05.60 E1 Employee Expense Reimbursement Form

Submit to the Superintendent. Use of this form is required by 2:125-E3, Resolution to Regulate Expense Reimbursements. Please print and attach receipts for all expenditures.

Name: Title/Office:

Destination: Purpose:

Departure Date: Return Date:

☐ Receipts attached Request Date:

☐ Estimated expenses attached (Completed 5:60-E2, Employee Estimated Expense Approval Form)(pre-approval is required for federal and state grants).

☐ Approved expense advancement (voucher) attached, if applicable* (Completed 5:60-E2, Employee Estimated Expense Approval Form.)

Actual Expense Report *Employees will be reimbursed for actual and necessary expenses that exceed the amount advanced, but must refund any expense advancement that exceeds the actual and necessary expenses incurred. (105 ILCS 5/10-22.32) For federal and State grants, employees will be reimbursed for actual and necessary expenses that exceed estimated expenses as permitted by Board policy 5:60, Expenses.
Auto Travel Allowance: per mile
Date	Auto Mileage Miles Cost	Travel Expenses	Lodging	Meals or Per Diem Bkfst \| Lunch \| Dinner	Other Item Cost	Daily Total





Subtotal
Advances	–
TOTAL (A negative amount indicates refund due from employee.)	$

Superintendent ☐ Approved ☐ Denied

(below maximum allowable amount): ☐ Approved in Part

☐ Grant Funding Source (if applicable): ____________________

Superintendent Signature Date

Comments: ______________________________________________________________

________________________________________________________________________

School Board Action ☐ Approved ☐ Denied

(exceeds maximum allowable amount): ☐ Approved in Part

☐ Grant Funding Source (if applicable): ____________________

Employee Signature Date

UPDATED: May 20, 2020