Expense Reimbursement Form
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1JOHNS HOPKINS UNIVERSITY
DEPARTMENT OF ECONOMICS
NON-TRAVEL & TRAVEL EXPENSE REIMBURSEMENT FORM
Please use this form to list your expenses for reimbursement. We need the following information:
Today’s Date: ________________
Receipts for the month of: ______________
Name: ____________________________________________________
Account to Charge (check one):
Research
Department
Grant
Meal Expenses: Reason______________________________________
Name of Attendees: ___________________________________
____________________________________________________
____________________________________________________
Travel Expenses: Purpose: ____________________________________________
Date of Trip: _________________________________________
Place: ______________________________________________
Reimbursements for supplies, etc. please attach receipts and add total.
Total Amount of Reimbursement: _______________________________
Regarding my trip to __________________________________________
from ___________________ to _________________, I attest that the trip is being/was taken for
business purposes and that vacation is not a major consideration for the travel.
Traveler’s signature ______________________________ Date ____________________
Traveler’s name (printed) _____________________________________
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Parent category: Business