If a slip is missing, submit a Lost receipt form so finance can evaluate and document the exception.

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