Fillable Cuesta Claim Form Fillable (Cuesta College)

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Cuesta Claim Form Fillable (Cuesta College)

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CLAIMANT________________________________________________________________________
ADDRESS ________________________________________________________________________
________________________________________________________________________
SSN or EMPLOYEE ID ___________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
VENDOR #____________
DATE ____________
SAN LUIS OBISPO COUNTY COMMUNITY COLLEGE DISTRICT
P.O. Box 8106
San Luis Obispo, California
93403-8106
CLAIM
MISCELLANEOUS
(DO NOT USE FOR TRAVEL, MILEAGE, OR CONFERENCE)
If this form is used in claiming reimbursement for personal expenditures made on behalf of
the district, receipted bills or sales tags verifying the expenditures must be attached.
Total $ _____________
CERTIFICATE OF CLAIMANT:
I hereby certify that the above claim and the items,
amounts and statements are true and correct; that
no part has heretofore been paid; that the expenses
were incurred by me while on ocial business for the
San Luis Obispo County Community College District.
Signature of Claimant
Account Number
Approved by Division Chair/Administrator
Budget Oce Approval
DESCRIPTION AMOUNT
0.00
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Cuesta Claim Form Fillable (Cuesta College)

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Completed 25 July 2020

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