Beloit College
Late Reimbursement Request Form
Instructions: This form should be completed when an expense reimbursement request is submitted more than 60
days after the cost was incurred or the conclusion of the business trip. It should be attached to the Employee
Expense Reimbursement Form and submitted to the employee’s supervisor and then to the Vice President for
Finance and Planning for approval.
Name:
Supervisor:
Department:
Date(s) of travel/expense:
Business purpose for travel/expense:
Please explain why your expense reimbursement request is being submitted more than 60 days after the latter
date that travel was completed or the expense was incurred.
Signatures:
Employee: Date:
Supervisor: Date:
Taxable Reimbursement Tax-Free Reimbursement No Reimbursement
Vice President for Finance & Planning: Date: